exempt waiting list solution, delivered at CCS
treat women’s health goods and services model aligned, clinically governed women’s health delivery
Delivered safely and compliantly within NHS estates
Backed by policy. Delivered from within. Ready to scale now.
The reality we’re ready to solve “763,000 women waiting. Thousands needing care now.”
Gynaecology has seen the sharpest waiting list growth in the NHS — tripling since 2014. Yet the solution isn’t more data. It’s delivery. This programme is purpose-built to reduce delays, minimise reliance on outsourcing and agency staffing, restore NHS capacity, distribute clinically verified consumables and medtech, and deliver safe, scalable, audit-ready seven-day care — all from within NHS estates.
Clinic by clinic. Theatre by theatre. Woman by woman.
This is how we turn backlogs into recovery.
What was once a delay is now a call to act.
Compliant. Direct award. Built for NHS delivery.
ALL SERVICES CAN BE PROCURED THROUGH EXISTING, GOVERNMENT-BACKED NATIONAL AGREEMENTS— ENABLING:
• Direct award functionality
• Fast-track mobilisation
• Pre-agreed pricing models aligned with national HRG tariffs — delivering up to 50% savings
• Trusted frontline managed services, already embedded within active NHS partnerships
APPROVED PROCUREMENT ROUTES
• NHS Shared Business Services (SBS)
- SBS10203: Insourcing of Clinical Goods & Services
• Crown Commercial Service (CCS) (Cabinet Office-backed)
- RM6276: Insourced Services to Support the Provision of Healthcare
• NHS Scotland
- NP676-22: Medical Insourcing Services
“The question isn’t whether we can act — it’s why wait, when NHS England has lifted the elective care cap, the Government has endorsed approved delivery routes through the Cabinet Office, and frontline insourced solutions are already in place and ready to deliver.”
Available, scalable, seven-day see-and-treat delivery
Already verified by Trusts including Barts Health NHS Trust and East Cheshire NHS Trust, this model supports expansion from three-, four-, or five-day service to full seven-day delivery by activating:
Underutilised gynaecology outpatient departments
Underutilised ambulatory and elective theatres
Underutilised community-based clinics and hubs
Underutilised disposable hysteroscopes — not classified as high-cost or exclusion-listed (NHS Payment Scheme 2025/26,
Section 5.5)
This approach reduces reliance on mobile units and privately built infrastructure, lowers emissions, increases patient throughput and ensures care is delivered where it belongs — within NHS estates, supported by integrated clinical governance and emergency pathways. This model embeds the RCOG- and BSGE-aligned see-and-treat approach — streamlining care by delivering diagnosis and treatment in a single visit. It improves RTT performance, increases throughput, enhances patient experience, and supports the NHS Net Zero strategy by reducing avoidable journeys and theatre usage.
Our seven-day women’s health services are designed and governed in line with national best practice, led by clinicians who are active members of the important colleges and societies.
Our clinicians adhere to national best practice guidelines, including GIRFT, NICE, and widely recognised gynaecological care standards, which inform the design, governance, and delivery of all services. These principles underpin our range of best value offerings, including our one-stop, see-and-treat model—enabling earlier intervention, minimising delays, and delivering improved outcomes for women.
✓ “Trusts should expand elective and outpatient services within existing facilities to reduce dependency on external sites”
✓ “Earlier access to diagnosis improves outcomes, reduces duplication, and eases pressure on acute services”
✓ “Ambulatory services and one-stop clinics should be adopted where clinically appropriate to improve RTT compliance”
✓ One-stop hysteroscopy and colposcopy is widely recognised as a gold-standard approach where clinically appropriate
✓ Ambulatory and outpatient hysteroscopy are increasingly recommended to support faster, lower-risk access to care
✓ Pain score thresholds, informed consent, and in-estate NHS delivery are central to safe, patient-centred provision
Session structure & see-and-treat flow
• One-Stop See-and-Treat Model
Diagnosis and treatment delivered in a single appointment, wherever clinically appropriate.
• Patient-Centred Consent
Women are fully informed, retain full choice, and may defer treatment if they wish — no pressure, no assumptions.
