Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential cost-effectiveness of NHS insourcing as a means to reduce elective waiting lists.

The Government supports efforts to utilise National Health Service capacity out of hours and over weekends, where it is a cost-effective and sustainable means of delivering additional activity. The most cost-effective route to do this is best determined at a local level, where integrated care boards and trusts can evaluate the options available to them.

We recognise insourcing as an opportunity to maximise productivity and efficiency and published guidance in 2024 to promote the effective utilisation of their services, available at the following link:

https://www.england.nhs.uk/long-read/guidance-for-trusts-on-the-use-of-insourcing/

The guidance is clear that, to promote value for money being achieved, arrangements should be at or below the unit prices set out in the NHS payment scheme. The guidance also asks all trusts to ensure that appropriate due diligence is undertaken before utilising insourcing solutions, including ensuring pay rates are at or below NHS England’s agency price caps.

This guidance sits alongside the Insourcing of Clinical Services Framework Agreement, published by NHS Shared Business Services, which supports local NHS organisations with the timely procurement of services, and which is available at the following link:

https://www.sbs.nhs.uk/services/framework-agreements/insourcing-of-clinical-services/

We have set clear elective priorities for the system in the Elective Reform Plan and 2025/26 Planning Guidance, including that every trust will need to deliver a minimum 5% improvement by March 2026. We expect trusts to be using all levers to deliver this.