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 thirdparty organisations to deliver medical services or procedures within NHS facilities. It differs significantly from locum or agency staffing 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.
5. Collaborative learning:
Insourcing fosters collaboration between NHS staff and external clinical teams, promoting knowledge-sharing and skill transfer. This approach not only addresses immediate needs but also contributes to long-term improvements in service delivery and professional development.
The Portland Clinical approach: Next Generation
Insourcing At Portland Clinical, we pride ourselves on being more than just a service provider— we are trusted partners to the NHS. Our delivery model is built on a ‘More Human Healthcare’ ethos, prioritising personal connections and long-term relationships over a corporate approach. This philosophy allows us to work seamlessly with NHS Trusts and Health Boards, aligning with their unique needs and goals to deliver exceptional patient care.
Our Next Generation Insourcing model goes beyond the traditional scope of insourcing by offering a fully managed, end-to-end patient pathway solution. This bespoke service enables NHS Trusts and Health Boards to address their specific departmental demands while improving efficiency, safety, and outcomes.
Our senior leadership team, with decades of combined clinical and operational experience, supports NHS Trusts and Health Boards in optimising resources, managing demand, and tackling elective care backlogs. Each member of our team undergoes a rigorous onboarding process to ensure they meet our high standards for professionalism, quality, and patient safety.
Through our Next Generation Insourcing approach, we help NHS Trusts and Health Boards deliver care that is:
- Safe and compassionate: Patients receive high-quality care tailored to their individual needs.
- Efficient and scalable: Our flexible delivery model can accommodate varying demands, from small-scale interventions to large-scale backlog reductions.
- Collaborative and innovative: We work alongside NHS staff to design and implement solutions that drive long-term improvements in patient pathways.
Case Studies: Delivering Results Nationwide
1. South Coast Multi-Site NHS Trust: Reducing Waiting Times Across Multi-Specialties
Portland Clinical partnered with a large multi-site NHS Trust on the South Coast to address backlogs in ENT, Oral and Maxillofacial, Gynaecology, and General Surgery. Over a six-month period, this collaboration enabled the Trust to deliver over 9,000 additional appointments, significantly improving access to critical treatments and surgeries. Our Next Generation Insourcing model also included triage support, patient booking services, and weekday on-site clinical management, demonstrating the transformative impact of effective collaboration.
3. East of England, NHS Trusts: a comprehensive solution
Portland Clinical mobilised a highly experienced team to support dermatology services across two NHS Trusts in Eastern England. In 2024 alone, we delivered 16,435 outpatient appointments and 5,525 minor operations, dramatically improving RTT positions and reducing patient waiting times. Our dedicated clinicians, working seamlessly with local teams, provided robust, long-term solutions to the backlog while maintaining high standards of care.
4. Southwest, NHS Trust: an integrated approach
In the Southwest, Portland Clinical implemented a specialised hernia pathway for 400 patients. This bespoke service included a Pre-Op OneStop clinic with anaesthetic reviews, followed by weekend surgeries. By considering estate layouts, streamlining booking processes, and integrating Trust team members into the delivery model, we optimised the patient journey. Patients were triaged for surgery during their Pre-Op Assessment and informed of their surgery date before leaving, ensuring a smooth and efficient process.
Driving elective recovery forward
At Portland Clinical, we are deeply committed to helping the NHS address its elective care challenges. Our clinically led and collaborative approach ensures that every patient pathway is designed with safety, efficiency, and compassion at its core.
The adaptability of our Next Generation Insourcing model allows us to scale our solutions to meet the unique demands of different Trusts, whether it’s supporting a cohort of 200 patients or addressing backlogs of over 20,000. By prioritising collaboration, innovation, and patient-centred care, we empower NHS Trusts and Health Boards to deliver lasting improvements in service delivery and outcomes.
As the NHS continues to navigate the pressures of elective recovery, Portland Clinical remains a trusted partner in reducing waiting times, improving patient access, and ensuring that every individual receives the high-quality care they deserve
More Human Healthcare
Partner with Portland Clinical to tackle your elective care challenges. Our bespoke, clinically led solutions are designed to reduce waiting times, optimise resources, and enhance patient care. Discover how our innovative Next Generation Insourcing model can support your Trust or Health Board.
Make a difference with Portland Clinical
Are you passionate about delivering exceptional healthcare and making a real difference in patients’ lives? At Portland Clinical, we’re always looking for dedicated professionals to join our growing team. Whether you’re a clinician, an operational expert, or a specialist in healthcare delivery, we offer a supportive environment where you can thrive. Join us and Tony Corner, our Medical Director, in leading the charge to reduce waiting lists and provide high-quality, compassionate care.
Portland Clinical
Tony Corner, Medical Director
0208 150 2221
tony.corner@portlandclinical.co.uk
www.portlandclinical.co.uk
Reference
1. Statistical Press Notice. NHS referral to treatment (RTT) waiting times data. September 2024. Published Thursday 14 November 2024 england.nhs.uk