• Nationally Aligned Protocols
Pathways follow guidance, including immediate therapeutic options such as biopsy, polypectomy, and IUD management.
• Integrated Digital Delivery
All documentation, histology, and reports are recorded directly in Trust systems — fully auditable from Day 1.
• Meets GIRFT & NICE Standards
Outpatient delivery aligned with GIRFT efficiency benchmarks and NICE guidelines for heavy menstrual bleeding.
• Designed for RTT Impact
Reduces diagnostic-to-treatment intervals, improving 18-week RTT performance and accelerating patient relief.
• Supports NHS Net Zero Strategy
Fewer visits mean lower travel emissions, better estate utilisation, and smarter energy use.
Clinic by clinic. Theatre by theatre. Woman by woman.
East Cheshire NHS Trust faced mounting pressure in its gynaecology department following staff retirements and a five-day service model. This led to a growing backlog of more than 600 women awaiting colposcopy — with over 350 already breaching NHS England’s clinically recommended timeframes.
With financial limitations and patient safety at stake, the Trust partnered with Frontline Insourcing to deliver a rapid, compliant recovery strategy — delivered entirely within NHS estates, without outsourcing, and without incurring additional financial pressure.
➢Location: North West England
➢Population Served: 410,000+
➢Specialty Area: Women’s Health
➢Backlog at Baseline: 640 patients
➢Breaches at Baseline: 350+ patients
Mobilising Safely. Delivering at Scale. Governed from Day One.
The implementation process began with structured mobilisation and close collaboration between Frontline Insourcing and East Cheshire NHS Trust. A rapid series of planning and governance sessions ensured full alignment on workforce deployment, clinical protocols, and operational readiness — including virtual handovers and weekend site visits.
Following financial approval, Frontline assembled a dedicated multidisciplinary team — including colposcopists from our Clinical Board, several of whom are educators and committee members — supported by a reserve bench to guarantee continuity of care.
All systems, from IT and digital reporting to medtech and clinical consumables, were reviewed and tested during a dedicated induction day. NHS SOPs documentation standards, and reporting frameworks were embedded before go-live.
A three-month Phase One model was launched to stabilise services, prioritise breached cases, and ensure every woman was seen under robust clinical oversight — delivered fully within the NHS estate.
Mobilised in under 4 weeks
NHS SOPs & national guidance implemented
Audit-ready, compliant, and safety assured from day one
“Their team was aligned, responsive, and integrated from day one — a seamless start to a life-saving service.”
— Trust Clinical Lead, Women’s Services.
The partnership delivered measurable, high-impact results. Within three months, the full 640-patient colposcopy backlog was cleared — including over 350 women who had breached NHS England’s clinically recommended timeframes.
Referral-to-treatment (RTT) performance improved dramatically, with new patient appointments offered within one week of referral — restoring compliance and public confidence.
Following this success, the Trust extended the service for a further six months to manage urgent two-week-wait patients. Weekend caseloads were flexibly reduced from 64 to 16 — maintaining continuity while aligning capacity to clinical need. This work is now expanding to include hysteroscopy services as part of a fully managed, in-estate women’s health model.
RTT compliance restored: ≤7-day referrals
Two-week-wait pathway supported
Dynamic resourcing model: flex-up, flex-down
“In just three months, we went from 350 breaches to offering appointments within one week. The impact on patients and staff has been profound.”
—
Deputy Chief Operating
Officer, East Cheshire NHS Trust
Feedback from women receiving care through the insourced managed service was overwhelmingly positive, highlighting clinical skill, professionalism, and emotionally supportive environments delivered within NHS settings.
Clinical excellence and clarity
"The procedure was quick, and I was made as comfortable as possible. Every step was explained clearly, and I was asked throughout if I was okay.”
Professional and person-centred care
"What a prompt, efficient team of dedicated professionals — personable, caring, and thorough throughout the procedure."
Supportive and unhurried environment
"They took their time, I didn't feel rushed, and everything was explained clearly.”
Addressing anxiety with empathy
"They were so kind and compassionate when I felt nervous. They chatted with me and kept me at ease the whole time.”
Overall patient experience
Patients described feeling “informed”, “comfortable”, and “well looked after” by a “lovely, incredible team” in a “very clean”, welcoming environment.
