The House of Lords has given cross-party backing to a shift in NHS purchasing away from lowest-price buying and towards value-based procurement, with peers arguing that paying more upfront for medical products can improve patient care and reduce costs over time.
The support emerged during 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 towards adopting value-based procurement across the NHS and social care in England.
What the approach changes
Value-based procurement weighs patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. According to the debate, the approach is already being introduced across the health service following national guidance published in June.
Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement exists to secure value for money for the health service but "can do much more". He framed the change as moving away from always choosing the lowest price and towards quality that improves patient outcomes.
Pilot evidence cited
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.
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 can prove a false economy where 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 may help prevent serious infections in vulnerable patients and avoid costly intensive care.
"It is the clinicians who know that the cheapest is not necessarily the best," she said, adding that clinicians' knowledge of outcomes for particular devices needs to be embedded in the tendering process.
Party figures weigh in
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 called the national guidance a "genuine step forward" but cautioned that financial pressures could still encourage NHS buyers to favour immediate savings over better long-term outcomes.
Responding for the Government, health minister Baroness Merron reaffirmed its commitment to value-based procurement and confirmed that NHS Supply Chain has adopted a "comply or explain" approach for future purchasing frameworks. She said the intention is 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 concerns
The debate also exposed questions over whether existing purchasing practice is consistent with the policy. Lord Hunt challenged 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 reconcile 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 is 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".