The NHS should look beyond the initial price of medical products and weigh whether paying more upfront can improve patient care and reduce long-term costs, peers argued during a House of Lords debate on the Health Bill that drew cross-party support.
The debate centred on an amendment tabled by Labour peer Lord Hunt of Kings Heath and backed 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 patient outcomes, clinical benefits and the wider costs of care rather than the purchase price alone. The approach is already being introduced across the health service following the publication of national guidance in June.
Pilot cited as evidence
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement existed to secure value for money but could achieve more. He argued the aim was to move away from always choosing the lowest price and toward 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.
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. 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. She cited specialist cardiac pacemakers as an example of more expensive devices that could help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care.
She said clinicians know that the cheapest option is not necessarily the best and understand the outcomes associated with particular devices, adding that this knowledge 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 push NHS buyers toward immediate savings over better long-term outcomes.
Government confirms monitoring
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.
Despite the broad support, the debate exposed concerns about whether current 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 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 tailoring products 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.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there was 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.