Established practice
Your spare theatre capacity could be generating millions in NHS waiting list revenue
Independent hospitals with underutilised theatres are well-placed to access NHS block contracts and waiting list initiative funding, but without a structured commercial approach, that capacity sits idle while the opportunity passes.
- steps
- 7
- steps
- to start
- 1 to 2 weeks
- to start
The short answer
The independent sector delivers a significant share of NHS-funded elective care, through NHS Standard Contracts held with integrated care boards (ICBs), patient choice and subcontracts from NHS trusts. ICBs have been capping independent sector activity since late 2025, so a vague offer will not get through. You need a specific offer of staffed capacity by specialty, the compliance basics the NHS expects (NHS Standard Contract terms, the Data Security and Protection Toolkit, national data submissions) and named relationships with the ICB and local trusts.
7 steps
Do it yourself: step by step
0 of 7 done
List theatre, outpatient, endoscopy and imaging sessions you can staff but do not fill, by specialty, for the next 12 months.
- Time
- 1 to 2 weeks
- Typical cost
- Staff time only
- Who does it
- Director of clinical services
Done when: A capacity table by specialty with sessions a week you could offer.
This problem is Solvable.
Copy this template
NHS capacity proposal outline
Free to copy, adapt and use. No sign-up.
NHS capacity proposal
To: [Name, role, ICB or NHS trust] From: [Name, role, hospital] Date: [date]
1. Purpose [Hospital name] can provide additional elective capacity in [specialty] from [start date] to help reduce waiting times for patients in [area].
2. Capacity offered
| Specialty | Pathway | Sessions a week | Cases a week | Start date | Minimum term |
|---|---|---|---|---|---|
| [Orthopaedics] | [Primary hip and knee replacement] | ||||
| [Ophthalmology] | [Cataract] | ||||
| [Endoscopy] | [Diagnostic upper and lower GI] |
3. Patient eligibility We can accept patients who meet these criteria: [ASA grade, BMI limits, exclusions agreed with clinicians]. Patients outside these criteria will be [returned to the referring trust or managed as agreed].
4. Pricing We propose payment at [national tariff or agreed local price] for each pathway.
5. Quality and safety
- CQC rating: [rating, date]
- Data Security and Protection Toolkit: [status, date]
- Relevant outcomes: [length of stay, readmission rate, infection rate, PROMs where collected]
- Consultants: [number] with practising privileges in this specialty
6. Reporting We will provide [monthly activity and waiting list data] in [agreed format] and submit required national datasets.
7. Contracting route We propose [NHS Standard Contract with the ICB, or subcontract with the trust].
8. Contact [Name, role, email, phone]
Avoid these
Common mistakes
- Offering capacity in general rather than by specialty, pathway and session.
- Approaching commissioners before the Data Security and Protection Toolkit is complete.
- Agreeing patient eligibility criteria too loosely and then returning complex cases.
- Letting NHS work spill into sessions planned for private patients.
- Underestimating the reporting and data submission work NHS contracts require.
Free personal check
Done by Paul Robinson, not software
Answer eight quick questions and I'll show you how ready you are to win NHS-funded work
What I need from you
- Eight tap answers about capacity, compliance and contacts
- Your main specialties
What you get
- How ready you look to an ICB or trust
- The three gaps to close before you approach them
- Which route fits you first
Within 2 working days
No sign-in, no sales call. I read every request myself and reply on WhatsApp.
Free tools
Check where you stand
Benchmarks
The independent sector delivered 7.5% of NHS elective care in February 2026, down from a peak of about 10% in late 2024 and early 2025
ICBs began capping provider activity with Activity Management Plans in the second half of 2025/26
Independent sector RTT activity fell 1.4% across 2025/26 and was 9% lower after the first two months of 2026/27 than in the same months two years earlier
NHS-funded volume is harder to win than in 2023 and 2024
Paul Robinson
14 years in UK private healthcare
I solve this one for hospitals
Want a hand? I'll look at your situation and tell you the three things I'd tackle first.
A few quick questions, about two minutes. I read every one myself and usually reply the same day.
No sales call unless you ask for one. Just a straight answer from me.
I reply personally, usually the same day.
Questions
Frequently asked questions
How do independent hospitals get NHS work?
Mainly through an NHS Standard Contract with an ICB, subcontracts from NHS trusts, and national frameworks. Where you hold an NHS contract for a service, patients can usually choose you under their legal right to choose.
What is the Provider Selection Regime?
The rules NHS commissioners in England have followed since 1 January 2024 when choosing who provides healthcare services. For healthcare services it replaced the Public Contracts Regulations 2015 and the 2013 NHS procurement regulations.
Will NHS work undercut our private prices?
It should not if you keep it in separate sessions and patients understand the different pathways. Be clear internally about which sessions are NHS.
Is NHS tariff profitable?
Often on marginal cost for spare capacity, rarely on full cost. Model it before you commit.
What data will we need to submit?
Activity and waiting list data in the formats your contract specifies, plus national datasets. Check this before you sign.
Last reviewed:
The Solvable community
You're not the only one with this problem.
One problem solved every week, on WhatsApp.
One message a week. No sales messages. Reply STOP any time.