Case study: Insourcing solutions to streamline patient flow and deliver savings in Norfolk

Case studies

Insourcing solutions to streamline patient flow and deliver savings in Norfolk


The waiting lists generated by the Covid-19 Pandemic and subsequent recovery period continue to have a significant impact on NHS trusts and the patients they care for. A robust strategy is required to reduce these waiting lists, which often includes insourcing arrangements.

Insourcing covers a range of medical and clinical services, with the aim to bolster service outputs and improve efficiency. These services are typically provided providers with the specialist capabilities needed to deliver an end-to-end service, including clinical governance and oversight.

Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) was under significant pressure to add capacity to their surgery pathway. In 2022 NNUH had a single Insourcing contract. Due to waiting list numbers this increased to a peak of 10 concurrent Insourcing contracts in early 2023. Due to operational pressures and release of finances, these were at times by necessity short-term, last-minute contracts that did not always allow trust staff or suppliers to plan resources effectively and deliver optimal value.


NNUH worked with the Hub’s Workforce team, who as a partner in the NHS Workforce Alliance, used the Insourced Services framework to identify suppliers and develop a bespoke, robust contract to meet their insourcing requirements.

This led to a standardised contract utilised across the trust, so that no potentially detrimental additions or amendments to the core terms were present, as well as supporting improved internal processes and governance.


Through their work with the Hub’s Workforce team and the NHS Workforce Alliance, NNUH was able to consolidate their Insourcing spend from 10 contracts to three, which covered their requirements for the remainder of the financial year.

Through challenging suppliers for better pricing, two of the three contracts delivered a 7.5% reduction in pricing.

NNUH are also benefitting from the improved protection which the NHS Workforce Alliance framework provides in terms of Clinical Negligence Scheme for Trusts – with all Insourcing contracts being to standard terms and conditions.

NNUH and the Workforce Alliance continue to work together to manage the contract and ensure the best outcomes are made available for the trust and the patients using the services. Future engagements will be formed on the back of the high level of co-operation and collaboration on the shared enterprises, and have helped develop a regional template of contract and best practice in this regard.

James Anderson, Head of Clinical Procurement, Norfolk and Norwich University Hospitals NHS Foundation Trust, said:

“Matthew (Green, Procurement Specialist in the Hub’s Workforce team) has been incredibly supportive over recent months, and we are grateful for this. It is the expertise that Matthew has provided us which have resulted in us improving our own knowledge on Insourcing contracts, and consequently improving our processes and governance when assessing the award of an Insourcing contract.

"All of this gives us more confidence, and a suitably robust governance process to apply to our contracts. Without Matthew’s advice, guidance and help in identifying risk, this would not be in place.”

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