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Waiting List Recovery – Insourcing Vs Outsourcing

Most NHS Trusts will need external support to recover their pre-Covid waiting list position. The choice is normally insourcing or outsourcing. What are the differences?

After an incredibly difficult 18 months, NHS Systems are now under immense pressure to provide a quicker and more efficient service.

In practical terms, outsourcing uses a third-party organisation to perform a clinic at an alternative premise to the NHS trust.

In contrast, insourcing is when a third-party organisation brings their workforce into a hospital to work within the same physical location.

As the UK’s longest standing insourcing provider, we have strong views but at the moment we believe a combination of both options will be needed at least in some specialisms in most trusts.

Below are some helpful hints when considering your plan.

Pick a partner to suit the local culture and environment

For patient safety and clinical governance, choosing a third-party to care for your patients is a crucial part of the decision making process. Look for evidence of a track record and always speak to others who have worked with that third party before making an award or inviting providers to tender. You can get a lot from seeking references up front.

Using your own premises and people who really understand your standard operating procedures, policies and local practice, will help ensure that the additional work not only has no adverse effect on core performance but may also enhance it through sharing best practice.

Pathway redesign – can we do things differently?

Insourcing will often give systems the opportunity to look at their current pathways and see if there are opportunities for new more efficient patient pathways. Looking at things out of hours when there is less demand on acute services, teaching and bed occupancy gives you and your insourcing partner a fresh pair of eyes to ask whether there are ways of doing this differently to improve patient experience. This may include technological developments your insourcing partner has seen or used elsewhere to create additional capacity.

Which is the better option for budgets?

Insourcing is typically significantly less expensive than outsourcing. Using NHS tariffs as a benchmark and looking for prices less than tariff is a good starting point.


We strongly suggest that you start by talking to some suppliers to assess their thoughts and approach – do this before any ITT (Invitation To Tender) – they may even help you shape the specification and make sure you are really asking the right questions. Also, ask them for references as not all providers are the same.

For further information and support, please contact us.

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