The NHS is under immense pressure, and for many, the scale of what’s being asked feels unprecedented. With Integrated Care Boards (ICBs) expected to halve their running costs by 2025/26, and acute Trusts under increasing scrutiny to reverse the corporate cost growth of recent years, the task is clear but daunting: deliver more care, to more people, with fewer resources.
This isn’t just a policy challenge; it’s a daily reality for those working across NHS organisations. Behind the headlines of a £6.6 billion projected deficit and the reshaping of Integrated Care Systems (ICSs) are real teams in procurement, estates, diagnostics and clinical services, being asked to do more, faster, and with less. They are looking for solutions that don’t just patch problems but genuinely help tackle the pressures on services and improve health outcomes.
There is no silver bullet, but there are some proven models that are already helping many Trusts navigate this increasingly hard terrain. Specifically managed services - by outsourcing equipment and diagnostic contracts, NHS teams are finding ways to unlock savings, simplify operations, and reduce the day-to-day strain on staff and systems.
Smarter model
Rather than negotiating with individual suppliers, trusts can obtain essential clinical solutions and state-of-the-art equipment such as fully kitted MRI suites, cath labs and endoscopy units, with the benefit of a single point of accountability and competitive pricing (derived from the partner’s ability to leverage its economies of scale).
The ongoing maintenance of the equipment can also be externally managed, ensuring faults are addressed quickly and effectively, and mitigating any delays for patients.
These combined benefits help to relieve pressure on stretched procurement and estates teams. Crucially, this model also frees up clinical and administrative staff to focus more time and energy on frontline care.
ICBs are expected to halve their running costs by 2025/26, and acute Trusts are under increasing scrutiny
Does it work?
Mersey and West Lancashire Teaching Hospitals NHS Trust offers a strong example of how a long-term managed service partnership can evolve to meet changing needs. Since 2014, they’ve had a fully-integrated, managed microbiology service. What began as a single contract has grown over time to encompass all aspects of the laboratory service, adapting to new demands and expanding capacity.
It’s helped the trust achieve more than £10 million in savings across microbiology services in the last 7 years. But the value hasn’t only been financial. The partnership has enabled centralised ordering, supported additional workload through integration with a third-party laboratory, and introduced a “non-touch” decontamination solution for endoscopy and theatres — helping to modernise processes and ease operational pressure.
Across the country, other trusts are seeing similar returns. At University College London Hospitals, their managed service model has delivered over £1.3 million in savings across multiple departments, including point of care testing for various blood tests such as glucose, histology and neuropathology.
And at Manchester University NHS Foundation Trust, they’ve achieved more than £1.5 million in savings by adopting the managed service provision of blood gas, glucose and ketone, blood clot and rapid whole blood hemostasis diagnosis laboratory testing, delivered at the point of care.
Where savings meet strategy
Procurement and clinical support functions are often seen as cost centres. However, with the right partnerships in place, they can become strategic levers for change, generating efficiencies that ripple across departments, improving planning, and contributing to patient outcomes.
What’s more, by structuring contracts under continuity of service frameworks and the classification of services heading regulation (which is used to categorise and standardise how healthcare services and spend are reported), trusts can unlock significant VAT savings that would otherwise be unrecoverable under standard arrangements. This isn’t a loophole, it’s a legitimate and proven method to reinvest funds back into patient services.
A path forward
No single intervention will meet the full challenge facing ICBs and NHS Trusts. However, managed services offer a pragmatic, scalable and proven way to release budget pressures while enhancing service quality.
As the health system navigates financial constraints and structural changes, there is growing recognition of the value that well-structured partnerships can bring. When managed effectively, these services offer a route to greater resilience, better resource planning, and measurable results, both operationally and financially.