This summer saw NHS England waiting lists continue to spiral out of control, reaching a record-high of 7.8 million people. This significant rise, combined with ongoing postponements due to strikes and other factors, has led to an increase in individuals opting to fund their own medical treatments.


According to recent research by YouGov, one in eight Britons have paid for private healthcare services in the last year. In December 2022, the number of patients seeking private medical care was 7.2 million. YouGov’s survey shows 53 per cent of those who went private did so “in order to be seen more quickly” and “around eight in 10 were people who previously would have always or typically used the NHS”.

With the rising demand for private healthcare options further illustrating the pressure on the NHS to address the waiting list crisis, it is more important than ever for public health decision-makers to consider all available options. Insourcing, in particular, can help NHS trusts unlock daily and weekend capacity while also improving quality of care for patients in a cost-effective way.

By providing additional capacity and expertise within NHS facilities, insourcing provides a promising solution to the NHS waiting list challenge. By partnering with insourcing companies, NHS trusts can leverage highly trained specialist teams to use space and equipment that lies unused to clear patient backlogs. In turn, this helps them achieve their current legal target of 65-week waits and the long-term objective of 18-week waitlists for non-emergency healthcare.

Another key advantage of insourcing is the ability to utilise underused resources within NHS hospitals during weekends. Insourcing companies can provide specialist teams to ensure that NHS facilities are operating at their full potential seven days a week. This extended operating schedule offers a significant benefit to patients, including working individuals and those with caregiving commitments who often struggle to find convenient weekday appointment slots. Moreover, by providing full bespoke teams dedicated to performing procedures at the hospital, insourcing ensures not only quality of care but also consistency, in contrast to ad-hoc gap-filling, which is often the case with agency staffing solutions.

Increasing capacity within NHS hospitals through insourcing contributes to the goal of providing localised care, contributing to NHS net zero ambitions. With enhanced resources and specialised teams, more patients can be seen locally, reducing the need for referrals to hospitals further afield and helping NHS patients be seen and treated in NHS environments they know and trust. In addition to helping ensure that healthcare services are accessible to all, regardless of their geographical location, the benefits of insourcing for patients include making visits and family visits easier, especially in rural areas, or for frail or elderly patients who rely on good local public transport links.

Financially, insourcing is a win-win. Companies use NHS equipment and charge lower rates per treatment, making their services productive and financially viable for trusts. Importantly, outpatient visits, diagnostics, and surgical procedures remain free at the point of care for patients, unlike the expensive self-pay charges incurred when turning to private hospitals.

The NHS aims to ensure that 92 per cent of people waiting for non-urgent treatment should wait no longer than 18 weeks from their referral to their first treatment. This was last met in September 2015. With the waiting list crisis reaching a critical point, more and more patients are dipping into their savings to buy private hospital care. The NHS can already tackle the waiting list challenge and ensure that patients are not financially penalised by properly embracing insourcing to address capacity issues, reduce waiting times, and ultimately ensure better patient care.


Claire Dubowski is the Chief Executive Officer of the NHS insourcing company, 18 Week Support. 18 Week Support works with over 50 trusts across the UK, performing over 100,000 procedures annually. More information on 18 Week Support is available here.