Cross-party peers have backed a move to make NHS purchasing look beyond the initial price of medical products and take greater account of patient outcomes and the wider costs of care. The support emerged during a recent House of Lords debate on the Health Bill, where peers considered an amendment tabled by Labour's Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff.
The amendment would require ministers to report annually to Parliament on progress towards adopting value-based procurement across the NHS and social care in England. The approach considers patient outcomes, clinical benefits and the broader costs of care rather than simply the purchase price. It is already being introduced across the health service following the publication of national guidance in June.
What value-based procurement means
Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement should ensure value for money for the health service but could do more. He argued for moving away from always choosing the lowest price and towards quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, conducted with health and hygiene company Essity, in which continence products suited to patients' individual needs led to a 48% reduction in leaks and an 8% fall in product use.
Baroness Finlay echoed his support and praised the work of the Department of Health and Social Care's Medical Technology and Innovation Directorate. She called for the approach to be adopted more widely across the NHS and social care.
Peers warn of false economies
Baroness Finlay argued that buying cheaper equipment could prove a false economy if it led to complications or further treatment, with the resulting costs often falling on different NHS budgets. She cited specialist cardiac pacemakers as an example of how more expensive devices could help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care treatment. A professor of palliative medicine, she said clinicians knew that the lowest price was not always the best option and that device outcomes should be embedded in the tendering process.
The proposals also drew support from former Health Secretary Lord Lansley, a Conservative peer, who warned that rigid pricing thresholds could prevent more expensive products from being properly assessed for their wider benefits. Liberal Democrat health spokesperson Lord Scriven described the national guidance as a genuine step forward but cautioned that financial pressures could still encourage NHS buyers to favour immediate savings over better long-term outcomes.
Government response and monitoring
Responding to the debate, health minister Baroness Merron reaffirmed the government's commitment to value-based procurement and confirmed that NHS Supply Chain had adopted a “comply or explain” approach for future purchasing frameworks. She said the intention was for value-based procurement to become routine practice when NHS teams purchased medical devices, consumables and services. The government has also commissioned independent monitoring of the national guidance, with annual reports over the next three years to assess its impact.
Questions over the Core List
Despite the broad support, the debate exposed concerns about whether existing NHS purchasing practices were consistent with the policy. Lord Hunt questioned NHS Supply Chain's recent decision to identify 79 additional product categories for potential inclusion in its Core List of standardised supplies, including urinary catheters and colostomy bags.
He warned that these were highly personal products rather than standard commodities and criticised the lack of prior consultation with relevant trade associations. Baroness Merron acknowledged the importance of products being tailored to individual patients but did not directly address the proposed expansion of the Core List. That left questions over how the NHS would balance greater standardisation with its commitment to clinically led, patient-centred procurement.
Health policy lobbyist Chris Whitehouse, whose agency Whitehouse Communications worked on the amendment with Essity, said there was now great support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.