A unified definition of value – developed with clinicians, patients, and industry – will reduce variation in access to existing products and prevent more medtech suppliers leaving the market, says MTG
A new report from the Medical Technology Group is calling on the NHS to adopt a single, nationally consistent definition of value in health technology procurement — one anchored in long term patient outcomes rather than upfront cost — warning that without it the NHS faces a deepening crisis of access to medical innovation.
The report, Measuring Value in NHS Procurement of Health Technologies, finds that the absence of a shared, system-wide definition of value is the central failure driving unequal access to medical technologies across England.
While NHS policy has long stated a commitment to outcomes-driven care, in practice procurement decisions continue to be shaped by immediate financial pressures and short-term cost metrics that bear little relation to what patients say they actually value.
The report states that the Department of Health and Social Care’s new Value-Based Procurement (VBP) programme acknowledges this problem and marks a meaningful step towards a longer term understanding of value over upfront cost.
However, the MTG warns that the framework’s impact will depend entirely on whether a clear, shared definition of value is established and consistently applied. It suggests that given NHS organisations interpret and weight value differently — variation in access and outcomes may persist even within the new framework.
The MTG is calling on the NHS to establish a unified definition of value, developed with clinicians, patients, and industry, that would provide consistency across procurement decisions, reduce variation, and create clearer signals for the medical technology sector.
What patients say value means
The report argues that there is a systemic limitation on how value is assessed when procuring new technologies and devices, with established approaches not capturing what patients truly value:
- More than half of patients identify “time to feeling completely well, back to normal” as their primary measure of whether a treatment has worked
- More than 60% identify avoiding complications and readmissions as central to the real cost of treatment
- Over half highlight reducing reliance on family, carers and social services — and minimising time away from work — as defining factors in treatment value
- Dignity, convenience, and control over treatment decisions are consistently raised by patients as material to how they assess care, yet are rarely quantified in procurement processes
The group argues that without a more ambitious understanding of patient value in procurement decisions, the NHS will continue to lag internationally when it comes to patient access to the best available medical technology and innovation.
Data from the ABHI’s (Association of British HealthTech Industries’) recent Pulse of the Sector survey reveals that 22% of health technology suppliers have removed a product from sale because the NHS selling price fell below the cost of production. A third have declined to bid for NHS tenders due to restrictive procurement requirements.
Understanding of value held back by lack of data and accountability
These findings build on earlier reports from the MTG’s Commission on NHS Culture, which found that NHS systems routinely lack the data and governance structures needed to understand whether services are performing well or delivering the outcomes intended.
Previous MTG analysis, drawing on Freedom of Information responses from 42 Integrated Care Boards found that across diagnostics, orthopaedics and continence care, there was variation in data collection and oversight, meaning procurement teams were unable to understand whether a technology had delivered the value it promised.
The MTG is calling on the NHS to:
- Adopt a single, nationally consistent definition of value, anchored in patient outcomes and developed with clinicians, patients, and industry
- Mandate the routine collection of real-world outcomes data linked to procurement decisions, covering patient outcomes, pathway impact, and resource use
- Hold Integrated Care Systems accountable not only for procurement choices, but for the outcomes those choices deliver
- Enable longer-term, outcomes-based partnerships between the NHS and the health technology sector, moving beyond short-term transactional purchasing
- Embed patient-reported outcomes — including recovery time, independence, and return to normal life — as the primary metric of procurement success
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 full report, Measuring Value in NHS Procurement of Health Technologies, is available here.
