Picking apples: how to achieve quick wins in NHS workforce deployment

By James Foxlee - 2nd Sept 2019

The margins between running a successful Trust and one that is failing, are thin and elusive. A whole basket of factors – some you can control, some you can’t – determine a Trust’s fate.

Staff morale, patient safety, quality of care, regulation and engagement are just some of those factors that make a difference. Another is workforce.

Workforce is often put in the ‘too difficult to do’ box. But without a grip on this, a Trust can easily find itself in a regulatory quagmire. And one thing that most agree on, is if you’re on the back foot with the regulators, then getting on the front foot again can be tricky and daunting.

One of the best things you can do is to consider where the quick wins are, the low-hanging fruit. Turning around a function 180 degrees in a short space of time is noticed and approved of by the regulatory authorities. However, what function do you choose and what resources are required? This decision in itself can feel like putting your money on the spin of a roulette table.

Fortunately, there are some areas you can achieve rapid and impressive results. Picking apples – temporary workforce spend

Staffing costs are an obvious source of savings, but there’s only so much you can do by cutting substantive employee positions before staff morale and patient safety might be compromised. An efficient use of temporary and flexible resources is absolutely critical. This means balancing your Staff Bank and use of agencies or locums.

Flexible resourcing management has been historically a notoriously tricky thing to get right. Not only are there multiple roles, specialities, locations, rates, suppliers and compliance to manage; there is the process of paying the temporary employee, where the best of intentions can quickly conspire to undermine your overall strategy.

The big problem is managing all these variables can quickly turn into a ‘cottage industry’ due to the time intensive nature of not only enabling, but managing the paperwork to meet CQC auditing requirements. The problem is further compounded when you have multiple sites to manage.

Technology is your friend

Digitisation has come relatively late to Flexible Resourcing, especially where medical roles are concerned. One reason for this, is many of the existing systems designed to manage eRostering were developed over twenty years ago and lack the technology to make a real difference without compromising functionality or massive project and infrastructure spend.

The legacy nature of such systems, encourages a perception amongst lay users that implementation requires much time and major change. This perception is entirely understandable when you look at the history of IT platforms in the NHS over the last thirty years, in particular the over ambitious national systems attempted in the 1990s and 2000s.

However, with the advent of ‘agile development’ techniques and mobile, cloud-based technology implementation needn't be a headache, and, crucially is a lot more affordable than many think.

Circular Wave’s Staff Bank software makes it easy for trusts to create and manage their own thriving staff banks, for themselves, so reducing dependency on agency staff. This in turn has a positive effect on patient safety, continuity of care and improved compliance.

How we helped a North East Trust pick their own low-hanging fruit

In April 2018 we worked with a large and demographically-varied acute trust in the North East of England to turn around their medical bank flexible resourcing. Tasked with a Staff Bank fill rate of 30% in six months (from an existing fill rate of under 1%), Circular Wave’s team got to work and by May 2018 the fill rate hit was 65%.

The result: a significant increase in bank fill rate, a fall in agency fees, and a sophisticated understanding of the trust’s temporary staffing situation. Furthermore, agency spend was cut by nearly 50% over the first year of operation – with Circular Wave’s platform a major factor in this success.

The results caught the attention of NHS Improvement – who praised it as a national exemplar. Compliance was commended, because at any one moment in time, the Trust knew its medical overspill shifts were being worked by the right doctors with the right skills while being automatically audited via our software.

Yes, but what about the money?

Our software can often be funded from existing budgets. For example, most existing Staff Banks, either manual or digital, rely on SMS messaging to connect with employees. In a large acute trust this can run to £20,000 per month or more in SMS charges. The Circular Wave platform uses internet messaging to contact employees, not only does this allow relevant, targeted and specific data to be sent, but there is no charge for an internet message. Move your bank onto our platform and just one of the benefits is you can use your SMS comms budget to more than cover the cost.

Our pricing model is transparent and fair. There’s a set-up fee, a single low annual system cost, and a subscription fee per user (whether administrator or candidate). We’re significantly more cost-effective than our competitors. We’re not an agency in disguise: you don’t pay us commission each time a vacancy is filled.

Help us to help you

We’re a small, agile, friendly and collaborative team and we understand the NHS – so we’d love to come and talk to you about your Trust’s low-hanging fruit and how we can help you pick it. To get in touch contact us via: www.circularwave.co.uk.

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