Cross-party peers in the House of Lords have backed a proposed requirement for ministers to report annually to Parliament on progress toward value-based procurement across the NHS and social care in England, arguing that purchasing decisions should weigh patient outcomes and long-term costs rather than the lowest upfront price.
The proposal was set out in an amendment to the Health Bill tabled by Labour’s Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. During the debate, peers described value-based procurement as an approach that considers clinical benefits, patient outcomes and the wider costs of care alongside the initial purchase price.
The approach is already being introduced across the health service following national guidance published in June. Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement existed to secure value for money but could achieve more. He argued that buying should move away from always choosing the lowest price and toward quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, conducted with health and hygiene company Essity, in which continence products tailored to individual patients’ needs led to a 48% reduction in leaks and an 8% fall in product use.
Baroness Finlay 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. She argued that cheaper equipment could prove a false economy if it led to complications or further treatment, with the resulting costs often 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 and potentially avoid costly intensive care.
“It is the clinicians who know that the cheapest is not necessarily the best,” said Baroness Finlay, a professor of palliative medicine. She added that clinicians understand the outcomes associated with particular devices and that this knowledge should be embedded in tendering.
The proposals also drew support from former Health Secretary Lord Lansley, a Conservative peer, who 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 for the government, health minister Baroness Merron reaffirmed its 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 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.
The debate also 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 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 of the Core List, leaving questions over how the NHS will 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 clear support across political parties for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.