Cross-party peers have backed a move to make the NHS in England look beyond the initial price of medical products and consider patient outcomes, clinical benefits and the wider costs of care when buying supplies.
The support came during a 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 toward adopting value-based procurement across the NHS and social care in England.
The approach is already being introduced across the health service following national guidance published in June. It is intended to weigh patient outcomes and the total cost of care rather than treating the lowest purchase price as the default measure of value.
Pilot evidence cited
Lord Hunt, a former health minister, said procurement should secure value for money but could achieve more. He argued that purchasing should move away from always choosing the lowest price and toward quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, run 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, a professor of palliative medicine, said 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 more expensive devices that could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
She also said clinicians know that the cheapest option is not necessarily the best and understand the outcomes associated with particular devices, adding that this knowledge needs to be embedded in the tendering process.
Political support and cautions
Conservative peer and former Health Secretary Lord Lansley 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.
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 buy 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.
Core List concerns
The debate also exposed questions about whether existing NHS purchasing practices are 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 open how the NHS would balance greater standardisation with its commitment to clinically led, patient-centred procurement.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there was now broad support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.