How does it work?

The Insourcing of Clinical Services Framework aims to support the increasingly popular use of medical insourcing across the NHS to secure extra clinical capacity to meet increasing demand. This short to medium-term solution allows trusts to retain capacity planning in house and ensure patients can be seen within the trust or via a remote/virtual consultation if appropriate. There are many benefits to this clinical insourcing framework, including increased visibility of the patient pathway and greater resilience of local services.

Specialties provided

Gastroenterology and endoscopy

Our team of expert consultant gastroenterologists and endoscopy trained nursing teams can provide additional support to hospitals at the weekend and midweek if required. We can manage the entire patient pathway from first attendance in the outpatient department through to endoscopy, follow up and discharge if required, and consistency of clinical teams is assured. Services can be tailored to meet your requirements, including:

  • Gastroenterology outpatient clinics
  • Two-week wait and straight-to-test procedures
  • Symptomatic oesophago-gastro-duodenoscopy, colonoscopy, flexible sigmoidoscopy and banding
  • Surveillance oesophago-gastro-duodenoscopy OGD and colonoscopy


Totally provides expert ophthalmologists and specialist clinical teams to provide outpatient clinics and surgical services.

We can provide a total patient service, including consultation, surgery and aftercare, to include:

  • Cataract and oculoplastic surgery
  • Oculoplastic
  • Outpatient clinics
  • Nurse pre-assessment clinics
  • Glaucoma
  • Medical retina


We work in partnership with hospitals to provide cost-effective insourcing solutions through a full range of surgical services and specialties. We can help you meet the rising demand for surgery including diagnostic procedures to help you reduce waiting times and ensure your waiting list backlog is cleared.

Our solutions can provide surgical services all the way from the patient entering the hospital, to post-surgical clinics following local process using local pathways. Our surgical teams include consultant anaesthetists, consultant surgeons and specialist nurses who will provide high levels of patient care to ensure a quick, safe recovery. Consistency of clinical teams is always assured. Specialties include neurosurgery, orthopaedic, urology, colorectal, vascular, plastic, reconstructive, spinal and gynaecology.



More than half the population is affected annually by skin disorders, and consultations in primary care and elective care continue to rise, driven by the increasingly ageing population, rising expectations of skin appearance and availability of improved treatments.

To help support increasing service pressures we can see patients for the first attendance through to day-case procedures and follow-up. Our consultants will follow all local referral pathways and if required, we also provide a one-stop service to patients from the clinic attendance, with minor procedures services which can be run concurrently with our outpatient clinics.


ENT and audiology

Over nine million people in England are living with some form of hearing loss (Action on Hearing Loss, 2015).

We offer ear, nose and throat (“ENT”) and audiology services which include a full pathway service from first attendance in clinic and pre-assessment to surgery and post-procedure follow-up using specialist consultants and expert nursing teams.



Respiratory diseases place enormous pressure on the acute healthcare system especially during the winter months. Running additional respiratory clinics to support the increasing demand can avoid unnecessary admissions by allowing rapid access to respiratory physicians and specialist nurses to enable stable patients to be managed in the community.

We provide consultant respiratory physicians to support hospitals with outpatient services following local process and pathways of care.



An increase in older adults combined with greater options to manage many inflammatory musculoskeletal disorders is increasing demand on rheumatology services.

Totally provides expert consultant rheumatologists to support hospitals’ outpatient services. Our experts will work in partnership with the local clinicians following local referral pathways and local management plans.


Anaesthetics and pain management

An estimated 14 million people in the UK live with chronic pain. Anaesthesia and good pain management play a vital role in the treatment and rehabilitation of patients.

We offer the full range of anaesthesia and pain management services in areas including:

  • Consultant anaesthetists for all surgical specialties
  • Pain management services