Cross-party peers have backed a shift in how the NHS in England 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 members considered an amendment on value-based procurement.
The amendment, tabled by Labour's Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff, would oblige ministers to report to Parliament each year on progress in adopting value-based procurement across the NHS and social care in England. The approach takes account of patient outcomes, clinical benefits and the broader costs of treatment instead of the initial purchase price alone, and is already being rolled out after national guidance was published in June.
Pilot points to tailored products
Lord Hunt, a former health minister and long-standing supporter of the policy, said procurement existed to secure value for money but could achieve more. The aim, he argued, was to move away from always choosing the cheapest option and towards quality that improves what patients experience. He cited a pilot run by South Tyneside and Sunderland NHS Foundation Trust with health and hygiene company Essity, in which continence products matched to individual needs produced 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 spread further across the NHS and social care. She warned that buying cheaper equipment could be a false economy where it led to complications or additional treatment, with the resulting costs often landing on different NHS budgets. Specialist cardiac pacemakers, she suggested, illustrated how more expensive devices could help prevent serious infections in vulnerable patients and potentially avert costly intensive care.
She also argued that clinicians understand the cheapest option is not always the best and know how particular devices perform, and that this knowledge should be built into tendering.
Support across parties, with caution
The proposals drew backing from Conservative peer Lord Lansley, a former health secretary, who warned that rigid pricing 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 towards immediate savings over better long-term results.
Replying for the Government, health minister Baroness Merron restated its commitment to value-based procurement and confirmed that NHS Supply Chain had adopted a "comply or explain" approach for future purchasing frameworks. The intention, she said, is 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 guidance, with annual reports over the next three years to assess its impact.
Core List questions remain
Despite the broad support, the debate exposed doubts about whether current purchasing practice matches the policy. Lord Hunt questioned NHS Supply Chain's recent decision to identify 79 additional product categories for possible inclusion in its Core List of standardised supplies, including urinary catheters and colostomy bags. He described these as highly personal products rather than standard commodities and criticised the absence of prior consultation with relevant trade associations.
Baroness Merron acknowledged that products need to be 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 purchasing.
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.