The House of Lords has signalled cross-party support for moving NHS purchasing away from the lowest headline price and towards value-based procurement, during a debate on the Health Bill.
An amendment tabled by Labour peer Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff would require ministers to report annually to Parliament on progress in adopting the approach across the NHS and social care in England. The model 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.
From lowest price to quality
Lord Hunt, a former health minister, said procurement exists to secure value for money for the health service but can achieve more. He argued the aim is to stop always choosing the lowest price and instead select 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 individual patient needs produced a 48% reduction in leaks and an 8% fall in product use.
Clinicians and the tendering process
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 taken up more widely across the NHS and social care.
She argued that cheaper equipment can prove a false economy when it leads to complications or further treatment, with the resulting costs often falling on different NHS budgets. Specialist cardiac pacemakers were her example of more expensive devices that can help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care. Clinicians, she said, know the cheapest option is not necessarily the best, and that knowledge of device outcomes should be embedded in 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 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.
Government response and Core List concerns
Health minister Baroness Merron restated the government's commitment to value-based procurement, confirming that NHS Supply Chain has adopted a "comply or explain" approach for future purchasing frameworks. She said the intention is for the approach 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 tensions over whether current purchasing practice matches the policy. Lord Hunt questioned NHS Supply Chain's decision to identify 79 additional product categories for potential inclusion in its Core List of standardised supplies, including urinary catheters and colostomy bags. He described these as 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 will reconcile greater standardisation with clinically led, patient-centred purchasing.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there is now broad cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.