Peers from across the political spectrum have backed a proposed duty on ministers to report annually to Parliament on progress towards value-based procurement across the NHS and social care in England, during a debate on the Health Bill in the House of Lords.
The amendment was tabled by Labour's Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. Value-based procurement weighs patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone, and is already being introduced across the health service following national guidance published in June.
Pilot results 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, arguing the aim was to move away from always choosing the lowest price towards quality that improves patient outcomes.
He pointed to 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 produced a 48% reduction in leaks and an 8% fall in product use.
Warning over false economies
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 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.
She cited specialist cardiac pacemakers as an example of more expensive devices that could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care. Clinicians, she said, know that the cheapest option is not necessarily the best, and their understanding of device outcomes 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 position
Health minister Baroness Merron reaffirmed the Government's commitment to value-based procurement, confirming 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 buy 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.
Concern over the Core List
The debate also exposed questions over whether existing purchasing practice is consistent with the policy. Lord Hunt challenged 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 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, leaving open 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 there was great support now for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.