The NHS should look beyond the upfront price of medical products and consider whether spending more initially can improve patient care and save money over time, peers argued during a House of Lords debate on the Health Bill — an approach that drew cross-party backing.
Labour's Lord Hunt of Kings Heath tabled an amendment, supported by crossbench peer Baroness Finlay of Llandaff, that would require ministers to report annually to Parliament on progress toward adopting value-based procurement across the NHS and social care in England. The approach weighs patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price, and is already being rolled out following national guidance published in June.
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement exists to secure value for money for the health service but can achieve more. He framed the shift as moving away from always selecting the lowest price toward quality that improves patient outcomes.
He pointed to a pilot at South Tyneside and Sunderland NHS Foundation Trust, conducted with health and hygiene company Essity, in which supplying continence products matched to individual patient needs produced a 48% reduction in leaks and an 8% fall in product use.
Clinicians and device choice
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 can prove a false economy when it leads to complications or further treatment, with the resulting costs often landing on different NHS budgets. She cited specialist cardiac pacemakers as an example of how more expensive devices can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care. Clinicians, she said, understand that the cheapest option is not necessarily the best, and their knowledge of device outcomes should be built into tendering.
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 response and monitoring
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 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.
Questions over the Core List
The debate also exposed concerns about whether existing NHS purchasing practices align 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 absence 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 open how the NHS would reconcile 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 support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.