The journey towards greater savings and self sufficiency with a locum bank
Great Western Hospitals NHS Foundation Trust was a long standing STAFFflow client of Liaison Workforce.
Great Western Hospitals NHS Foundation Trust was a long standing STAFF flow client of Liaison Workforce. The success of STAFF flow agency direct employment at the Trust had delivered valuable savings but the challenge to reduce agency spending costs was ongoing. It was keen to increase the use of its own medical locum bank and needed strategies, a system and support to do so.
The Trust team met with Liaison Workforce to review the next steps in its temporary staffing journey and it was decided to upgrade to the new TempRE service. For agency direct employment, this would deliver enhanced reporting and accountability for budget holders and importantly, it also included the locum bank service with weekly payroll.
TempRE was initially introduced for agency direct employment, and implemented rapidly. The Trust achieved impressive fill rates; with near 100% of all medical locum agency spend being processed through TempRE. Liaison Workforce further supported the Trust by analysing its accounts payable spend to identify any agency payments that had bypassed the system, these could then be challenged and brought within medical staffing control.
Based on this success, the Trust made a choice to expand the service to also incorporate Allied Health Professionals, where utilisation of TempRE and therefore savings are increasing.
The enhanced TempRE reporting offered important benefits to support the Trust’s objective of reducing its agency costs. The Trust was able to receive detailed reports including a breakdown of agency spend by department and grade; missed savings and the identification of significant rate and commission variations by agency and by locum.
The Trust was able to then make its budget holders more accountable for spend outside of the agreed parameters
as overspend could be identified and challenged. The data was also valuable to inform the bank project.
TempRE agency direct employment has seen an overall spend reduction of 47% equating to a £2million reduction in agency spend
Since the implementation of TempRE Bank, Liaison Workforce has met with the Trust to conduct regular on-site reviews to share best practices and analyse regional bank rates. This has helped the Trust negotiate bank rates with senior clinicians and benchmark already established bank rates for junior doctors. Weekly pay was also introduced, provided by Liaison Workforce, to ensure that bank remained an attractive option over agency work. This improved bank participation and boosted the fill rate further.
Liaison Workforce also provided a full time onsite support resource. This Liaison Workforce Customer Support team member played a key ‘hands on’ role in training and influencing users, supporting on the system and ensuring that
the project stayed on track.
Again, management information played a key role in the bank’s success. For example, the information was used to
negotiate bank rates with long term agency consultants to gain a full migration of these staff onto the Trust bank.
The below graph shows the steady bank fill rate growth since the introduction of TempRE. Peak fill rate of 72.13% for all Medical Locums in April 2017. The effect of IR35 also meant a lower agency fill rate due to lack of worker availability.
The highest proportion of medical agency spending was on consultants, at 68%. The Trust was keen to specifically target high cost, long term agency consultants and to switch them to bank contracts.
This was done by using the Liaison Workforce reporting and the Trust approaching the right candidates at the right time and negotiating their rates, enabling them to make a significant change to locum spend. The consultant bank fill rate grew from 23.73% in June 16 to 42.50% in November 2017. From FY17/18 to FY18/19 the consultant bank fill rate increased by a further 17%.
We felt that TempRE could help us tackle our particular challenge of growing our staff bank and the team has certainly delivered on that objective. The next steps for us will be working with Liaison Workforce to develop a collaborative regional bank and to work with others regionally to identify trends and share learning.
Business:
Great Western Hospitals NHS Foundation Trust
Challenge
Reduce agency spending costs
Solutions
TempRE