Peers from across the political parties have backed a change that would require ministers to report annually to Parliament on progress towards adopting value-based procurement across the NHS and social care in England.
The proposal came as an amendment to the Health Bill tabled by Labour's Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff, and was debated in the House of Lords during consideration of the legislation.
Value-based procurement assesses patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. National guidance published in June is already being introduced across the health service.
Pilot results cited in the debate
Lord Hunt, a former health minister and a long-standing advocate of the approach, said procurement existed to secure value for money for the health service but "can do much more", arguing that the aim was to move away from always choosing the lowest price and towards quality that improves patient outcomes.
He pointed to a pilot run by South Tyneside and Sunderland NHS Foundation Trust with Essity, a global health and hygiene company, 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 the tendering process
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 where it led to complications or further treatment, with the resulting costs often falling on different NHS budgets. Specialist cardiac pacemakers, she said, illustrated how more expensive devices could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care treatment.
"It is the clinicians who know that the cheapest is not necessarily the best," she said, adding that clinicians understand the outcomes associated with particular devices and that this knowledge needed to 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
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, and that independent monitoring of the national guidance had been commissioned, with annual reports over the next three years to assess its impact.
Questions over standardisation
The debate also exposed concerns about whether existing 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 the 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 the question of how the NHS will balance greater standardisation with its commitment to clinically led, patient-centred procurement.
Health policy lobbyist Chris Whitehouse, whose agency Whitehouse Communications worked on the amendment with Essity, said it was clear there was now broad support for value-based procurement across the political parties and "a real desire to see it rolled-out with momentum across the NHS in England".