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NHS Workforce Alliance Insourcing Framework: How It Reduces Waiting Lists

27/02/2026
Healthcare Management , Insourcing Services , NHS and private hospitals
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The NHS offers a universal care promise, but even with superior infrastructure, the capacity is not always translated into treated patients. Demand for clinical services continues to increase, while staff shortages overwhelm NHS teams. NHS trusts look for clinical teams that run additional lists safely and consistently using the insourcing model.

The NHS Workforce Alliance Insourcing Framework provides a compliant and operational route for NHS hospitals to bring in fully governed clinical teams to deliver clinical activities on-site. It allows these organisations to increase productivity without capital expansion or long procurement cycles.

In this blog, let’s explore how the NHS Workforce Alliance framework is a practical tool for accelerating elective recovery.

What is the NHS Workforce Alliance Insourcing Framework?

Insourcing allows NHS trusts to tackle backlogs and retain capacity planning in-house by extending medical and clinical services using spare and out-of-hours capacity within the trust. Medical or clinical providers with specialist capabilities deliver these end-to-end services compliant with the NHS workforce alliance framework.

The framework for insourcing services supports the Provision of Healthcare Services by the NHS and public bodies. It’s free to access and offers support for the delivery of clinical services to meet waiting time targets. For adult and paediatric patient services, the NHS Workforce Alliance insourcing framework provides access to various services such as:

  • Diagnostics and diagnostic imaging
  • Dermatology
  • Cardiology
  • Endoscopy
  • ENT
  • General and specialist surgery
  • Gynaecology
  • Ophthalmology
  • Urology
  • Orthopaedics
  • Physiotherapy

The framework provides a cost-effective and compliant solution to contract with providers for working alongside NHS teams. The consistent standards of the framework ensure appropriate delivery of services with NHS compliance.

Why NHS Waiting Lists Keep Growing

In the UK, NHS waiting times for healthcare have risen to critical levels. Waiting list balloons due to the following reasons:

  • Volume of new referrals continues to grow due to an ageing population with increasingly complex needs that outpace completed treatments.
  • Chronic staff vacancies exist across specialities, limiting the number of consultations and procedures that can be performed.
  • Hospitals experience a significant backlog in terms of investment for hospital expansion and maintenance, leading to limited estate and a lack of modern equipment.
  • Bed blocking continues to increase as the capacity gap in adult social care is on the rise.
  • Administrative complexities and outdated IT systems hinder the ability of the NHS staff to perform efficiently.

How the Workforce Alliance Insourcing Model Works

The NHS Workforce Alliance’s insourcing model provides a procurement framework. NHS hospitals can use it to hire external clinical teams for delivering clinical services within their hospital premises during spare capacity hours, like evenings and weekends. The end-to-end clinical service model works in the following manner:

  • Services are performed on the NHS premises using existing hospital infrastructure.
  • The provider supplies a multidisciplinary team, which can include consultants, nurses, and support staff, to work alongside NHS regular staff.
  • The provider is responsible for clinical oversight, including liability, while the trust continues to retain control over patient pathways and records.
  • Contracts are typically based on specific deliverables, for example, completing 20 diagnostic scans per day.

The NHS Workforce Alliance Framework RM6276 simplifies the insourcing process by providing a list of pre-vetted suppliers who are pre-checked for quality, compliance, and NHS Employers Check Standards. Insourcing cost is generally set at a discounted NHS National Tariff with a flexible contracting option through Direct Award (choosing a provider directly) or Further Competition (securing the best value provider).

Adhering to the framework, the trust identifies the backlog area and selects a provider from the pre-vetted suppliers. The direct award option speeds up the process while ensuring compliance with the framework. Once the call-off contract is signed, service mobilisation begins. The chosen insourcing provider completes activity delivery and reports to the NHS.

How Insourcing Reduces NHS Waiting Lists

The insourcing service providers, once contracted, start activating existing hospital resources outside of core hours, such as in the evenings and weekends, for service deliveries. They bring external clinical teams to work on-site so that NHS trusts can increase their patient throughput without additional overhead costs or patient disruption.

Insourcing reduces waiting lists by running additional sessions in NHS trusts’ operating theatres, diagnostic suites, and clinics. Insourcing enables NHS trusts to meet the 18-week Referral to Treatment (RTT) targets by having clinical teams fill individual gaps. While the NHS retains control, the insourcing provider manages the entire patient pathway, ensuring efficiency and high volume. Patients experience faster treatment at their own hospital with continuity of care.

Key Benefits for NHS Trusts

NHS Trusts can strategically expand clinical capacity and maintain strict operational and financial control with an insourcing model. Using the NHS Workforce Alliance framework to hire insourcing providers offers the following benefits:

  • Increased utilisation of theatres and diagnostics
  • Faster elective recovery
  • Pressure relief for substantive teams
  • Reduced reliance on high-cost ad-hoc staffing
  • Tariff-aligned service delivery
  • Continued control of patient pathways
  • Continuity of care for patients at their local hospitals by teams they already trust
  • Reduced pressure on NHS staff

When the Workforce Alliance Framework Works Best

When the NHS trust has the physical capacity but lacks the staff to use it, the Workforce Alliance Framework offers the best solution. It is ideal in the following scenarios:

  • Out-of-hours capacity: Hospital facilities are used during evenings and weekends when they are dormant, so that the infrastructure gets used for patient service delivery.
  • Rapid elective recovery: Allows NHS trusts to meet their 18-week standard RTT targets by mobilising a full clinical team quickly.
  • Specialised backlogs: High-volume and low-complexity procedures can be quickly delivered by insourcing providers.
  • Budgetary constraints: When NHS trusts don’t have funds for expensive outsourcing or agency staffing, the insourcing model works as services are priced at or below the NHS national tariff.

Insourcing is a short-to-medium term solution that can work well for 6-12 months. However, long-term staffing shortages must be met using recruitment and training initiatives. Also, when NHS trusts already operate at full capacity, the insourcing model may not be the ideal solution.

NHS Insourcing Services in Wolverhampton

The right insourcing partner acts as an extension of the NHS team. Their multidisciplinary workforce supply caters to the varied patient needs in the NHS hospitals. By partnering with a locally responsive provider, NHS teams can reduce risk, stabilise services, and reduce pressure on substantive staff. Explore NHS Insourcing Services in Wolverhampton offered by Secure Healthcare Solutions for expanding elective capacity with existing NHS infrastructure in a low-risk and compliant manner.

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