Insourcing vs Outsourcing NHS: Key Differences Explained

NHS trusts manage diverse types of hospitals, clinics, and specialist services in England. The increasing patient demand, tighter resources, and increasing cost of healthcare make it harder for the NHS to keep services accessible to patients. 

Therefore, NHS trusts look for solutions to organise work, execute day-to-day solutions, and take care of patients without any compromise. 

For this purpose, two approaches are commonly used — insourcing and outsourcing. Both extend capacity, but they work in different ways, impacting hospitals and patients differently. In this blog, we have explained insourcing vs outsourcing in the NHS, their meanings, differences, and the insourcing advantage. 

What is insourcing in the NHS?

Insourcing in the NHS is a service arrangement where an external clinical provider delivers necessary clinical services inside the premises of an NHS trust. 

Depending on the needs, the provider uses theatres, clinics, or diagnostic centres of the trust and provides patient services using a whole team of doctors, nurses, anesthesiologists, and others. 

NHS retains full control of governance, patient records, and pathways. The provider brings their own staff and works in sessions, while the activity remains within the NHS systems. 

Patients don’t go anywhere, and often, patients won’t even know that they are getting services from insourced staff. 

More commonly, trusts use an insourcing model for fulfilling services like endoscopy, outpatient work, elective procedures, and diagnostics when they need extra capacity on the NHS grounds. 

What is outsourcing in the NHS?

When the NHS contracts external providers to deliver healthcare services on behalf of the NHS, but outside of the NHS services, it’s called outsourcing. The third-party provider is responsible, under contract, for staffing, equipment, and service delivery. 

In outsourcing, the NHS monitors standards, but patient pathways are self-managed by external providers. While external providers are still expected to follow NHS guidelines, the control is minimal. 

Often, patients have to be moved to these external facilities for diagnostics, outpatient clinics, elective surgery, or even routine care when an outsourcing model is used to extend capacity or access specialist facilities. 

Now that we have defined insourcing and outsourcing, we will show you the differences between the two in the next section. 

Insourcing Vs Outsourcing NHS: Key Differences

Here are the key differences between insourcing and outsourcing in the NHS:

Type of Care	Level of Independence	Type of Support Provided	Living Arrangement	Best Suited For
Assisted Living	Moderate to High	Help with daily tasks such as cleaning, meals, and medication reminders	Private flats or apartments with shared communal areas	Older adults who want independence with light support
Residential Care Home	Low to Moderate	24-hour personal care, meals, and supervision	Private or shared rooms in a managed facility	Seniors needing regular personal care but not medical treatment
Nursing Home	Low	24-hour nursing and medical support	Managed facility with healthcare staff	People with complex medical needs or ongoing conditions
Home Care (Domiciliary Care)	High	Carers visit at home to help with personal tasks	Individual’s own home	Those who wish to stay at home with flexible support hours
Retirement Housing (Sheltered Housing)	Very High	Minimal or no personal care; emergency call systems available	Self-contained flats or bungalows	Independent seniors who need a secure and social environment
Insourcing – Location	On-site	Work takes place inside NHS premises	NHS facilities	Trusts wanting care delivered internally
Outsourcing – Location	External	Work shifts to an external provider’s site	Provider’s facilities	Trusts lacking space or resources
Insourcing – Control	High	NHS oversees pathways, records, and governance on-site	NHS-managed environment	Organisations needing full operational control
Outsourcing – Infrastructure	Provider-dependent	Uses the provider’s own space, staff, and equipment	External infrastructure	When specialist facilities are required
Practical Use (Comparison)	Varies	Insourcing: when space exists. Outsourcing: when rooms or specialists are lacking	Mixed	Decision-making for NHS operational planning

While both extend capacity and provide clinical support teams, NHS trusts choose insourcing more often for the reasons given below.

Why NHS Trusts Are Choosing Insourcing in 2025

Some of the reasons why NHS trusts prefer insourcing are:

• Long waiting lists and capacity pressure: Many trusts are under intense pressure from growing patient wait lists and unmet demand for diagnostics or elective care. With insourcing, they can use spare theatre and clinic capacity during evenings or weekends to service more patients on-site.
• Better resource utilisation: Underused resources like theatres, diagnostic suites, or clinics can be used by external teams to make better use of the trust’s infrastructure to provide core patient services.
• Oversight and continuity of service: Services remain on trust premises, under the purview of the NHS body, so that control over pathways, governance, and records continues to adhere to NHS England’s guidance.
• Cost-effective: Compared to agency staffing and external providers, commissioning services allows trusts to save money while using their own unused estate and extend services beyond regular hours.

The staffing partners support NHS trusts with insourcing services with highly trained medical staff for a wide variety of medical and clinical services. 

How Staffing Partners Support NHS Insourcing Services

By providing vetted and skilled external healthcare professionals during evenings, weekends, or out-of-office hours, staffing partners support NHS insourcing services in the following ways:

Improve planning and engagement

Patients can get continuity of care with planned in-source staffing. Communication between departments continues to remain seamless. NHS trusts can scale rapidly in a short time with an insourced workforce. 

Reduce backlog

By instantly expanding the medical team availability, staffing partners help trusts tackle their long waiting lists and backlog to achieve important targets like Referral to Treatment (RTT) benchmarks. 

Provide specialised staff

Highly skilled and pre-vetted medical staff in a wide range of specialities can be placed in NHS trusts needing insourcing services. They can work in diagnostics, allied health professions (AHPs), and elective surgeries. 

Optimise usage of existing facilities

The insourcing staffing partners make full use of the existing NHS infrastructure during underutilised times. It maximises the asset efficiency of NHS trusts without additional facilities or handling the logistics of moving patients. 

Support operational control

NHS trusts retain the full operational command and oversight of clinical governance and patient safety when they use the services of insourced staffing partners. 

Save money long-term

Consistently using insourcing staffing services provides NHS trusts with a more planned and sustained workforce solution. This avoids the need to hire expensive last-minute agency staff or use full outsourcing. 

Stay compliant

Many staffing partners work through approved NHS frameworks, like the NHS Workforce Alliance or HealthTrust Europe (HTE). This ensures compliance with national standards and price caps. 

While insourcing is a natural and affordable choice, outsourcing still has value when NHS trusts suddenly need external support. 

When Outsourcing Still Has a Role

Even though outsourcing healthcare to third parties comes with risks for NHS trusts, it’s still needed in the following conditions:

• Insufficient in-house capacity during major theatre bottlenecks
• Sudden need for specialised infrastructure, which otherwise can be expensive for NHS trusts
• Unexpected demand spikes, like seasonal demand or pandemic backlog, where insourcing staff may not be sufficient
• Need for temporary third-party support until long-term plans are developed

Outsourcing carries high risk, and complex clinical care can become problematic, with less NHS control. That’s why insourcing is automatically preferred, while outsourcing is only used when in-house options are constrained. 

NHS Insourcing Services by Secure Healthcare Solutions

NHS trusts looking for ways to unlock extra capacity can make use of NHS Insourcing Services in Wolverhampton, offered by Secure HealthCare Solutions. 

Our framework-compliant service model provides full-fledged clinical teams with pre-vetted staff. We deliver care within the premises of the NHS trust using existing equipment and estate. So, this can be an ideal solution to manage an increase in demand while ensuring compliant patient care.