The NHS is being pressed to look beyond the sticker price of medical products and weigh whether higher upfront spending improves patient care and trims costs over time, after the argument won cross-party support in the House of Lords.
The case was made during debate on the Health Bill, where peers considered an amendment tabled by Labour's Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff. Under the amendment, ministers would have 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 initial purchase price alone. The approach is already being introduced across the health service following national guidance published in June.
A pilot's numbers
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement exists to secure value for money but can do more. The aim, he argued, is 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 patients received continence products matched to their individual needs. The trust recorded a 48% reduction in leaks and an 8% fall in product use.
False economies 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 wider adoption across the NHS and social care. Buying cheaper equipment can prove a false economy, she said, if it leads to complications or further treatment whose costs often land on different NHS budgets. She pointed to specialist cardiac pacemakers, where more expensive devices can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
Clinicians, she added, know that the cheapest option is not necessarily the best and understand the outcomes particular devices deliver, so that knowledge should be embedded in the tendering process.
Conservative peer Lord Lansley, a former health secretary, 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 outcomes.
Government response and a Core List dispute
Health minister Baroness Merron reaffirmed the government's commitment, confirming 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. Independent monitoring of the national guidance has been commissioned, with annual reports over the next three years to assess its impact.
The debate also exposed friction over 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. Such items, he warned, are highly personal rather than standard commodities, and he criticised the absence 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 Core List expansion, leaving open how the NHS will reconcile greater standardisation with clinically led, patient-centred procurement.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there is 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.