The NHS has changed how it buys medical equipment, shifting away from decisions based mainly on the cheapest up-front price and towards a new value-based procurement (VBP) model that focuses on lifetime value.
New Procurement Model Prioritizes Patient Outcomes
The approach, now being rolled out across the NHS in England, is designed to weigh factors such as patient outcomes and experience, workforce impact and wider system costs, rather than simply the purchase price of a product.
One trial involving continence products reported reductions in product usage and leakages, alongside improvements in staff satisfaction and patient confidence, while also cutting the overall cost of care.
Industry Reaction
Hygiene and health company Essity, which makes TENA incontinence products, welcomed the rollout. Richard Maddison, from Essity, said: "For too long, procurement decisions have often been driven by the lowest purchase price rather than the outcomes delivered for patients and the wider healthcare system. Value-based procurement recognises that the cheapest product is not always the most cost-effective option. By considering factors such as patient experience, clinical outcomes, workforce impact, and overall system costs, the NHS can make decisions that improve patient outcomes while delivering better value for taxpayers."
Financial Pressures and Potential Savings
The changes come as the NHS faces rising demand and ongoing financial pressures. Supporters of the new model argue it could help ensure patients receive products that better meet their needs, and reduce complications such as urinary tract infections and skin damage, while supporting mobility and wellbeing and lowering avoidable hospital admissions.
Current Challenges
Essity said data it gathered in 2025 found more than half (53%) of 110 NHS Trusts that responded to its Freedom of Information requests said they were capping the number of continence products provided to patients. The FOI requests asked Trusts to confirm whether they had introduced limits on products often used to support patients, including after bowel surgery. The company said 58 Trusts reported having a cap, with 34% of those limiting patients to three products a day and 66% limiting them to four.
Around 14 million people in the UK live with some degree of urinary incontinence, while the NHS spends an estimated £5.13 billion each year on incontinence-related care. Essity said the shift to value-based procurement could help deliver savings, with potential cost reductions to the NHS projected at £500 million a year for incontinence products alone.
Healthcare Professionals' Views
Research commissioned by Essity among 500 healthcare professionals found 71% believe patients could be more independent if the quality and fit of continence products were improved.
Maddison for Essity said: "Procurement is not simply a purchasing exercise. The products selected by the NHS can have a profound impact on a person's dignity, confidence, independence, and overall wellbeing. When patients receive products that are appropriate for their individual needs, the benefits extend far beyond the individual. We see reduced pressure on healthcare professionals, fewer avoidable complications and admissions, and ultimately better value for the NHS as a whole."
