From Outsourcing to Insourcing: How the NHS is Redefining Workforce Procurement
The NHS is at a pivotal moment in how it delivers and commissions care. As waiting lists reach record highs, with 7.5 million people in England currently awaiting treatment, the need for innovative workforce and capacity solutions has never been greater.
The British Medical Association warns that the “combination of ongoing pressure on services, the backlog of care and chronic workforce shortages means waiting times have increased to record highs”, limiting the ability of many Trusts to recover post-pandemic. Meanwhile, the Independent Healthcare Providers Network (IHPN) highlights that Community Diagnostic Centres (CDCs) have the potential to speed up and improve patient access to tests and scans.
Against this backdrop, the NHS is re-evaluating how services are delivered and how capacity is sourced. A growing number of Trusts are transitioning from traditional outsourced contracts toward insourced, clinically led service models that offer greater control, faster mobilisation, and measurable quality assurance.
This shift from outsourcing to insourcing represents more than a procurement trend. It’s a structural change in how the NHS is rebuilding resilience: keeping delivery within its governance framework while partnering with trusted clinical providers to enhance access, reduce waiting lists, and strengthen patient outcomes. In this article, we’ll take a look at what these changes mean for the industry and the benefits it offers.
The Drawbacks of Outsourcing
Historically, the NHS has relied heavily on outsourcing to manage its vast array of services, from clinical processes to back-office functions. This approach allowed the NHS to tap into specialised expertise and technology, ostensibly reducing costs and administrative burdens.
However, outsourcing has its drawbacks. These issues are particularly important for the NHS, which spans hundreds of NHS trusts and relies on efficiency to function. Some of the key issues associated with outsourcing in the NHS include:
Quality Control Challenges: Maintaining high standards of service quality can be difficult when operations are handled externally.
Dependency and Lack of Flexibility: Outsourced contracts can lead to a dependency on external providers, reducing the NHS's ability to adapt quickly to changing healthcare needs.
Economic Impact: Money spent on foreign or multinational corporations may not stay within the local economies or the UK.
Security Concerns: Outsourcing can lead to increased risks in data security and patient confidentiality.
Fragmented Workforce Models: Overreliance on multiple external suppliers can complicate workforce planning and governance, leading to inconsistent patient experiences.
With these issues in mind, it’s no surprise that the NHS was actively seeking alternative solutions to address the patient backlogs and skills shortages affecting it.
The Shift Towards Insourcing
The move towards insourcing denotes a major strategic pivot to regain control over procurement and service delivery in the NHS. Insourcing is the practice of bringing previously outsourced services back in-house and managing them within the organisation itself. This transition is fueled by several motivating factors that the NHS is looking to address, such as:
Enhanced Control
Insourcing enables the NHS to have direct oversight over its operations. This direct control helps ensure that the standards of quality and efficiency align with the expectations and values of the NHS.
Improved Agility
By managing services internally, the NHS can be more flexible and responsive to immediate healthcare needs. This agility is important in a landscape where medical technologies and patient needs evolve rapidly.
Cost Efficiency
Initial outsourcing may appear cost-effective, but managing services in-house can lead to long-term savings. These savings are achieved by eliminating middleman fees, reducing contractual expenditures, and optimising resource allocation based on actual needs.
Data-Led Oversight and Accountability
Increasingly, NHS Trusts and Integrated Care Boards are using insourcing not only to regain control but to introduce measurable, data-driven improvements.
Platforms such as Globe Workforce Solutions’ Healthcheck provide real-time insights into activity, utilisation, and patient outcomes, helping Trusts track performance and demonstrate progress against NHS England’s elective recovery and diagnostic targets.
This shift reflects a wider move toward transparency and accountability in workforce delivery, where clinical quality, capacity, and patient outcomes are continuously measured, reviewed, and optimised through live data.
Implementing Insourcing: Challenges and Strategies
While the benefits of insourcing are clear, the transition process is fraught with challenges. The NHS is one of the largest employers in the world, so, understandably, a transition of this scale would be challenging. Some of the main issues include the need for significant upfront investment in infrastructure and technology, the complexities of change management and the skills gap that can exist within existing NHS staff.
Overcoming Resistance to Change
Change management is a key part of shifting from an outsourcing to an insourcing model for the NHS. This involves managing the expectations of stakeholders, training staff to take on new roles, and maintaining service continuity during the transition.
Training and Development
Investing in training and development is a big part of the NHS already, but this should include equipping NHS staff with the necessary skills to handle insourced functions. This not only involves technical skills but also managerial and strategic planning capabilities.
Technology and Infrastructure
Developing the right infrastructure, including IT systems and management tools, is key for supporting insourced services. This technology must be robust enough to handle the NHS’s complex data and service delivery needs.
Case Studies and Success Stories
Several NHS trusts have successfully transitioned to insourcing models, bringing services such as patient catering, facility management, and even some clinical services in-house. One excellent case study clearly demonstrates how insourcing can be a success for the NHS. Radiotherapy treatment was becoming more challenging to deliver, with a rise in patient waiting times and a need to use radiotherapy staff for department protocols and research.
Our team at Globe Workforce Solutions created a bespoke solution that incorporated a project manager and clinical lead to tackle the implementation and delivery. This provided the NHS Trust with a full end-to-end team of clinicians alongside management of integration to make use of out-of-hours capacity on-site. With a team of 9 radiotherapists, we successfully removed the patient backlog over 3 months. It worked so well that the service has been extended to continue to run, ensuring that patient treatment here meets NHS targets.
Helping the NHS Do More With Insourcing
The move from outsourcing to insourcing within the NHS is a significant shift towards a more controlled, efficient, and patient-centred approach to procurement. By focusing on building internal capabilities, the NHS aims to deliver higher-quality care while also fostering local economic growth. This transition, while challenging, promises to redefine the operational capabilities of the NHS, ensuring it remains one of the world's leading healthcare providers in an era of rapid change and innovation.
If you have any questions about insourcing get in touch or would like our help to create a tailored insourcing solution for you, then please get in touch with our team at Globe Workforce Solutions today for more information.
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