The NHS has transformed its approach to purchasing medical equipment, moving away from decisions based solely on the cheapest upfront price towards a new value-based procurement (VBP) model that emphasizes lifetime value. This strategy is now being implemented across NHS England, aiming to consider factors such as patient outcomes, experience, workforce impact, and overall system costs rather than just the purchase price.
Trial Results Show Benefits
One trial focusing on 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. Hygiene and health company Essity, which manufactures TENA incontinence products, welcomed the rollout.
Richard Maddison from Essity stated: "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 recognizes 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."
Addressing Financial Pressures
The changes come as the NHS faces rising demand and ongoing financial pressures. Supporters argue that the new model could help ensure patients receive products that better meet their needs, reducing complications like urinary tract infections and skin damage, while supporting mobility and wellbeing and lowering avoidable hospital admissions.
Essity reported that data gathered in 2025 revealed more than half (53%) of 110 NHS Trusts responding to 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 noted that 58 trusts reported having a cap, with 34% limiting patients to three products a day and 66% limiting them to four.
Potential Savings and Impact
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.
Research commissioned by Essity among 500 healthcare professionals found that 71% believe patients could be more independent if the quality and fit of continence products were improved. Maddison added: "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."
