NHS trusts have paid almost £1bn to private healthcare companies to run extra services in their own hospitals.
We found out where the money is really going.
What is Insourcing?
It’s a confusing term. Normally it means bringing outsourced work back in-house. The NHS uses it differently.
NHS insourcing means paying a private company to treat NHS patients, inside NHS buildings, usually run by NHS staff working extra shifts. To a patient, it might look no different to normal NHS care. But the money doesn’t stay in the NHS. It goes to a private company, often (as our investigation has discovered) owned by a private equity firm.
Where does the money go?
Follow the money, and it leads to private equity.
Medinet and HealthHarmonie, two of the biggest insourcing providers, were bought by the European private equity firm Fremman in 2023. NHS trusts have paid these two companies more than £126m over the last three years.
18 Week Support, the second largest provider, has received more than £107m from NHS trusts since being bought by the US private equity firm Summit Partners in 2022.
Acacium Group, which trades as Xyla, has been paid more than £200m by NHS trusts and is now controlled by the Canadian private equity firm Onex.
One private equity firm didn’t hide its interest. It told investors that “persistent NHS capacity constraints” made the health service an “attractive market”. Patients waiting longer for care isn’t a problem to these firms. It’s a business opportunity.
Where is the pressure worst?
Gastroenterology, dermatology and radiology rely on insourcing more than any other area, and these are also areas with some of the NHS’s longest waits.
The three trusts that spent the most on insourcing over the last three years are Northern Care Alliance, University Hospitals Sussex and Mid and South Essex NHS Foundation Trusts.
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