Procurement
Rethinking value in NHS procurement
In this article, Thomas Owens, outlines why long-term outcomes must outweigh short-term cost – especially in pressure ulcer prevention. He calls for the NHS to embed lifecycle value, clinical performance, and sustainability into every purchasing decision.
Across the NHS, procurement remains one of the most influential forces shaping care quality, safety, and sustainability - yet it often operates under immense short-term pressure. With constrained budgets and mounting demands, purchasing decisions are frequently driven by lowest upfront price rather than long- term performance, lifecycle cost, or patient outcomes. This short-termism is understandable in a
system where every pound is scrutinised. But the consequences are significant. Cheaper, less durable equipment might deliver a saving on day one, yet over its lifetime, it can cost the NHS far more through failures, replacements, and the hidden impact on clinical outcomes and staff efficiency.
The real cost of pressure ulcers Pressure area care provides a clear case in point. Pressure ulcers cost the NHS an estimated £3.8 million every single day, one of the most expensive and preventable patient safety issues. Much of this burden stems not from clinical error, but from the equipment frontline staff are given to work with. When
mattresses fail prematurely, or can’t adapt to patients’ changing needs, the result is predictable - higher ulcer incidence, longer hospital stays, and greater cost. Additionally, pressure ulcers don’t just drive financial cost, they also affect morale and staffing efficiency. Each serious ulcer can add unprecedented additional hours of wound management nursing per week, patient repositioning and documentation. That’s time diverted away from other patients. In a system already facing in the region of 47,000 nurse vacancies (reported in 2022), innovative equipment that prevents additional clinical complications can directly relieve pressure on stretched nursing teams and improve retention by reducing burnout, a hidden human cost not often addressed when considering the procurement of medical devices.
The real cost of short-term savings To put the scale into perspective, the NHS spends around £30 billion each year across an estimated 80,000 suppliers.1
shifts in procurement strategy can have a significant impact on value, efficiency and patient outcomes. This scale highlights why procurement decisions must move beyond short-term savings to focus on solutions that deliver sustained performance and measurable benefits for patients and staff alike. That said, procurement teams are tasked with delivering value for money, yet the definition of “value” itself is often too narrow. Traditional tender frameworks tend to evaluate products by their purchase price and minimal compliance requirements rather than by measurable performance data. This approach inadvertently reinforces a disposable mindset. In the pressure care category, for instance, the market has long accepted that mattresses will fail within short cycles, often due to fluid ingress or foam breakdown, and simply be replaced. High turnover has become normalised, benefitting suppliers who profit from repeat sales rather than durability. But every failure creates a ripple effect of
With such vast and complex purchasing activity, even small
inefficiency with lost clinical time, disrupted patient care, waste disposal costs, and unnecessary environmental impact. In a healthcare system striving for net-zero and sustainable procurement, this model is no longer fit for purpose. The challenge is not just about cost control, it’s about how we measure success. True value must encompass clinical efficacy, product longevity, staff efficiency, sustainability, and total cost of ownership. Anything less risks embedding inefficiency into NHS operations for years to come.
Proving that long-term value delivers The Trezzo pressure area care innovation was developed in partnership with NHS clinicians to address the exact factors that drive equipment failure and cost escalation. Since 2017, the technology has undergone multiple independent trials, including evaluation by the University of
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www.clinicalservicesjournal.com I February 2026
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