➢ Leadership Reflections
Alexander Borg, Deputy Chief Operating Officer, East Cheshire NHS Trust
“Frontline Insourcing were quick and professional in mobilising the support we needed. Just three months on, we do not have a waiting list for colposcopy, and anyone referred is offered an appointment within a week.”
Vicky Bond, General Manager – Clinical Support Services (Operational Hub, Macclesfield DGH)
“East Cheshire have been using the services of Frontline to support a recovery plan of our endoscopy waiting list position. The interaction with all the team clinical and non-clinical has been extremely positive.”
➢ Nursing Perspective: In Their Own Words
Harpal Bassi, Sister, Outpatients Department, East Cheshire NHS Trust
“All of the insourcing team were friendly, professional and approachable. They respected our systems and supported our staff. Some of the best nurses I’ve ever worked with — so easy to talk to and incredibly inclusive.”
“Patient feedback was overwhelmingly positive, and we adapted some of our own processes based on the team's experience. Their support helped us reduce our backlog safely and confidently.”
All services are clinically led and governed by highly experienced consultant gynaecologists, nurse consultants, and clinical directors with specialist expertise in hysteroscopy, colposcopy, urogynaecology, surgical and ambulatory care.
Our leadership team includes active members, educators, and committee participants within the Royal College of Obstetricians & Gynaecologists (RCOG) and the British Society for Gynaecological Endoscopy (BSGE).
All SOPs and governance protocols are aligned with:
GIRFT guidance
NICE recommendations
NHS-specific governance standards
Fully audit-ready, end-to-end pathway documentation
Embedded: incident reporting, PGDs, pain score tracking, feedback loops
Continuous assurance, peer-led clinical audit, and real-time oversight
Together, they lead clinical design, supervision, mobilisation, and quality assurance across all NHS partner sites — ensuring every service is safe, compliant, and centred around the needs of women.
Our clinical leadership includes:
• Caroline Bell – Consultant Nurse & Programme Director
• Suzanne Taylor – Consultant Nurse & Clinical Educator
• Mr Christopher Lindley – Lead for Ambulatory Gynaecology Service
• Mr Nibedan Biswas – Clinical Director for Gynaecology
• Mr Francis Gardner – Clinical Director for Gynaecology
Flexible Service Models. Transparent, NHS-Aligned Pricing.
Delivery Models
Full Service: End-to-end provision with a multidisciplinary clinical team, clinical oversight and governance, includes disposable scopes and all necessary consumables
Partial Service: End-to-end provision with a multidisciplinary clinical team, clinical oversight and governance
24/7 Capacity: Fully configurable schedules, designed to meet specific Trust demand and elective backlog reduction targets
Ambulatory & Surgical Models: Specialist delivery across colposcopy, hysteroscopy, and minor operative procedures
Consumables & Goods
Disposable hysteroscopes, medtech and consumables available via NHS SBS10203
All devices used are non–high-cost and not excluded under the 2025/26 NHS Payment Scheme
Pricing Approach
Structured as a percentage of national HRG tariff, offering up to 50% savings
Inclusive of staffing, clinical governance, reporting, and optional equipment provision
No hidden fees. No financial penalties. Designed to maximise flexibility and value for the Trust
All equipment and services available via direct award through our national procurement agreements
Each session operates as a four-hour block, with procedures delivered in outpatient settings or surgical theatres, based on patient complexity and Trust configuration, including:
• Diagnostic hysteroscopy – A thorough assessment of the uterine cavity
• Diagnostic hysteroscopy with biopsy –Investigation with targeted tissue sampling for further analysis
• Hysteroscopy and endometrial polyp morcellation – A minimally invasive procedure for the treatment of heavy menstrual bleeding
• Hysteroscopy and removal of retained contraceptive products – A minimally invasive treatment to safely remove retained products of conception
• Intrauterine System (IUS) Insertion and Retrieval – Insertion or removal of coil
The see-and-treat pathway has been designed to streamline the diagnosis and management of abnormal uterine bleeding (AUB), significantly reducing the number of required appointments while enhancing patient experience.
