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Last Updated on 09/11/2026 by Sarah Sarsby
Peers have called for NHS purchasing to prioritise patient outcomes and longer-term savings, while questioning how the Health Bill’s planned reorganisation will support value-based procurement and access to innovation.
During the House of Lords committee debate on 28 October, Lord Hunt of Kings Heath argued that procurement should look beyond a product’s initial price to consider quality and its impact on care. He welcomed progress towards value-based purchasing and asked whether NHS Supply Chain would maintain that commitment under Department of Health and Social Care ownership.
He illustrated the approach through an Essity pilot at South Tyneside and Sunderland NHS Foundation Trust. Patients received absorbent continence products matched to their clinical needs and preferences, even when more expensive than alternatives.
He said: “This is a wonderful example of hugely improved patient outcomes because they did not go for the cheapest products”.
Baroness Finlay of Llandaff explained why such benefits can be overlooked when purchasing decisions focus on individual budgets. Equipment that appears expensive can prevent complications, reduce patient distress, and avoid expenditure elsewhere. Savings from cheaper products may therefore fail to reflect the overall cost of care.
She called for clinicians’ knowledge of devices and outcomes to inform tendering, and encouraged wider adoption across the NHS and social care.
Lord Lansley identified a related obstacle: tenders making assessment of value conditional on meeting a pricing threshold. He warned that thresholds could exclude consideration of patient experience, clinical outcomes, and a product’s useful life. Price could carry weight without becoming a barrier to evaluating wider value.
Welcoming national guidance published in June, Lord Scriven nevertheless warned: “But with NHS financial pressures, the temptation will always be to grab the lowest price today, without the skills, the capacity, and a finance regime that rewards long-term value.”
He asked what changes ministers would make to reward longer-term value beyond individual pilots.
Health minister Baroness Merron confirmed NHS Supply Chain’s ‘comply or explain’ approach for future frameworks, with pricing thresholds considered case by case. She outlined independent evaluation of the guidance, with annual reports over three years.
Lord Hunt’s Amendment 211 would require annual reporting to Parliament on value-based procurement of medical devices, consumables, and services across England’s NHS and social care sector. It has not yet been agreed.
Peers also questioned NHS Supply Chain’s future ownership, oversight, continuity of supply, and retention of procurement expertise following NHS England’s abolition. Baroness Merron said its shareholding would transfer to the department without the transfer itself changing operational responsibilities or contracts. A proposal requiring a statutory report before the transfer was withdrawn.
On 3 November, scrutiny turned to how suppliers access NHS support and secure wider adoption of innovations.
Lord Kamall proposed a statutory requirement for a single national access point through which innovators could obtain coordinated support from England’s health innovation networks:
“The purpose is not to create another bureaucratic layer; on the contrary, it is intended to reduce complexity, improve co-ordination and ensure that innovators spend less time navigating the system and more time developing solutions that could benefit patients.”
Lord Scriven argued that the NHS Innovation Service already provided an entry route. The greater challenge was spreading proven technologies: an innovation adopted in one location could encounter the same barriers elsewhere. He highlighted the resources needed for pathway redesign, staff training, and evaluation.
Baroness Merron said the existing service allowed one request and product record, with referrals based on product type, maturity, and location. Support could span networks and regions without another application.
She argued that Lord Kamall’s proposal risked duplicating this existing service by funding another access route. Prescribing an operating model in legislation could also restrict its development. Nationally funded health innovation networks’ work would continue under the Secretary of State’s oversight.
Lord Kamall withdrew his proposal and asked how ministers would improve awareness of existing support.
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