Intended for healthcare professionals


Outsourcing the NHS

BMJ 2015; 350 doi: (Published 19 February 2015) Cite this as: BMJ 2015;350:h875
  1. Gareth Iacobucci, news reporter
  1. 1The BMJ, London WC1H 9JR, UK
  1. giacobucci{at}

Where ideology outstrips performance

Outsourcing in the NHS in England has increased substantially over the past 15 years as both Labour and Tory led governments have pursued policies of divesting frontline care and non-medical support services to external suppliers. Department of Health figures show that the proportion of the overall NHS budget spent on private healthcare providers increased from 2.8% in 2006-07 to 6.1% in 2013-14.1 2 An independent study by Oxford Economics has calculated a growth in the private sector’s turnover from outsourced frontline healthcare services from £6.9bn (€9.3bn; $10.6bn) in 2010 to £12.2bn in 2013.3

Non-medical services such as finance, contracting, and IT have also been heavily outsourced. In 2010, the NHS Confederation estimated that the total spend on “back office” functions across the NHS in England was £2.8bn.4 It suggested that a minimum of £600m of this could be released for frontline care if it was divested from the NHS, presenting a big opportunity for the private sector.

It is difficult to quantify how much non-medical work in the NHS has been outsourced to date, but the direction of travel is clear, with the coalition government’s Health and Social Care Act 2012 set to prompt the full scale outsourcing …

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