Workforce Supply: a spotlight on temporary staffing Monday 20 July 2015 #nhsworkforcesupply www.nhsemployers.org/workforcesupply
Welcome and overview of the national context for temporary staffing Ruth Warden, Assistant Director of Employment Services, NHS Employers @NHSE_Ruth # nhsworkforcesupply
Agency Spend The drivers of agency spend Sickness absence, poor leave planning and gaps in doctors rotas Historical reductions in training commissions A focus on safe staffing levels following the publication of the Francis Report Increasing demand for NHS services particularly in areas such as accident and emergency *Figures from Monitor consolidated Foundation Trust accounts and Department of Health / NHS Trust Development Authority financial returns and quarterly monitoring.
What is happening at the national level to try and address agency spend? agency spend has a high political profile recently with the Secretary of State and Simon Stevens both talking about the need to tackle it new national controls introduced staffing toolkit national rollout programme Lord Carter Review of Operational Productivity has a focus on workforce productivity actions to increase workforce supply include: o Health Education England increases in training commissions particularly nursing o international recruitment by individual trusts o Health Education England return to practice campaign o focus on retaining existing staff. NHS Employers five high impact actions increase understanding of the issue manage the process and take control including the use of frameworks manage your workforce, create a sustainable supply work collaboratively engage with staff NHS Employers resources to support employers - A series of how to guides on specific aspects of agency spend: - how to reduce expenditure on medical locums - how to use shift systems and workforce planning to effectively reduce costs - how to take control of planned leave - how to source temporary staff. Plus a series of workforce supply events.
Group work: what would effective management of temporary staffing look like in your organisation? # nhsworkforcesupply
Refreshments # nhsworkforcesupply
Workforce efficiencies: responsive workforce and the use of technology Nicola Myronko, Responsive Workforce Clinical Lead, Derbyshire Community Health Services NHS Foundation Trust @myronko Sara Boulton, Team Leader, Derbyshire Community Health Services NHS Foundation Trust Liz Jones, Head of Healthcare Marketing, Allocate Software @amplifythegrape # nhsworkforcesupply
Workforce efficiencies- Responsive workforce and the use of technology Nicola Myronko Clinical Lead responsive workforce Sara Boulton Team Leader staffing solutions
Our vision
Our Journey
Outcomes (our reality)
How we arrived there
System implementation
Benefits Realisation
Safe Care
Shift Fill rates
Agency fill rates
Contact details Nicola.myronko@nhs.net Sara.boulton@nhs.net
Lunch # nhsworkforcesupply www.nhsemployers.org/workforcesupply
The use of staff banks to reduce agency spend Joanne Pugh, E-rostering Senior Nurse, South Tees Hospitals NHS Foundation Trust @jo_jopugh Morgan Warrilow, Client Relationship Manager, NHS Professionals # nhsworkforcesupply
The use of Staff Banks to Reduce Agency Spend Jo Pugh E-roster Senior Nurse Lead, South Tees Hospitals NHS Foundation Trust. Morgan Warrilow - Client Relationship Manager NHS Professionals
An Overview Objective: Successfully eliminate Nursing Agency use, to improve quality compliance and cost efficiency. How.. Implemented an agency ban Increased our NHSP use Substantial savings Clear action plan Impact assessments Strong leadership
Our Journey Nov 2013 - As part of our productivity in Nursing cost Improvement initiative Agency was identified as a focus. Dec 2013 - Initial Action Plan was developed and circulated. Jan 2014 - Concerns raised by some high use areas. Jan 2014 - Impact assessments completed and submitted. Feb 2014 - Action Plan revised and implemented.
