A cross-party group of peers has thrown its weight behind a shift in NHS procurement in England away from choosing medical products primarily on initial purchase price and toward assessing patient outcomes, clinical benefits and the wider costs of care.
The support emerged 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 backed by crossbench peer Baroness Finlay of Llandaff. The amendment 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 is already being introduced across the health service after national guidance was published in June. The model is intended to take account of the full cost of care rather than the initial purchase price alone.
Pilot cited as evidence
Lord Hunt, a former health minister, said procurement had to secure value for the health service but could achieve more. He argued for a move away from always selecting 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 were matched to patients’ individual needs. The pilot led to a 48% reduction in leaks and an 8% fall in product use.
Baroness Finlay, a professor of palliative medicine, said buying cheaper equipment could be a false economy if it led to complications or further treatment, with the resulting costs often falling on different NHS budgets. She pointed to specialist cardiac pacemakers as an example of more expensive devices that could help prevent serious infections in vulnerable patients and avoid costly intensive care.
She also argued that clinicians understand which devices produce particular outcomes and that this knowledge should be embedded in tendering.
Minister confirms ‘comply or explain’
The proposals drew support from former Health Secretary Lord Lansley, a Conservative peer, who warned that rigid price thresholds could stop more expensive products from being properly assessed for their wider benefits. Liberal Democrat health spokesperson Lord Scriven called the national guidance a genuine step forward but cautioned that financial pressure could still push NHS buyers toward immediate savings over better long-term outcomes.
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 and said the aim was for value-based procurement to become routine 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.
Core List concerns
The debate also exposed unease about whether existing NHS purchasing practice is 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 said such products were highly personal 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 will reconcile greater standardisation with its stated 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 strong cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.