Cross-party peers have backed a push for the NHS in England to weigh patient outcomes and the wider costs of care, rather than only the purchase price of medical products, during a House of Lords debate on the Health Bill.
The debate centred on an amendment tabled by Labour peer Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. It would require ministers to report annually to Parliament on progress towards adopting value-based procurement across the NHS and social care in England.
Value-based procurement considers patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. The approach is already being introduced across the health service following national guidance published in June.
Pilot evidence cited
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement existed to ensure value for money for the health service but could do much more. The aim, he said, was to move away from always choosing the lowest price and towards 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 suited to patients' individual needs led to a 48% reduction in leaks and an 8% fall in product use.
Clinicians and tendering
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. 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 that because clinicians understand the outcomes associated with particular devices, 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 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.
Government response
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.
Core List concerns
The debate also exposed concerns about whether existing 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.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there was now great support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.