In line with NICE guidelines, this pathway enables hysteroscopy and necessary treatments within a single visit, where clinically appropriate. By consolidating the diagnostic and treatment process, we help hospitals optimise resources, reduce costs, and improve patient outcomes.
Initial Consultation & Scan
• A 20-minute appointment with a hysteroscopist and nurse
• Includes an ultrasound scan and, if required, a pipelle biopsy
See & Treat Hysteroscopy
• A 30-minute appointment for diagnostic hysteroscopy, with polypectomy if necessary
• Delivered by a clinician — either a consultant or nurse practitioner — and supported by a dedicated scrub nurse and healthcare assistant, who also fulfils the vocal local role.
• Flexible pricing model – This appointment does not have a standard national tariff and requires local pricing agreements. However, it is typically more cost-effective than the combined MA12Z and MA31Z tariffs
By adopting our best-value see-and-treat hysteroscopy service, your organisation can enhance efficiency, improve patient outcomes, and reduce operational strain, all while ensuring adherence to best-practice guidelines.
We provide a full see-and-treat hysteroscopy service, delivering a streamlined, patient-centred model that integrates history-taking, diagnostics, and treatment in a single visit. This efficient approach optimises patient flow, minimises delays, enables timely clinical interventions, supports sustainability by reducing avoidable follow-up appointments and CO₂ emissions.
Endometrial ablation is not available on a see-and-treat basis due to the requirement for cavity assessment and a normal biopsy result prior to treatment. However, ablation services can be provided for pre-planned cases.
For waiting list cases requiring diagnostic hysteroscopy, Pipelle biopsy, and IUS insertion or retrieval, nurse consultants can typically accommodate six patients per four-hour session — enabling up to twelve cases per day.
We provide fully nurse-led colposcopy services, delivered in accordance with NHSCSP (NHS Cervical Screening Programme) standards for both diagnostic colposcopy and LLETZ treatment.
Our comprehensive service packages are designed to rapidly reduce patient waiting times, support elective recovery, and maintain continuity of care.
All services are delivered by BSCCP-accredited nurse colposcopists, who manage patients across the full care pathway from initial attendance through to discharge. This includes:
Performing diagnostic and therapeutic procedures
Interpreting and communicating results to patients and GPs
Entering outcomes into colposcopy databases in line with national standards
In addition to our consultant-led model, our nurse-led model ensures high-quality, timely care, while reducing demand on consultant-led capacity offering a sustainable and scalable solution for Trusts under pressure.
One-Stop Model – A fully integrated approach combining patient history, diagnostic assessment, and treatment within a single appointment, reducing the need for multiple visits.
Optimised Capacity – Designed to improve patient throughput, preventing bottlenecks in the care pathway, and supporting elective recovery targets
Consumables & Equipment Support – Where Trust consumables (e.g. disposable hysteroscopes) are limited, we can supply and transport all necessary equipment to ensure seamless, uninterrupted service delivery.
Available, scalable, in-estate, seven-day see-and-treat delivery.
• Clinics can be scheduled as single or double sessions per day, per team, operating within a single-room setup
• Contracts offer flexibility, enabling trusts to scale services up or down based on patient demand and clinical capacity
• If additional disposable hysteroscopes or consumables are required, they can be preordered to ensure seamless service delivery without delays
This adaptable model ensures efficient service provision while maintaining high-quality patient care and operational resilience.
As part of our comprehensive See & Treat hysteroscopy service, we understand that maintaining a well-stocked supply of high-quality consumables is crucial for ensuring seamless clinic operations. To minimise disruptions and support healthcare providers in delivering uninterrupted care, we offer a flexible consumables supply service tailored to your specific needs.
