Revolutionising NHS Trust with Insourcing: A Comprehensive Guide to Clinical Support Services

Insourcing within NHS Trusts is a strategic response to the pressing challenge of reducing patient waiting times. This approach, which involves using internal resources and capacities to provide healthcare services, contrasts with traditional outsourcing. Insourcing capitalises on underused resources within NHS hospitals, particularly during weekends, to enhance service delivery. This method effectively reduces patient waiting lists, improves the quality of care, and maintains continuity within the familiar NHS environment. Moreover, insourcing is financially viable as it uses NHS equipment at lower rates per treatment, ensuring that outpatient visits, diagnostics, and surgical procedures remain free at the point of care for patients. However, insourcing also faces challenges related to value for money, potential conflicts of interest, and its impact on agency staff rates and financial pressures on trusts.

The sustainability of insourcing is under scrutiny, especially in light of the NHS Long Term Workforce Plan, which aims to increase the NHS workforce and decrease reliance on agency staff. The success of this plan could challenge the insourcing model by reducing its demand. Despite these challenges, the flexibility and adaptability of insourcing are evident in the variety of services it can encompass, such as cardiology diagnostics, dermatology, and endoscopy. While offering a promising solution to the NHS’s current challenges, insourcing necessitates careful consideration of its implementation, financial implications, and potential long-term impact on workforce and service delivery models​

What is Insourcing of Clinical Support Services for NHS Trust?

Insourcing of clinical support services in NHS Trusts is a strategic approach designed to leverage internal or contracted healthcare professionals within an organisation’s own facilities. This model, supported by the Insourcing of Clinical Services framework from NHS Shared Business Services (NHS SBS), aims to address increasing demands on healthcare services by providing a short- to medium-term solution that maintains in-house capacity planning and patient care within the trust’s facilities. The framework agreement encompasses a wide array of medical and clinical services, including diagnostics, treatment, and patient follow-up, and even allows for virtual consultations where suitable​​.

The adoption of insourcing has been particularly significant in the wake of the COVID-19 pandemic, as NHS Trusts seek to manage increased waiting lists and ensure timely patient care. The NHS Workforce Alliance framework for Insourced Services supports this initiative by offering a range of services, such as cardiology diagnostics, endoscopy, and general surgery. This insourcing model is distinct from outsourcing, primarily in its use of the Trust’s premises and equipment for delivering services, often outside regular working hours to maximise resource utilisation​​​​.

Organisations like Your Medical Services highlight the practical benefits of insourcing, including enhanced patient satisfaction, improved cost efficiency, and reduced waiting times. By using the Trusts’ unused capacities, insourcing helps address the backlog in patient care, providing services like cancer diagnostics and surveillance while maintaining the continuity of care and high standards. This approach not only alleviates the burden on existing healthcare infrastructure but also contributes to more efficient and integrated healthcare delivery within the NHS​​.

The Role of Insourcing in Enhancing Clinical Services

Insourcing within NHS Trusts has emerged as a pivotal strategy in enhancing clinical services, particularly in the context of managing increased patient care demands and reducing waiting times. This approach involves employing third-party organisations to perform medical services on trust premises, offering a distinct advantage over traditional locum or agency staffing by providing a comprehensive end-to-end service. The Insourcing of Clinical Services framework agreement, in particular, supports this adoption across the NHS, enabling trusts to secure additional clinical capacity. Key elements of this framework include:

  • Broad Specialization Coverage: Services cover a wide range of specialties like cardiology diagnostics, diagnostic imaging, endoscopy, and orthopaedics.
  • Cost-Effectiveness and Compliance: Ensures services are compliant with NHS standards and provide a cost-effective solution.
  • Enhanced Capacity Planning: Allows trusts to retain in-house capacity planning while ensuring timely patient care.

The integration of insourcing into the daily operations of NHS trusts has shown significant benefits, especially in surgical pathways. A more integrated, collaborative approach, where external specialists work alongside NHS teams, can enhance the quality and efficiency of patient care. This method involves forming ‘allied’ teams of regular extra theatre workers and NHS staff, with the following advantages:

  • Improved Operational Efficiency: These teams work together on weekdays and weekends, optimising the use of NHS facilities.
  • Enhanced Service Quality: The integration of insourced staff with NHS teams leads to more cohesive and effective patient treatment, directly translating into better clinical outcomes.
  • Flexibility and Innovation: Insourcing allows for agile responses to changing demands and innovative solutions to ongoing challenges in patient care.

How Clinical Insourcing Services Reduce Patient Waiting Lists

One of the most significant impacts of insourcing is on patient waiting lists. By bringing in specialists to work in-house, NHS Trusts have managed to handle a higher volume of patient cases more efficiently, significantly chopping down waiting times.

This model isn’t just about clinical swiftness; it also streamlines administrative tasks, often the silent culprits in delaying patient care. The evidence is in the numbers – NHS Trusts report substantial reductions in waiting times following the implementation of insourcing in various departments.

The Financial Aspect of Insourcing

When it comes to the bottom line, insourcing might seem like an uphill investment at first. However, it often turns out to be more cost-effective in the long run compared to outsourcing. By internalising services, NHS Trusts gain better control over their budgets and avoid the fluctuating costs linked with external services.

The Future of Insourcing in Healthcare

Looking ahead, insourcing in healthcare is poised to evolve, with a growing emphasis on technology and patient-focused services. We can expect to see the integration of digital health tools and telemedicine within insourced services, revolutionising how care is delivered.

Innovations could include advanced data analytics for optimising services and AI-driven tools, further enhancing efficiency and patient care.


Insourcing within NHS Trusts is a pioneering strategy that is reshaping the future of healthcare services. This approach is not merely a temporary fix to current challenges; it represents a fundamental shift towards a more efficient, patient-centred healthcare system. The integration of cutting-edge technologies like digital health tools, telemedicine, and AI-driven diagnostics is poised to revolutionise the way care is delivered. These advancements are set to enhance the responsiveness and effectiveness of healthcare services, aligning perfectly with the NHS’s commitment to innovation and patient care.

As we look to the future, insourcing in NHS Trusts stands at the forefront of healthcare evolution. It symbolises a shift from traditional methods to more integrated, technologically advanced healthcare solutions. This transformation promises not only immediate improvements in patient care but also paves the way for a more robust, innovative healthcare system. In essence, insourcing is not just solving the problems of today but is also laying the groundwork for a more resilient and patient-focused NHS, ready to meet the challenges of tomorrow.

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