Insights from Chris Sleight, Ambassador for Diagnostics Services at Health Now
Across the NHS, the pressure to reduce backlogs while maintaining high-quality patient care has never been greater. Trusts are being asked to do more, faster, often with limited internal resource and increasing operational complexity.
For many years, the go-to solutions have been familiar: recruit locums or outsource work externally. But as systems evolve, so too must the approach.
We sat down with Chris Sleight, Health Now’s Ambassador for Diagnostics Services and a highly experienced NHS leader, to explore why insourcing is increasingly being recognised as a more effective, lower-risk solution.
The Hidden Burden of Traditional Locum Models
For many NHS managers, bringing in locum staff has long been the default response to capacity gaps. But as Chris explains, the reality is often far more complex (and costly) than it appears on the surface.
“Bringing locums in was always challenging and carries risks. Even if you could find an available locum, you had to put them through all your local processes (governance, training, induction) and you’re paying them while they’re not even being productive.”
Beyond the administrative burden, there’s also the question of consistency and quality.
“You never really knew what you were getting. You could get someone who was excellent, but also you could recruit someone who takes many days to get up to speed and then leaves before they even become fully productive; and this carries the additional risk of demotivation your substantive workforce.”
While locums can play an important role, relying on them as a primary solution introduces variability, risk, and operational strain.
Outsourcing: Fast, But at What Cost?
Outsourcing (particularly in diagnostics) has grown rapidly, offering fast turnaround times and scalable reporting capacity. On paper, it solves a critical problem.
But Chris urges Trusts to look beyond speed alone.
“Yes, you might get a report back in a very swift response time, but you lose elements of control. If a clinician wants to challenge that report or have a conversation with the reporter, it can become infinitely more difficult than if you report in house.”
This disconnect can have real clinical implications.
“If something doesn’t quite fit the clinical picture, it becomes critically necessary for best patient care for the requestor to speak to the person who reported it. But if they are on the other side of the world, at 2am, that’s not going to happen.”
There are also broader governance considerations.
“When patient data leaves your organisation, even digitally, you introduce and increase information governance risks. Questions around ownership, security, and accountability all need addressing.”
While outsourcing can provide short-term relief, it often creates new challenges around continuity, communication, and control.
Insourcing: A More Balanced, Lower-Risk Model
Insourcing offers a fundamentally different approach, one that combines additional capacity with operational alignment.
Rather than sending work out, insourcing brings vetted, specialist teams into the Trust environment to work alongside existing staff, using internal systems and governance processes.
For Chris, this is where the model truly stands apart.
“With insourcing, you are getting high-quality staff who are already vetted, already compliant, and ready to work. If there’s an issue, you go straight back to the provider, they carry that risk for you.”
This shift in responsibility is significant.
“With insourcing, you are not carrying the risk of recruitment, onboarding, or performance. That’s managed for you, while you still retain full control of your service.”
What about cost implications?
Chris also commented:
“One of the obvious concerns for NHS managers when considering insourcing would be the costs. But you need to look at the overall value for money the model offers including the hidden costs of other approaches. In my opinion insourcing is a much better value for money model than the cost of failed recruitment, continual recruitment of locums, or risking “burnout” of your own workforce with increased overtime or extended hours. Coupled with the clear clinical benefits, insourcing is a model anyone with capacity and demand pressures simple must consider.”
Protecting Turnaround Times and Patient Outcomes
One of the most compelling advantages of insourcing is its direct impact on patient care.
Chris is clear: delays in diagnostics don’t just affect performance metrics, they affect outcomes.
“Anytime you’re sending work out, there’s an increased risk of prolonging turnaround times compared to work being performed “in house”. That will lead to delays in diagnosis, delays in treatment, and ultimately worse outcomes and prognosis for patients.”
By increasing on-site capacity, insourcing helps maintain (or even improve) turnaround times.
“You’re effectively increasing your workforce back towards a full-time equivalent, or expanding to meet demand. That means reports are done quicker, decisions are made faster, and patients are treated sooner.”
Solving Both Sides of the Diagnostic Bottleneck
In areas like radiology, the challenge is rarely singular. As Chris explains, there are often two bottlenecks:
- Getting patients scanned (Image acquisition)
- Getting those scans reported (Image reporting)
“You’ve got two waiting lists. If you only fix one, you can create pressure on the other – for example by training your radiographers to do in house reporting – as the old saying goes – You’re robbing Peter to pay Paul.”
Insourcing allows Trusts to address both simultaneously, whether that’s increasing scanning capacity, reporting capacity, or both.
“Ultimately, you need enough staffing resources, even with digital systems and AI to support workflow. Insourcing gives you that flexibility, without compromising your existing workforce.”
A Better Experience for Patients
Beyond operational efficiency, insourcing also improves the patient experience.
“If you don’t have insourcing, and you lack image acquisition capacity, patients often have to go elsewhere for scans and that’s usually inconvenient.”
Keeping care within the local Trust (or within local community diagnostic centres) reduces travel, improves accessibility, and maintains continuity of care.
Certainty, Stability, and Partnership
Perhaps one of the most underrated benefits of insourcing is the certainty it provides.
“If you sign a contract for three radiographers for six months, you know you’ve got that capacity. You’re not worrying about someone leaving or having to recruit again. Even if someone “leaves”, the insourcing company fill that gap to maintain the contacted levels”
This reliability allows teams to plan with confidence and focus on delivering care, rather than constantly firefighting staffing gaps.
A “Win-Win” for Trusts and Patients
For Chris, the conclusion is clear.
“It’s a win-win. It strengthens your staffing levels, reduces risk, and maintains turnaround times. And for patients, that means faster diagnoses and better outcomes.”
While no single solution will solve every challenge facing the NHS, insourcing represents a practical, scalable, and clinically aligned approach. One that supports both operational performance and patient care.
Interested in how insourcing could support your service?
Health Now works in partnership with NHS Trusts to deliver high-quality, consultant-led insourcing solutions across diagnostics, medicine, and surgery. Contact our team on 020 3343 5971 or email info@healthnow.co.uk to learn more.