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NHS insourcing: addressing the backlog
The NHS faces one of the most significant challenges in its history: tackling the elective care backlog. So, could insourcing help provide an answer? Portland Clinical explains why this strategy is increasing in popularity and how it can make a difference.
According to NHS England’s latest figures, from September 2024, there are 7.6 million RTT (Referral to Treatment) pathways open, representing patients waiting to start treatment.1 This includes an estimated 6.1 million unique individuals. Worryingly, only 58% of patients on the elective care waiting list are seen within the 18-week target, and nearly 250,000 patients have been waiting for over a year. With 1.7 million new RTT pathways initiated in September alone, the demand for elective care continues to grow at a rapid pace. These numbers underscore the
unprecedented pressures on the NHS and highlight the urgent need for solutions to reduce waiting times and improve access to care. Lord Darzi recently framed the issue succinctly in his report: “It is not a question, therefore, of whether we can afford the NHS. Rather, we cannot afford not to have the NHS, so it is imperative that we turn the situation around.” His report further stressed the need for a multifaceted approach
to tackle this crisis, including incentivising NHS staff to work extended hours, leveraging insourcing providers to optimise existing NHS capacity, and outsourcing to private healthcare providers where appropriate. The importance of elective recovery was
reinforced by the Prime Minister in his speech on 5th December 2024, where he reiterated that reducing waiting lists and improving access to non-urgent medical treatments is now a critical priority. At the NHS Confederation’s Achieving the 18-Week Standard for Elective Care event in September 2024, insourcing emerged as a key strategy for addressing the challenges of elective recovery.
What is insourcing, and why is it effective? Insourcing is defined as the utilisation of third- party organisations to deliver medical services or procedures within NHS facilities. It differs significantly from locum or agency staffing
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solutions, as insourcing provides a complete end-to-end service rather than simply supplying personnel. This distinction makes insourcing an attractive, cost-efficient, and scalable solution for addressing the elective care backlog. The rising popularity of insourcing can be
attributed to its many advantages: 1. Cost-effectiveness: Insourcing is delivered within NHS premises, reducing overhead costs and typically activity is delivered below the NHS tariff. NHS resources, such as operating theatres and outpatient departments, can be used more efficiently, reducing expenditure and ensuring the public sector benefits from existing infrastructure.
2. Enhanced patient experience: Patients receive care in familiar NHS settings, which fosters trust, provides continuity of care, and facilitates easier access to medical records. This seamless integration improves safety, efficiency, and overall satisfaction with the healthcare journey.
3. Increased capacity: Insourcing enables NHS Trusts and Health Boards to optimise underutilised hospital facilities, such as operating theatres, outpatient clinics, and diagnostic services, particularly during evenings, weekends, and other off-peak hours. This approach enhances overall capacity without the need for significant capital investments.
4. Rapid deployment: Unlike the lengthy process of building new facilities or hiring additional permanent staff, insourcing offers a quick and flexible solution to tackle immediate backlogs. This agility is crucial in addressing urgent challenges while maintaining service quality.
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www.clinicalservicesjournal.com I January 2025
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