The NHS should assess medical products by patient outcomes and the wider cost of care rather than by purchase price alone, according to cross-party peers who backed value-based procurement during a House of Lords debate on the Health Bill.
Peers considered an amendment tabled by Labour peer Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. It would require ministers to report annually to Parliament on progress in adopting value-based procurement across the NHS and social care in England.
Value-based procurement takes account of clinical benefits, patient outcomes and the downstream costs of care, rather than only the initial price of a product. The approach is already being introduced across the health service after national guidance was published in June.
Pilot cited as evidence
Hunt, a former health minister and longstanding advocate of the policy, 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 towards quality that improves patient outcomes.
He pointed to a pilot at South Tyneside and Sunderland NHS Foundation Trust, run with health and hygiene company Essity. Providing continence products suited to patients’ individual needs led to a 48% reduction in leaks and an 8% fall in product use, he said.
Finlay supported the amendment 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.
She argued that 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 and potentially avoid costly intensive care.
Finlay, a professor of palliative medicine, said clinicians understood that the cheapest option was not necessarily the best and that evidence on device outcomes needed to be embedded in tendering.
Support and caveats
Former Health Secretary and Conservative peer Lord Lansley also supported the proposals, warning 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. She confirmed that NHS Supply Chain had adopted a “comply or explain” approach for future purchasing frameworks.
Merron said the intention was for value-based procurement to become routine 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.
Core List questions
The debate also exposed concerns about whether existing NHS purchasing practices were consistent with the policy. 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. 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 cross-party support for value-based procurement and a desire for it to be rolled out with momentum across the NHS in England.