The House of Lords has given cross-party support to a proposed requirement for ministers to report annually to Parliament on progress in adopting value-based procurement across the NHS and social care in England.
The amendment, tabled by Labour peer Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff, was considered during a recent debate on the Health Bill. Value-based procurement considers patient outcomes, clinical benefits and the wider costs of care, rather than focusing only on the initial purchase price.
Guidance already in place
The approach is already being introduced across the health service after national guidance was published in June. Lord Hunt, a former health minister, said procurement should secure value for money but could do more. He argued that buying should 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 matched to patients' individual needs were followed by a 48% reduction in leaks and an 8% fall in product use, according to the figures he presented.
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 wider adoption. She argued that cheaper equipment could be a false economy if it led to complications or further treatment, with costs falling on different NHS budgets. She pointed to 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 also said clinicians understand that the cheapest option is not necessarily the best and know the outcomes associated with particular devices, adding that this knowledge should be embedded in tendering.
Political support and caution
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 to the debate, health minister Baroness Merron reaffirmed the government's commitment to value-based procurement. She said NHS Supply Chain had adopted a 'comply or explain' approach for future purchasing frameworks and that the intention was for value-based procurement to become routine when NHS teams buy medical devices, consumables and services. The government has commissioned independent monitoring of the national guidance, with annual reports over the next three years to assess its impact.
Core List questions
Despite the broad support, the debate exposed concerns about whether existing purchasing practices are 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 said 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. That left 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 strong cross-party support for value-based procurement and a desire to see it rolled out with momentum across the NHS in England.