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A Scalable Insourcing Solution - Countess of Chester


Client Challenge
Countess of Chester Hospital NHS Foundation Trust faced increasing pressure on outpatient services driven by rising referral volumes and national targets to reduce waiting lists.
Demand was outpacing available capacity across multiple specialties, making it increasingly challenging to maintain timely patient access and improve RTT performance.
The Trust required a flexible, scalable solution to rapidly increase capacity - without compromising on governance, patient experience or clinical quality.


Our Solution


Agile Insourcing partnered with the Trust to deliver a clinically led insourcing model focused on increasing outpatient capacity and supporting elective recovery.
By deploying experienced multidisciplinary teams, Agile enabled the Trust to quickly expand outpatient, diagnostic and theatre activity, supporting sustained improvements in waiting list performance.
With the ability to mobilise services within 1–2 weeks, Agile provided a responsive and reliable solution aligned to the Trust’s operational and clinical needs.


 

Top 5 Headline Results

  • Over 14000 appointments offered and delivered in 2025 alone.

  • 70%+ of activity delivered across high‑pressure RTT specialties (ENT & Dermatology)

  • 11 specialities supported across outpatients, diagnostics, and theatres

  • 99%+ of planned activity successfully delivered

  • 98%+ patient satisfaction

In the last 12 months alone, Agile Insourcing has delivered over 14,000 outpatient appointments, with more than 70% focused on high‑pressure RTT specialties, demonstrating a trusted, high‑volume delivery model that continues to scale based on performance.


Expanding a proven partnership

The partnership began in June 2022, initially supporting Dermatology outpatient clinics and Minor Operative Procedures.
Following strong results and measurable improvements in RTT performance, the Trust expanded the partnership across additional specialties.
Agile now supports 11 specialties, all mobilised within 1-2 weeks, including:

  • Gynaecology

  • ENT

  • Endocrine

  • Oral & Maxillofacial Surgery

  • Breast Services

  • Ophthalmology

  • Plastic Surgery

  • Vascular Surgery

  • Cardiology

  • Echocardiography

This rapid expansion reflects a trusted partnership model that delivers consistent results and scalable capacity.


How we made this partnership a success
✔ Close collaboration with clinical and operational teams through regular performance reviews
✔ Rapid mobilisation with dedicated insourcing managers overseeing delivery and go-live
✔ Full, consistent clinical teams including consultants and support staff
✔ Pre-go-live site visits, service reviews and operational planning to ensure readiness
✔ Flexible delivery across evenings, weekends and high-demand periods
✔ Transparent reporting and governance oversight, with regular on-site reviews



Team involved
  • Professor Nick Cheshire – Medical Director
    Provides clinical leadership, working alongside Trust teams to ensure all Standard Operating Procedures and governance requirements are met.

  • Sarah Schofield – Director of Clients
    Leads client relationships, working closely with Trust stakeholders to shape solutions, support service expansion and ensure long-term partnership success.

  • Leanne Hawkins – CQC Registered Manager & Insourcing Lead
    Oversees all activity delivery, ensuring governance excellence, reviewing data and aligning services with Trust processes and requirements.


“Agile have been a reliable partner in supporting the Trust's elective recovery and RTT delivery.  Agile have supported our trust with insourcing within a large number of different specialties across outpatients and theatres.  They have mobilised activity at pace, worked flexibly with our clinical and operational teams, and demonstrated a strong focus on patient safety, governance, and service quality.   Their service has enabled us to deliver additional activity during periods of capacity constraints. There has been good senior oversight and assurance provided through regular e-mail and face to face contact with our senior leadership team. I would not hesitate to recommend their services to other organisations who are facing similar capacity pressures”. 

 

Sioned Davies

 Acting Director of Performance and Operational Improvement

 The Countess of Chester Hospital NHS Foundation Trust

Looking for support to increase outpatient capacity?

If your Trust is looking to expand capacity, improve RTT performance and deliver high-quality patient care through a clinically led model, Agile Insourcing can help.

Contact Sarah Schofield, Director of Clients [email protected] to discuss how we can support your service.