Alex Chilvers, Operations Director,18 Weeks Support

Trusts are under increasing pressure to improve service delivery, while undertaking significant cost-cutting measures; traditionally outsourcing has been a way to tackle such problems. Outsourcing can be flexible and permits Trusts to gain access

to additional clinical capacity to reduce patient waiting times. However, these benefits often come with a heavy price tag and potential patient safety concerns. Research suggests that using private providers who charge above the national tariff is simply a “quick fix” that adds to the Trust’s problems. Recent research by the Centre for Health and Public Interest (CHPI) found that Trusts struggle to monitor such contracts and that it is difficult to know whether a provider is ‘cutting corners, or reducing quality in order to gain extra revenue.’


A new solution

Insourcing is a relatively new concept but one that is beginning to gain significant traction with the NHS. At 18 Week Support our consultant led clinical teams are brought in to work directly within the Trust, and in collaboration with existing in-house teams. This solution has a number of benefits over outsourcing.


By utilising any spare assets or capacity within a Trust, the 18 Week Support insourcing allows for a high volume of patients to be seen in a relatively short space of time. This can help a Trust clear backlogs, and simultaneously meet an increase in demand.


Paradoxically, more activity leads to more income and reduced waiting times. Moreover, insourcing may be delivered below the national tariff, any savings can be passed directly on to the Trust. By bringing in our external clinical and management expertise to work alongside a Trust’s own clinical and operational teams, there is the added bonus of creating a shared learning experience and boosting staff morale – another major NHS concern, and one which is inherently tied to performance. Insourcing also enables the Trust to retain overall control over service delivery; by seeing patients within a hospital’s own setting, the Trust can monitor the safety and success of these services and any concerns or complaints can be dealt with quickly.


Enhanced patient care

Insourcing also makes better use of existing resources. There is a greater continuity of care and improved patient flow as patients are seen within the Trust’s own setting and managed from referral through to discharge. Equally, research has indicated that patients prefer to be seen at an NHS Trust rather than a private setting, reducing the risk of patient non-compliance and high cancellation rates. DNA rates for an insourced solution are also consistently lower than for outsourcing. We have also found that if the Trust manages the back-office administrative support, there is no risk to patient confidentiality or issues of information governance. Administrative errors, such as duplicate bookings, can be avoided, meaning precious resources are not wasted.

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