Action Plan ISSUE ACTION TIMEFRAME LEAD FINANCIAL SAVING 1. Booking of agency nurses/hcas to stop on a phased basis Stop booking agency RNs within JCUH/FHN except for Allerton ward, FHN 1 st February 2014 Jo Hutchinson (with Senior Nurses) - 180,397.65 Agency V NHSP 2013.xlsx Stop booking agency CSWs within JCUH/FHN except for neuro (wards 24, 25 & 26) 1 st February 2014 31 st May 2014 for Neuro wards Stop booking of Agency CSWs for community - except for PCHs 1 st February 2014 31 st May for PCH s Stop booking of RNs for community - who are currently the highest users most of their current vacancies will be filled by the end of Jan. Manage vacancies Introduction of NHSP community Nurse programme 31 st May 2014 In the absence of the above escalation time to Agency will change from 72 hours to 24 hours ie requests will go to Agency closer to the time at which the booking is required giving NHSP a greater opportunity to fill shifts. 20th Jan 2014 Completed
Action Plan
400,000.00 350,000.00 300,000.00 250,000.00 200,000.00 150,000.00 100,000.00 50,000.00 0.00 Savings seen 2013/14 to 2014/15 Total Bank Spend Total Agency Spend YTD Total Total Bank Total Agency Spend Spend Spend Total Spend 2013/14 3,656,045.60 586,680.59 4,242,726.19 2014/15 3,680,092.40 63,226.19 3,743,318.59 Change 24,046.80 523,454.40 499,407.60 Total spend has decreased by 11.8%. Last Agency invoice was billed in October 2014, this is due to Agencies having an excessive accounting lag. The average Cost per Shift has decreased by 10.1% Net reduction in spend of 500K Registered in England & Wales no.6704614. VAT no.gb983501510 Registered Office: NHS Professionals Ltd, 3 rd Floor, Edward Hyde Building, 38 Clarendon Road, Watford, Hertfordshire, WD17 1HZ
Benefits of Partnership working with NHSP Consistent/quality workforce Data/reports Assisted with staff communications Monitored the use of agency and the migration of staff from agency Developed excellent working relationships with ward managers Improved engagement Promoted registration and recruitment (CSWD/EU) NHSP can do attitude
Letter send to agency staff by the trust
Challenges Managing the change process: Influencing those not engaged (departments and individuals) Dealing with resistance - VIPs Maintaining a positive attitude Logistical challenges Dealing with frustrated managers National challenge of migration to high cost Agencies
Lesson learned Key to our success: Maintain a consistent approach Maintaining a positive and inclusive approach with the Flexible Worker Effective and regular communications regarding the progress Trust NHSP lead is also E-roster lead Invite NHSP along to New Starter Trust Induction days Development of Trust wide SOP for Managing Staff Shortages/Policy Monitoring compliance of SOP
Achievements Savings 500K from 2013/14 to 2014/15 NHSP Bank Only (BO) staff feel valued and more connected to the trust 12 months on and maintained success, with improved compliance An appetite to drive further efficiencies Increased productivity with more Multi Post Holders (MPHs) registering with NHSP and more shifts worked by BO staff Active Flexible Workers Average shifts worked 400 8.0 350 7.0 300 6.0 250 200 150 5.0 4.0 3.0 2.0 BO Staff MPH Staff Av per Bank Only Av per MPH Staff
Next Steps Continue to use our substantive staff effectively Continue to support NHSP to recruit BO and MPH Actively encourage leavers to join NHSP Maximise existing Bank workers potential: NHSP outbound calling programme Never Cancel Bank policy to increase Bank Fill and reduce unwanted refusals Introduction of further NHSP workforce development programmes Propensity modelling Overtime migration Regional and national action on migration of workers to high cost Agencies
Most importantly Strong Leadership Operational management Senior management Partnership working Trust NHSP Client relationship team based on site and responsive Engagement with multiple NHSP departments
Group work: what are your next steps? # nhsworkforcesupply
Wrap up and reflections on the day Ruth Warden, Assistant Director of Employment Services, NHS Employers @NHSE_Ruth # nhsworkforcesupply
Future workforce supply events workforce supply: the shape of your workforce 7 September Birmingham workforce supply: attracting the best and strengthening your brand workforce supply: what does good recruitment practice look like? workforce supply: engage, improve and retain your workforce www.nhsemployers.org/workforcesupply
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