Transforming an NHS Trust Legal Department: From Outsourced to Outstanding

Building a Stronger, Smarter Legal Function

Healthcare Legal partnered with an acute NHS Trust to deliver a complete transformation of its legal services. Over the course of a year, we worked closely with the Trust to review its operations, streamline processes, and strengthen its in-house capability.

Previously, the Trust relied heavily on outsourced legal support — with most claims and inquests handled externally. Our aim was to create a sustainable, efficient, and cost-effective legal service that would deliver long-term value and empower the internal team to take ownership of their work.

When Outsourcing Becomes a Bottleneck

The Trust’s legal department was under strain. High levels of outsourcing meant escalating costs and limited visibility over active matters. Paper-based systems made communication slow and cumbersome, and a lack of defined processes or performance standards led to inconsistent outcomes.

Internally, skill gaps and resource limitations created pressure points, while externally, delays in meeting evidence requests had begun to affect relationships and compliance performance. The department needed structure, strategy, and a more sustainable model of delivery.

Turning Insight into Action

Our first step was to conduct a detailed departmental review — assessing structure, workflow, and cost allocation. From there, we designed and implemented a programme of change focused on efficiency, capability, and accountability.

Key improvements included:

Restructuring the legal team to maximise existing strengths and create a framework for growth.
Recruiting two new skilled team members to build a robust, sustainable in-house function.
Introducing a fully electronic working environment, replacing outdated paper systems and freeing up physical space for other teams.
Establishing clear KPIs and SOPs to ensure consistency, transparency, and accountability across all cases.
Improving compliance by eliminating Schedule 5 notices through proactive evidence management.
Rebuilding stakeholder trust via improved responsiveness and communication.

Delivering Measurable, Meaningful Results

Within twelve months, the Trust saw substantial improvements across every key performance area:

£250,000 projected annual savings in external legal spend.
Inquest outsourcing reduced from 90% to 30%.
Claims outsourcing reduced from 100% to 0%.
Full digital transformation of departmental workflows and records.
Enhanced governance and accountability, eliminating compliance breaches.
Stronger internal culture and stakeholder relationships, driving collaboration and confidence.

A Lasting Legacy of Improvement

Today, the Trust’s legal department operates as a confident, capable, and fully integrated in-house service. By reducing reliance on external providers and embedding smarter systems, processes, and people, the Trust has achieved lasting change — not just in efficiency and cost control, but in culture, capability, and confidence.

This project demonstrates how strategic, sector-specific legal consultancy can deliver transformational results for healthcare organisations — combining operational insight with practical legal expertise to create lasting impact.