The NHS‘s approach to medtech procurement is failing patients by putting short-term costs ahead of outcomes, a new report has warned.
The Medical Technology Group said the lack of a shared definition of value was driving unequal access to medical technologies across England.
Its report argues that procurement decisions remain shaped by immediate financial pressures and short-term cost measures, despite NHS commitments to outcomes-driven care.
Barbara Harpham, chair of the Medical Technology Group, said: “The NHS’s Value-Based Procurement programme signals a clear intention to move beyond price and towards a broader understanding of value when it comes to medical technology.
“However, intent alone is not enough to drive change in the sector, and the process to deliver VBP is a complex and challenging one.
“Without stronger accountability, better data, and a clearer definition of what value means in practice, there is a risk that variation persists and patients continue to receive unequal and inequitable care.”
The group said the Department of Health and Social Care’s Value-Based Procurement programme acknowledges the problem and marks a move towards considering long-term value rather than upfront cost.
However, the report warned that NHS organisations could continue to interpret and give different weight to value without a clear national definition.
It called for a single definition developed with clinicians, patients and industry to make procurement decisions more consistent, reduce variation and give medtech suppliers clearer requirements.
The report said established purchasing processes often failed to capture the factors patients considered important when judging whether treatment had worked.
More than half of patients identified the time taken to feel completely well or return to normal as their main measure of treatment success.
More than 60 per cent said avoiding complications and hospital readmissions was central to the true cost of treatment.
More than half also highlighted reduced reliance on family, carers and social services, as well as spending less time away from work.
The report said patients regularly identified dignity, convenience and control over treatment decisions as important, but these factors were rarely measured during procurement.
The group warned that without a broader understanding of patient value, the NHS would continue to lag behind other countries in providing access to medical technology and innovation.
It also cited an Association of British HealthTech Industries survey which found that 22 per cent of suppliers had removed a product from sale because the NHS selling price had fallen below its production cost.
A third of suppliers had declined to bid for NHS tenders because of restrictive procurement requirements, according to the survey.
The findings build on earlier reports from the group’s Commission on NHS Culture, which found that NHS systems often lacked the data and governance needed to assess whether services were performing well or delivering their intended outcomes.
Previous analysis of Freedom of Information responses from 42 Integrated Care Boards found differences in data collection and oversight across diagnostics, orthopaedics and continence care.
The group said these differences left procurement teams unable to determine whether a technology had delivered the value it promised.
It is calling on the NHS to adopt a nationally consistent definition of value anchored in patient outcomes and developed with clinicians, patients and industry.
The report also recommends routinely collecting real-world outcomes data linked to procurement decisions, covering patient outcomes, effects on care pathways and resource use.
It calls for Integrated Care Systems to be held accountable for the outcomes produced by their purchasing decisions, rather than only for the decisions themselves.
Other recommendations include longer-term, outcomes-based partnerships between the NHS and health technology companies, moving beyond short-term transactional purchasing.
The group also wants patient-reported outcomes, including recovery time, independence and return to normal life, to become the main measure of procurement success.
