The BRILLIANT solution to the ever increasing problem “NHS Waiting Lists”.

There is no end to the Waiting lists and it is ever increasing. The Trusts on the other hand have got a double edge sword to deal with: Improve service delivery efficiency and cut down costs. The pressure intensity amplifies when care delivery misses the target time, summing to a penalty of up to £5000 per patient per month, under the new NHS “fining” regime.


Outsourcing – The obvious solution since old times – But how effective is it?

For a long period of time, one of the obvious answers that immediately comes to mind is OUTSOURCING. But many a times on critical analysis, it’s effectiveness has been posed with a big question mark. Let’ see why?


Any time availability
Extra clinical capacity
Reduce waiting Times


Patient Safety Risk
Patient confidentiality Risk
Patient Journey and hassle
Highly Expensive (Rates above national tariff)
Does not address all issues. More of a Quick Fix
Extra resources & admin for monitoring such contracts

The Centre for Health and Public Interest (CHPI) in their recent research found that Trusts find it a struggle to monitor Outsourcing contracts and that it is difficult to know whether a provider is ‘cutting corners, or reducing quality in order to gain extra revenue.’ (Source: as on 09.04.2016, 14:50hrs)


A relatively new concept but makes sense in so many different ways that it is a Win-Win situation for all stake holders.
The concept involves an arrangement where the provider performs the clinic “In House”. The Clinical team comes to the Trust/ Hospital Premises, sees the patient, performs procedures if necessary and updates clinical records within the hospital on a regular basis in collaboration with the existing clinical and management team of the Trust/ Hospital.
This is a perfect arrangement where the rewards and advantages in comparison to Outsourcing are huge.

Efficient cutting down on waiting times
Better utilization of existing hospital resources (By using existing clinical rooms & admin of the hospital)
No hassle for patients, better, safer and more efficient Care
No delay in updating Patient information PAS on hospital records and clinical correspondence & letters
No risk to patient confidentiality
No more heavy admin burden on Trust with contracts & monitoring as in Outsourcing
Less Risk on Organisational Reputation

This concept has become immensely successful because of 4 main factors:
1. It paves way for large patient numbers to be seen within a short span of time and availability of more clinical rooms multiplies the volume with tremendous effect on diminishing back log.
2. The concept reduces waiting lists at a fast pace with least expenditure on expenses (both admin & funds).
3. To top it off with a cherry, more activity leads to more income as the insourcing can be delivered at or often below the national tariffs along with much less waiting times and away from the shadow of penalty threats levied by commissioners. Thus the savings can be directly passed on to the Trust.
4. Insourcing pools expertise from different sources under one umbrella and working alongside the Trust’s own clinical & operational team brings in room for shared learning experience and morale boost for all staff involved.
The bonus is that the Trust still retains overall control of the service delivery making it much convenient for monitoring the processes within their own premises ensuring safety, confidentiality and a prompter quality care. There is better continuity of care and much efficient patient flow as management from referral through to discharge occurs within their premises and full control.
Patient satisfaction is maintained at high standards since they would prefer to be catered at the Trust facilities than any private setting. This ensures less DNA and less risk of non-compliance in comparison to Outsourcing.
Moreover, since the Trust manages the admin support for back-office, no risks are posed to delay in updating patient information to hospital records and no risks are prone on patient confidentiality or information governance issues. Since this arrangement avoids admin errors of duplicate booking or incorrect information conveyance, precious resources are not wasted.



It has been a long continued argument from all angles of the public, pressure groups and campaigners that the NHS should remain public and not be sold off to private contractors. This demand is well nourished and respected by the use of insourcing where the utilization of existing Trust resources are maximised clubbed with highly efficient methodology in reducing NHS Waiting Lists and adorned equally by management and clinicians for the savings fed back to the Trust. Any service availability expansion plans including 7 day service, enhanced hour service or extended hour service can be efficiently attained without negotiating with Trust staff who may not intend to avail themselves for extended or enhanced hours.
(Reference – –Facilities management)