Value-based procurement has drawn cross-party support in the House of Lords, where peers argued that the NHS should look beyond the purchase price of medical products and consider whether spending more upfront could improve patient care and save money in the long run.
The calls came during a recent debate on the Health Bill, in which 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 weighs patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. It is already being introduced across the health service following the publication of national guidance in June.
Pilot results cited in the debate
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement existed to secure value for money for the health service but could do much more. He argued for moving 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, conducted with health and hygiene company Essity, in which providing patients with continence products suited to their individual needs led to a 48% reduction in leaks and an 8% fall in product use.
Baroness Finlay, a professor of palliative medicine, praised the work of the Department of Health and Social Care's Medical Technology and Innovation Directorate and called for the approach to be adopted more widely across the NHS and social care. She 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. Specialist cardiac pacemakers, she said, illustrated how more expensive devices could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care treatment.
Baroness Finlay said clinicians were the ones who knew that the cheapest option was not necessarily the best, and that their understanding of outcomes for particular devices needed to be embedded in the tendering process.
Backing and caveats from across the parties
The proposals also attracted support from a former health secretary, Conservative peer Lord Lansley, 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.
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 purchase 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 standardisation
Despite the broad support, the debate also 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, leaving 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 clear support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.