Source: Greener NHS – NHS Net Zero Strategy (2020–2040)
• NHS England has committed to achieving Net Zero by 2040, with a focus on reducing patient travel emissions and streamlining healthcare processes
• Traditional three-appointment models for hysteroscopies contribute to unnecessary patient journeys, increasing CO₂ emissions
✓ See & Treat pathways reduce patient travel, cutting NHS carbon emissions
✓ Disposable hysteroscopes remove the need for sterilisation processes, reducing NHS environmental impact
✓ Supports NHS sustainability goals while improving clinical efficiency
See & Treat Policy Alignment
• NHS England, RCOG, and BSGE advocate for one-stop See & Treat hysteroscopy services to improve efficiency and patient experience
• The NHS GIRFT (Getting It Right First Time) programme highlights See & Treat as a proven method to streamline gynaecology pathways
• See & Treat services directly align with NHS England’s Elective Care Transformation objectives, reducing unnecessary hospital visits
✓ Rapidly deploys See & Treat hysteroscopy teams, reducing NHS workload while improving patient flow
✓ Improves patient satisfaction, as one-stop appointments replace multiple visits
✓ Enables NHS Trusts to meet RTT and diagnostic targets inestate, ensuring more efficient, patient-centred care
✓ Frontline Insourcing professionals operate in accordance with national and local Trust guidelines to ensure best practice in outpatient hysteroscopy is delivered to women.
We can supply and bring consumables directly to your clinic as part of our service, ensuring operational efficiency and eliminating the risk of supply shortages. Key consumables include:
• Single-use hysteroscopes to ensure optimal hygiene, sterility, and safety
• Compatible with various imaging and fluid management systems
• Reduces the need for costly sterilisation processes
• Single-use operative sheaths for disposable diagnostic and operative hysteroscopes
• Sterile tubing sets for fluid irrigation and suction, supporting clear intrauterine visualisation
• Sterile saline solution for uterine distension during hysteroscopy
• Pressure bags and infusion sets for controlled delivery of fluids
• Pipelle biopsy devices for endometrial sampling
• Curettes for endometrial aspiration and tissue collection
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2
3
4
Polyp & Fibroid Removal Instruments
Graspers & Scissors
• Resectoscopes and morcellators for intrauterine polyp or fibroid removal
• Loop electrodes for endometrial ablation procedures
• Fine hysteroscopic instruments for precise tissue manipulation
• Used in retained product removal, adhesiolysis, and operative hysteroscopies
• Pre-packaged sterile drapes designed for hysteroscopy procedures
• Includes gowns, gloves, swabs, and cleaning materials to maintain aseptic conditions
• A range of intrauterine coils for insertion and replacement as part of the hysteroscopy service
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• Cervical dilators to aid hysteroscope insertion in difficult cases
• Foley balloons for post-procedure bleeding control
• Guaranteed Availability – No delays due to supply shortages
• Seamless Integration – Equipment provided directly in line with your clinical requirements
• Cost-Effective Solutions – Reduces procurement and storage burdens
• Regulatory Compliance – All consumables meet MHRA and NICE safety standards
• Customisable Packages – Supplies can be tailored to your clinic’s specific needs
Consultant-Led Hysteroscopy Service
Nurse-Led Hysteroscopy Service
Comprehensive Service with Disposable Hysteroscopes
• Delivered by a Consultant Hysteroscopist, supported by a Staff Nurse and Healthcare Assistant (HCA)
• Suitable for more complex operative cases requiring senior clinical oversight
• Ensures high-quality, consultant-led decisionmaking and intervention
• Led by an experienced Nurse Hysteroscopist, with a Staff Nurse and HCA providing support
• Designed to optimise capacity while maintaining high clinical standards
• Ideal for routine diagnostic hysteroscopies and selected operative treatments & procedures
• Available with either Consultant-Led or Nurse-Led Hysteroscopy Services
• Frontline Insourcing can supply all necessary disposable hysteroscopes for the duration of the contract
• Ensures Trust-owned scopes remain available for routine clinics, minimising disruption to day-to-day operations
• Reduces reliance on sterilisation processes, enhancing efficiency
Results Reporting & Clinical Review
• A dedicated 1–2 hour session each week for reviewing, documenting, and sharing results from the previous clinic sessions
• Ensures timely followup, supports continuity of care, and enhances communication with the wider clinical team
• Will be structured as part of the hysteroscopy package
Customisation & Cost Transparency
• Flexible contract durations – available for short-term insourcing projects or long-term service agreements
• Scalable pricing –based on session volume, clinical team requirements, and consumable provisions
• Clear and competitive pricing – ensuring transparency with no hidden costs
• Delivered by a Consultant Hysteroscopist, supported by a Staff Nurse and Healthcare Assistant (HCA)
• Suitable for more complex cases
• Ensures high-quality, consultant-led decisionmaking and intervention 1
• Led by an experienced Nurse Hysteroscopist, with a Staff Nurse and HCA providing support
• Designed to optimise capacity while maintaining high clinical standards
• Ideal for routine diagnostic hysteroscopies and selected operative treatments
• Available with either ConsultantLed or Nurse-Led Hysteroscopy Services
• Frontline Insourcing supplies all necessary disposable hysteroscopes for the duration of the contract
• Ensures Trust-owned scopes remain available for routine clinics, minimising disruption to daily operations
• Reduces reliance on sterilisation processes, enhancing efficiency and patient throughput
• A dedicated 1–2 hour session per week for reviewing, documenting, and sharing results from recent clinics
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• Ensures timely follow-up, supports continuity of care, and enhances communication with the wider clinical team 4
Our centralised clinical audit and governance system allows for real-time monitoring and quality assurance, tracking key procedural details to maintain high standards in service delivery and compliance.
