Peers from across the political spectrum have backed a change in how England's NHS buys medical products, arguing that purchasing decisions should weigh patient outcomes and the wider cost of care rather than the lowest upfront price. 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 towards adopting value-based procurement across the NHS and social care in England. The approach takes account of patient outcomes, clinical benefits and the downstream costs of care instead of the initial purchase price alone. It is already being introduced across the health service following national guidance published in June.
The case for paying more upfront
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement exists to secure value for money for the health service but can achieve considerably more. The point, he argued, is to move away from always choosing the lowest price and instead buy for 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, in which continence products matched to patients' individual needs led to a 48% reduction in leaks and an 8% fall in product use.
Clinical judgement and false economies
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 cheaper equipment can prove a false economy when it leads 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 can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
She also argued that clinicians know the cheapest option is not necessarily the best, and that their understanding of outcomes for particular devices should be embedded in the tendering process.
Conservative peer Lord Lansley, a former health secretary, 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 commitments
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.
Standardisation questions remain
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 are 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 open how the NHS will balance greater standardisation with its stated 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 is now clear cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.