Key Summary
- NHS trusts face mounting pressures from hiring freezes, capacity constraints, and administrative demands.
- Framework agreements, such as NHS Shared Business Services, provide compliant structures for outsourcing support functions.
- Connext complements these frameworks with independent contractor agreements, enabling trusts to scale services without permanent headcount increases.
- The real value extends beyond cost savings—flexibility, operational continuity, and resilience remain top priorities.
- Outsourcing clinical back-office work through NHS frameworks positions trusts to maintain quality standards in challenging workforce conditions.
NHS organisations today operate in an environment where expectations continue to rise but resources remain tightly controlled. Funding restrictions and workforce shortages make it increasingly difficult to balance front-line care with the essential but often unseen back-office operations that keep the system running smoothly. Functions such as patient record management, medical coding, claims handling, and scheduling do not attract public attention, yet they are critical for compliance and service delivery.
When hiring freezes are in place, these functions become even harder to sustain. Trusts cannot easily bring in new staff, yet the need for timely and accurate administration continues to grow. This creates operational strain, with existing staff covering more ground and processes at risk of delay. NHS frameworks for outsourcing were designed to give trusts a way to access specialist support in a compliant, structured manner. When combined with flexible service models, these frameworks can make a significant difference in maintaining stability during difficult workforce cycles.
The NHS Back-Office Strain
The NHS workforce is under persistent pressure. The overall sickness absence rate for NHS Hospital and Community Health Services staff (HCHS) was 5.3% in November 2023, unchanged from October 2023, and slightly lower than the 5.5% recorded in November 2022. This creates ripple effects across administrative departments, where backlogs in coding, billing, or scheduling can delay care pathways and financial processing.
Hiring freezes, often introduced as part of cost control measures, compound these challenges. With vacancies left unfilled, existing staff shoulder additional duties. Administrative errors increase, turnaround times lengthen, and trusts may struggle to keep pace with regulatory requirements. In these circumstances, outsourcing provides a practical option to sustain operations without bypassing hiring restrictions.
The Framework Approach
To provide a structured pathway for procurement, the NHS uses frameworks that allow trusts to source services from pre-approved suppliers. NHS Shared Business Services (NHS SBS) is the largest of these initiatives, created to deliver back-office services including finance, payroll, procurement, and IT. Its mandate has been to help NHS organisations save time, reduce risk, and focus resources on patient care.
Frameworks like NHS SBS bring several advantages:
Compliance and governance alignment
Trusts can be confident services are procured within NHS rules.
Pre-vetted suppliers
Providers go through a selection process, ensuring quality standards are met.
Faster access
Frameworks cut down on the time required for individual procurement exercises.
Potential efficiencies
Shared services models aim to deliver savings through economies of scale.
For many trusts, however, the challenge is not simply sourcing a provider. It is securing flexible support that can be deployed quickly, scaled according to demand, and sustained without creating permanent staff positions.
Connext: Extending Flexibility Through Independent Contractor Agreements
This is where Connext adds value. By working within NHS frameworks while offering independent contractor agreements, Connext provides trusts with the ability to bring in clinical back-office support without adding to their official headcount. This arrangement is particularly important for organisations facing hiring freezes, since it allows them to maintain service levels while remaining compliant with policy.
The benefits of this approach include:
Scalable support
Trusts can increase or reduce administrative support as workload changes.
Continuity of service
Independent contractors can step in during staff absences or periods of high demand.
Rapid deployment
Support can be introduced quickly without lengthy recruitment processes.
Governance alignment
Services are delivered within the structure of NHS procurement frameworks.
While outsourcing inevitably carries a cost dimension, many trusts see the greater value in flexibility. It enables them to adapt to challenges without disrupting patient care or breaching workforce restrictions.
Beyond Cost: Building Operational Continuity
The conversation about outsourcing in healthcare often begins with cost savings. Yet for NHS organisations, the real priority is continuity. Clinical back-office functions are highly interdependent with care delivery. If billing processes slow down, funding flows are disrupted. If coding or documentation is delayed, compliance can be jeopardised. If scheduling falters, patient journeys are affected.
Connext’s model is designed to support continuity first. Cost efficiencies may follow, but they are not the primary driver. By leveraging frameworks and flexible agreements, trusts can protect the reliability of these essential functions. In an environment where staff shortages and hiring freezes may persist, this continuity provides resilience and reassurance.
For more on how independent contractor agreements can help healthcare organisations navigate hiring freezes, explore our blog on Securing Talent When Hiring is Frozen: Independent Contractors to the Rescue.
Frequently Asked Questions (FAQs)
Frameworks like NHS SBS provide structured, compliant procurement pathways that allow NHS trusts to source administrative and support services without lengthy tendering processes.
Cost savings play a role, but the greater value comes from flexibility, resilience, and the ability to maintain operational continuity even when hiring restrictions are in place.
Yes. Connext uses independent contractor agreements that enable trusts to scale back-office teams flexibly, ensuring services continue without creating new permanent roles.
