PROCUREMENT
Value-based procurement in NHS pathology services
Beth Loudon provides an introduction to value-based procurement for practitioners working in NHS pathology services, who may have limited exposure to NHS purchasing practice. This article expands on common challenges and offers practical steps to make VBP workable.
Value-based procurement (VBP) aims to shift NHS procurement from a narrow focus on price and meeting a specification to a broader assessment of patient outcomes, whole-life cost and system efficiency. In diagnostics and pathology, this promise is compelling but hard to realise.
Diagnostic tests enable decisions; they
rarely deliver clinical outcomes on their own. As a result, the evidence needed to prove value is distributed across clinical pathways, data systems and behaviours that sit outside the laboratory. This article aims to explain VBP, set out the specific barriers for in vitro diagnostics and pathology, and offer practical steps that the NHS, laboratories and suppliers can take to make VBP a feasible approach. The ambition is clear: a system
that chooses technologies for their impact on patients and services rather than their sticker price. Geting there requires tailored evaluation questions, beter access to real-world data, clearer separation between specification and value, and enhanced capability across procurement and clinical teams.
What VBP means in the NHS Value-based procurement is not a new concept, but it has had limited traction in NHS markets. It has been used to refer to specific medtech products which claim to offer additional value beyond that of alternatives (fewer bed days, reduced infection rates). However, VBP is an alternative methodology of procurement which determines the areas of value that can be delivered through procurement, and bidders are required to provide evidence against the value domains. The adoption of VBP has accelerated more recently with the publication of NHS guidelines for VBP by the Department of Health and Social Care (DHSC), and a number of pilots that are currently underway in the NHS, albeit none are in diagnostics. This acceleration is in part due to the ambition that VBP will support the NHS 10-Year Plan in delivering improved productivity, help keep patients safe, and reduce waiting lists. At its core, VBP asks a simple question:
Perfect atribution is not required to run VBP. Instead, pragmatic, observable measures that laboratories and clinical teams can influence together should be realised.
which product or service creates the greatest overall value for patients and the health system? In practice, this means decision-makers consider a wider set of value criteria than unit price. These include clinical outcomes, operational productivity, pathway efficiency, resilience, sustainability and inequalities impact. For a therapeutic device, these criteria can often be evidenced by trials or registries that link use directly to patient outcomes. For diagnostics, the same logic applies but the evidence chain is longer. A test improves outcomes only if it
May 2026
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