Insourcing vs. Outsourcing

What’s best for your NHS Trust?


The COVID-19 Pandemic has brought unprecedented challenges for the whole of society, the NHS is still trying to achieve a comprehensive understanding of the impact Coronavirus is having on the health of the nation.

Recently released figures show the huge challenges the NHS faces in the next couple of years, of trying to regain control over hospital waiting lists.

There is much discussion about what the options are for the NHS - Outsourcing and Insourcing are two options being considered and whilst you may know what Outsourcing is, Insourcing is a relatively new workforce solution.

So, what are they and what’s the difference?

Whilst both methods appear similar on the surface; both offer to reduce waiting lists and are available for a wide range of specialties.

With both options, a full external team is used - from nurses to consultants and receptionists, who must deal with the backlog of patients and the waiting list backlog at each Trust.

How do they each work?

Insourcing brings the team into your trust and hospital and works through unused wards. Generally, what happens is the insourcing team will come in over a full weekend when certain wards and equipment aren’t being used to utilise the free space.

  • Insourcing - outside company, outside staff, own hospital
  • Outsourcing - outside company, outside staff, outside premises

Outsourcing is slightly different, whereby the outsourcing team will work out of a separate location rather than your own trust and hospital facilities - although due to the site being used and not being your own, there can be higher costs associated with Outsourcing compared to Insourcing.

From the patient’s point of view, they often prefer and appreciate being treated and seen to in the same location they were previously.  The familiarity can be comforting and with some of the treatments being carried out by insourcing teams, such as cancer treatment or pain management, comfort can be extremely important.

These are details that you can discuss with your potential suppliers - Despite the lack of familiarity, the Outsourcing location may be a convenient location for the patients and preferred, but the flip side is that it may be inconvenient, which makes the quality of the ‘patient experience’ decrease.

What is the best option for your Trust?

This can differ from trust to trust and what is needed on an individual basis. Both Outsourcing and Insourcing, provide different benefits to tackling the waiting list crisis.

Following Protocol

Whether it be Insourcing or Outsourcing, these agencies will be representing your trust. With Insourcing, you can work closely with the supplier to fine tune the work and develop working relationships with the staff.  This is needed so that all parties are getting the most out of the partnership and you can see first-hand the quality work and service that the supplier is providing.

For example - when working with Agile Workforce, you will get regular meetings to review patient feedback to ensure standards are being upheld, as well as reviewing performance against KPIs. These regular meetings may allow you to have more time away from the Insourcing department to deal with other things, with updates on progress coming to you in the regular meetings.

With Outsourcing at a separate site, you may not get to create the same working relationships and will be less available to visit and have visibility along the process.  However, if you have full trust in their service, it will allow you time to do other things that you may otherwise be spending at the site.

Cost Reduction

As well as the reduction of waiting list times, another merit is the potential cost savings that you can gain through these partnerships. Whilst both Insourcing and Outsourcing have their individual benefits based on the agency, Insourcing is generally more cost effective, as you’re bringing in an experienced team to your own premises, rather than Outsourcing to a private provider where they have the cost of their site on top.

High levels of patient satisfaction

From the patient's point of view, they can often prefer and appreciate being treated and seen to in the same location that they have been doing previously, the familiarity can be comforting, and with some of the treatments being carried out by insourcing teams, treatments such as cancer treatment or pain management can benefit from Insourcing, where comfort is often extremely important.

Fast Implementation

Sometimes the need for an external agency can be anticipated and you can set up a partnership well in advance, but at other times, situations of need are sprung upon you. When looking for your Insourcing/Outsourcing provider, it may be important for you to know what their implementation time is. This can vary from Agency to Agency, but Agile Workforce are experienced in quick, robust, and easy implementation from 2-4 weeks depending on the scale.

There’s no one right answer for which option is best for your Trust, often a combination of the two solutions will help address the waiting list challenges across the wide range of specialties.


You need to consider whether or not you can provide a better service.  If you have the resources and expertise to provide a good service, then insourcing is the option for you.

If this is not the case, and similar services have successfully been outsourced to private providers who have a different skillset and expertise to contracting authorities, then it makes sense to outsource to the providers.

If you would like to talk to the team about Insourcing solutions for your Trust, please contact us on 01756 860095 or

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