NHS staff strike over hospital outsourcing plans
LONDON, UNITED KINGDOM — Hundreds of facilities staff at East Suffolk and North Essex NHS Foundation Trust (ESNEFT) walked out between August 19 and 23 in the latest of more than 30 strike days against plans to outsource catering, cleaning, portering, and security roles to Sodexo.
Colchester staff walk out over outsourcing
More than 350 workers at Colchester Hospital, Aldeburgh Hospital, Felixstowe Hospital, and several ESNEFT community sites in Suffolk and Essex have been striking in waves since mid-2024 against the trust’s decision to consolidate all soft facilities services under a single private contractor.
UNISON argues the move will create a two-tier National Health Service (NHS) workforce, with new staff at outsourced sites earning less and working under inferior conditions to their directly employed NHS colleagues.
Caroline Hennessy, head of health at UNISON Eastern, said the trust had prioritized cost savings over the welfare of essential workers.
“It’s incredibly disappointing to see ESNEFT make this reckless decision to sell essential cleaners, porters, caterers and other staff out of the NHS,” Hennessy said.
Staff at Ipswich Hospital, whose roles were transferred to OCS under an earlier contract, already receive fewer days of annual leave and less sick pay, and missed out on a one-off payment made to directly employed NHS staff.
Trust’s cost math overrides union opposition
ESNEFT’s decision follows a business process outsourcing (BPO) evaluation that found a fully outsourced facilities model would cost £5 million (US$6.3 million) less per year than the status quo and £12 million (US$15 million) less than an in-house alternative, according to an Outline Business Case considered by the board in April 2024, as reported by the BBC.
The trust projected a deficit of approximately £35 million (US$44 million) for the 2024/25 financial year. Internal communications obtained by UNISON showed the chief executive had already told staff the plan would “go ahead regardless” of strike action. The trust said the Sodexo contract complied with public procurement regulations.
The £5 million annual saving in ESNEFT’s business case reflects the same margin compression driving facilities and back-office outsourcing decisions at health systems across the United States.
In 2024, Adventist Health reported a $224 million operating loss before outsourcing six back-office functions, including information technology (IT), finance, and supply chain, to vendor partners. UnityPoint Health and PeaceHealth made similar operational transitions in 2026.
The top healthcare outsourcing companies in the U.S. now serve facilities management, revenue cycle, and IT support roles, as the market for administrative outsourcing in healthcare expands globally.
Health system leaders evaluating this model can explore vendor options through the ultimate guide to outsourcing and review how business process outsourcing (BPO) providers structure healthcare services.
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