Value-based procurement in wound management: A transformative approach

Lisa Wood and Ross Burton examine the advantages of value-based procurement (VBP) as a transformative method for wound care that emphasises clinical efficacy, improved patient outcomes, and cost savings over the long term

Wound care represents a significant demand on healthcare systems globally, and in the UK, the financial burden is striking. With the National Health Service (NHS) spending an estimated £8.3 billion annually on wound management ⁽¹⁾, balancing cost efficiency with clinical outcomes has never been more crucial. Value-based procurement (VBP) offers a transformative approach to managing this challenge. By prioritising clinical efficacy, patient outcomes, and long-term savings over mere cost-cutting, VBP aligns with the broader goals of sustainable healthcare.

The financial reality of wound management

A closer examination of NHS expenditure reveals a startling disparity between the costs associated with healed and unhealed wounds. While healed wounds account for £2.7 billion of the total expenditure, unhealed wounds consume a disproportionate £5.6bn. ⁽¹⁾ This imbalance underscores the need for effective and innovative approaches to wound care that prioritise healing and minimise prolonged treatment.

What is value-based procurement?

VBP shifts the focus from simply purchasing the cheapest products to evaluating the overall value a product or service brings to patient care. In wound management, this involves choosing interventions, dressings, and therapies that may have higher upfront costs but ultimately result in better healing outcomes, reduced interventions, and improved patient quality of life. The key to success in this model lies in evidence-based decision-making, where clinical data guide procurement choices.

Tailored interventions for better outcomes

Central to value-based procurement in wound care is the emphasis on personalised treatment plans. Each wound is unique, requiring a tailored approach based on factors such as the wound stage, level of exudate, presence of infection, and patient preferences. Holistic wound assessment enables clinicians to match the most appropriate dressing or therapy to the specific needs of a patient, thereby creating an optimal healing environment.

For instance, compression therapy is a proven strategy for managing venous leg ulcers (VLUs). VLUs represent only 15% of all wound types but account for a staggering 39% of management costs. ⁽¹⁾ Immediate application of compression therapy prevents disease progression, reduces complications, and encourages self-management among patients, ultimately saving resources. ⁽²⁾ However, the success of such interventions is contingent upon a clinician’s knowledge of product performance, patient adherence and the underlying dynamics of wound healing.

Evidence-based pathways and multidisciplinary collaboration

The National Wound Care Strategy Program (NWCSP) highlighted the importance of standardised, evidence-based care pathways to reduce variations in treatment and improve outcomes. ⁽³⁾ These pathways provide clinicians with structured frameworks that support informed decision-making, while ensuring patients receive consistent care.

A case study presented in a Medicines Management Webinar illustrated the impact of multidisciplinary collaboration. An 86-year-old patient with bilateral leg ulcers generated treatment costs exceeding £80,000 per year. Following a multidisciplinary team review, the introduction of advanced dressings that initially had a higher price point facilitated wound healing and delivered a substantial overall cost saving. This example demonstrates the crucial role of collaboration across specialties in achieving both clinical and financial objectives.

Addressing the needs of community nursing

Community nursing plays a pivotal role in wound management, dedicating up to 50% of its workload to this area. ⁽¹⁾ With limited resources, community nurses face the dual challenge of managing high patient loads while ensuring effective care. A published article by Hallas-Hoyes et al in 2021 ⁽⁴⁾ showcased the benefits of a value-based procurement model through the adoption of the Atkin & Tickle lower limb pathway. ⁽⁵⁾ Over 18 weeks, 72% of VLUs treated within this framework achieved healing, aligning costs with national benchmarks and improving patient quality of life.

Empowering patients through self-care

A cornerstone of value-based procurement is the empowerment of patients to actively participate in their care. Self-care models not only reduce the strain on healthcare systems but also foster a sense of ownership among patients. By equipping patients with the tools and knowledge to manage their wounds, clinicians can focus on more complex cases, further improving efficiency and outcomes. ⁽⁶⁾

Challenges in implementation

While the benefits of VBP are evident, translating it into practice remains challenging. Resistance to change, limited awareness of the long-term benefits, and the upfront costs of adopting new interventions can hinder progress. Transparent formularies, clinician education, and robust data collection are essential to overcoming these barriers.

Moreover, dressings themselves do not heal wounds. Instead, they create conditions conducive to healing. This distinction is critical in guiding procurement strategies that account for the interplay between product performance, patient compliance, and broader clinical pathways.

The future of value-based procurement

The future of wound management lies in embracing VBP as a standard practice. By combining evidence-based practice, multidisciplinary collaboration, and patient-centred care, healthcare providers can tackle the dual challenges of rising costs and increasing patient needs. The focus must shift from short-term cost savings to long-term value creation, ensuring that patients achieve optimal outcomes while reducing the financial burden on the NHS.

Key areas of focus for the future include:

1. Incorporating advanced technologies:
   • Innovations such as smart dressings that monitor healing progress and antimicrobial therapies can revolutionise wound care.
2. Strengthening data analytics:
   • Robust data collection and analysis can help identify trends, measure outcomes, and refine procurement strategies.
3. Expanding training and awareness:
   • Clinicians must be equipped with the knowledge and skills to implement VBP effectively.
4. Policy support and funding:
   • Policymakers and healthcare leaders must prioritise funding and guidelines that support this transformative approach.

VBP in wound management is more than a cost-saving strategy; it is a commitment to delivering better care for patients while addressing the sustainability of healthcare delivery. By focusing on clinical efficacy, patient empowerment, and evidence-based decisions, VBP has the potential to transform wound management. The journey may be complex, requiring cultural shifts and investment, but the rewards in terms of improved healing rates, reduced costs, and enhanced quality of life are well worth the effort.

Let us strive for a future where every patient receives the best possible care, and healthcare providers operate with both efficiency and compassion at their core.

References

1. Guest, J.F., Fuller, G.W. & Vowden, P. (2020) ‘Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013’, BMJ Open, 10(12), e045253. doi: https://doi.org/10.1136/bmjopen-2020-045253.
2. NICE (2023) Venous leg ulcer – management: Clinical Knowledge Summaries. London: National Institute for Health and Care Excellence. Available at: https://cks.nice.org.uk/topics/leg-ulcer-venous/management/ (Accessed: 11 September 2025).
3. National Wound Care Strategy Programme (2020) Health impact assessment: National Wound Care Strategy Programme. Kent, Surrey and Sussex Academic Health Science Network. Available at: https://thehealthinnovationnetwork.co.uk/wp-content/uploads/2023/08/20200909_NWCSP-Health-Impact-Assessment_final.pdf (Accessed: 11 September 2025).
4. Hallas-Hoyes, L., Williamson, S., Kerr, A., Andrews, T. & Calladine, L. (2021) ‘An advanced self-care delivery model for leg ulcer management: a service evaluation’, Journal of Wound Care, 30(9), pp. 751–762.
5. Atkin, L. & Tickle, J. (2016) ‘A new pathway for lower limb ulceration’, Wounds UK, 12(2), pp. 32-36.
6. NursingCenter (2021) ‘Patient-Centered Education in Wound Management’, NursingCenter. Available at: https://www.nursingcenter.com/cearticle?Issue_ID=5984127&Journal_ID=54015&an=00129334-202108000-00003.

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