A Practical Guide to Winning NHS Contracts in 2026
The NHS is large, complex and increasingly decentralised. According to a 2024 National Audit Office (NAO) report, NHS Supply Chain estimates that the NHS collectively spends approximately £8 billion each year on medical equipment and consumables (from gloves and paper to stents and prosthetic hips). This scale presents a significant opportunity for suppliers who can meet both clinical and procurement requirements.
However, despite the large market value, not all of that spend flows through centralised procurement. For example, the same report noted that around £3.4 billion of that spend was occurring outside the NHS Supply Chain in 2023-24. This leads to inefficiencies and loses potential savings.
In the rest of this post, we explore how procurement works in the NHS, what suppliers need to get right (especially in clinical and regulatory evidence), how frameworks and pilots’ function, and what time & resource planning is needed.
Understanding the NHS procurement architecture
If you want to win business with the NHS, you need to understand where decisions are made. The structure is multi-layered:
National Level: Organisations like NHS England (and its related bodies), the Department of Health & Social Care (DHSC), bodies that run frameworks, set national purchasing/innovation strategy, regulate medical devices, etc. They often issue tenders or frameworks that span multiple regions or the whole country.
Regional / System Level: Integrated Care Systems (ICSs) are a key structure. There are 42 ICSs covering populations of 1-3 million. These combine provider and commissioner functions, coordinate care regionally, and increasingly influence procurement especially for goods/services that can be standardised or scaled across the geography. (Source: Tussell)
Local / Trust Level: Individual NHS Trusts (hospital trusts, community trusts etc.) make many purchasing decisions locally. Especially for consumables, equipment specific to local needs, and where speed or local clinical leadership is important.
Targeting the correct level
To be successful:
Identify whether your product is best suited for national frameworks (large scale, high volume, broadly applicable), or whether you are better starting locally or regionally.
Engage clinical leads early (e.g. consultants, clinical procurement teams) so that your product is seen as clinically useful/needed, not just a cost item. Early clinical validation and buy-in can make the difference in pilots or tenders.
Recognise that national policies may cascade down: being listed on a national framework (or approved by national bodies) can help unlock regional or local adoption.
Clinical evidence and regulatory checks
For any product to be taken seriously, especially medical devices or digital health technologies, the clinical/regulatory evidence needs to be robust. Key components:
MHRA compliance / Device Regulation: If it is a medical device or diagnostic, it must be authorised/registred under the UK regulatory regime (e.g. UKCA marking, post-market surveillance, safety reporting). Non-compliance is often a deal breaker.
Relevant NICE Guidance (or equivalent in devolved nations): NICE has various programmes (Health Technology Guidance, Diagnostics Assessment, Interventional Procedures, etc.). These evaluate safety, effectiveness, cost-effectiveness. Having NICE guidance in your favour provides legitimacy.
Evidence Standards Framework for Digital Health Technologies: If your product is a digital health technology (app, software, SaaS, AI etc.), NICE’s ESF sets out evidence tiers and what is expected in terms of safety, performance, value.
Clinical Endorsement, Pilot Data & Peer-Reviewed Studies: Running pilots with measurable patient outcomes, cost outcomes, patient safety etc., and publishing or otherwise making the data available, helps a lot. Clinical endorsement (from respected clinicians or institutions) boosts credibility.
Interoperability with Electronic Patient Records and Data Systems: NHS trusts will check whether new equipment or digital products integrate with existing systems (EPRs, health record platforms), data security, cybersecurity, the Data Protection Act, etc. If integration is difficult or risky, adoption may stall.
Frameworks, pilots and the adoption pathway
Securing a place on a procurement framework is often a critical route to broad access. Some key points:
Procurement Frameworks: These are contractual arrangements with pre-approved suppliers. Once on a framework, NHS organisations can call off contracts (i.e. buy from you) without running full tenders each time. But frameworks are competitive to get onto, have strict criteria, and are time-boxed (often lasting up to 4 years). Companies must meet quality, financial, regulatory, evidence, and other standards to qualify. View the Procurement frameworks here.
Dynamic Purchasing Systems (DPS): Some frameworks are dynamic, meaning new suppliers can be added over time if they meet certain criteria. Useful for “innovation” or rapidly evolving product categories. I
Pilots / Early Deployment: Especially for products or technologies that are novel, untested at scale, or have uncertain outcomes, doing a pilot (either at one trust or ICS level) is useful. The pilot should define clinical KPIs (patient outcomes, safety), financial KPIs (cost savings, cost avoidance), and ideally measurable ROI. Clear pilot results make scaling easier.
Adoption Pathways: NHS England / other bodies have established “implementation/adoption” pathways (e.g. Accelerated Access Collaborative, MedTech Funding Mandate etc.) to help innovations get to market and be adopted more broadly. Being aware of these and aligning your product & evidence to what those pathways require, helps.
Timelines and resource planning
Bringing a product into the NHS is seldom quick. The timeline depends on the product type, regulatory requirements, evidence generation etc. Plan for:
Regulatory Dossier Preparation: Time needed to compile all necessary documents (e.g. safety data, device specs, risk assessments, software security, interoperability etc.). Sometimes regulatory reviews or clinical trials may be required.
Clinical Evaluations / Pilots: Pilots often take many months to set up, run, collect sufficient data, analyse it, report. Delays are common (e.g. approvals, procurement, installation/training etc.).
Tender / Framework Cycles: Framework agreements are often renewed every few years; the tender for a framework can have fixed windows. If you miss a tender window, you may have to wait years.
Cashflow and Manufacturing Capacity: There are often up-front costs (development, testing, certification). Also need to ensure you can supply at scale, with consistency.
Commercial & Pricing Strategy: NHS buyers will look for products that deliver value: total cost-of-ownership, maintenance, consumables, training etc. Be clear on costing, ongoing support, lifecycle costs.
Stakeholder and Change Management: Adoption at scale often means changing how staff work, procuring, installing, training etc. Expect resistance, delays, need for champions, change management.
Conclusion
Winning NHS contracts depends on more than just having a good product. Key ingredients are:
Clinical credibility – safety, performance, regulatory compliance, peer-reviewed or pilot data, NICE or similar guidance.
Regulatory evidence – meeting MHRA requirements, interoperability, data security etc.
Effective use of frameworks and pilots – arrange early pilots with clear measurable outcomes, aim to get listed on relevant frameworks or DPS.
Timely resource & cashflow planning – from dossier through trials/pilots, production, regulatory approval, tender windows.
If you build the business case carefully around measurable patient outcomes and financial impact, engage clinical and procurement stakeholders early, and align your product with NHS frameworks and regulatory expectations, you maximise your chance of success.