One contract, one Wales: standardising lymphoedema garment provision through a national procurement model

Before 2014, lymphoedema compression garment provision in Wales was fragmented, with wide variation in access, prescribing routes, product quality and cost, resulting in inequity for patients and inefficiency. Given the chronic nature of lymphoedema and the central role of compression therapy, a more consistent national approach was required. This commentary describes the rationale, development and impact of implementing a single national procurement contract and standardised garment formulary for lymphoedema care in Wales. Between 2014 and 2023, a clinically led, collaborative procurement process was undertaken involving national clinical leadership, procurement services, clinicians, patients and independent laboratory testing to inform garment selection. The resulting contract improved equity of access, strengthened quality assurance, standardised prescribing practice and enabled all-Wales audit and exception monitoring. This model demonstrates how national procurement, grounded in clinical evidence and stakeholder engagement, can reduce unwarranted variation, optimise value-based healthcare and support consistent, person-centred care across community and specialist settings.