Key Audit Metrics Recorded:
✓ Patient demographics (age, referral pathway, clinician, location)
✓ Pre-procedure assessments (GA vs. outpatient options, risk factors)
✓ Referral source (2WW, GOPD, internal referral, GP referral)
✓ Clinical indications (PMB, polyps, HMB, AUB, ultrasound findings, fertility investigations, hyperplasia follow-ups, etc.)
✓ Procedure performed, devices used, and duration
✓ Pain scores (VAS assessment), complications, and patient satisfaction
By adhering to strict governance, evidence-based practice, and real-time auditing, Frontline Insourcing ensures that our hysteroscopy services meet NHS, RCOG, and BSGE best-practice standards, while maintaining a safe, patient-centred, and highly effective care model.
Reference: BSGE Hysteroscopy Benchmarking Report – EJOG 2021 https://www.bsge.org.uk/wp-content/uploads/2021/07/Benchmarking-hysteroscopyEJOG2021.pdf
Phase Timeframe Activity
Phase 1: Preparation Weeks 1-2
Meetings, site visits, and final logistical planning
Phase 2: Implementation Weeks 3-4
Service launch and initial support
Phase 3: Monitoring Ongoing (First 3 Months)
Feedback collection, adjustments, and continuous improvement
Phase 4: Evaluation Post 3 Months and Annually
Comprehensive review and integration of long-term improvements
By aligning with DHSC, NHS England, RCOG, BSGE and government priorities, Frontline Insourcing offers:
✓ Immediate, scalable solutions for gynaecology service recovery
✓ See & Treat hysteroscopy models to cut waiting times and improve diagnostic efficiency
✓ Workforce resilience solutions to address NHS staffing shortages
✓ Sustainability-focused models that support NHS Net Zero goals
Proposal Objectives
• Reduce Waiting Times: Expand capacity with our See & Treat service, eliminating the need for additional appointments by integrating diagnosis and treatment in a single visit. By providing disposable scopes and insourcing solutions, we help prevent bottlenecks in the patient pathway, reducing waiting list pressures and improving patient flow
• Improve Affordability: Deliver cost-effective, high-quality hysteroscopy services that align with NHS budgets, ensuring financial sustainability without compromising clinical excellence
• Optimise Operations: Ensure seamless service integration through streamlined processes, including robust compliance frameworks, efficient recruitment strategies, and effective rota management. Our structured approach enhances service efficiency, workforce stability, and operational reliability
By implementing these objectives, Frontline Insourcing enables Trusts to reduce waiting times, improve patient access, and enhance service efficiency, ensuring the best possible outcomes for women’s healthcare
We support NHS Trusts in restoring timely, high-quality access to essential women’s health services
— through safe, compliant, and audit-ready seven-day care delivered entirely within NHS estates.
By embedding fully managed, clinician-led services — supported by trusted consumables and existing NHS infrastructure — we unlock capacity, ease operational pressure, and ensure women are seen sooner, closer to home, and under the governance they trust.
This is not just a recovery model.
It is a forward-looking, NHS-aligned solution — built for long-term resilience, fairness, and truly patient-centred care.