Agency usage reduced from 16.2% to 1.1% across Nursing, Midwifery, Allied Health Professionals, Healthcare Scientists and Support Services
Off-framework agency usage completely eradicated
Registered bank fill of 76.6% achieved, up from 44.9%
The Situation
The Northern Care Alliance NHS Foundation Trust (NCA) is one of the largest NHS providers in the country and was established in October 2021, bringing together staff and services from the former Salford Royal NHS Foundation Trust and the Pennine Acute Hospitals NHS Foundation Trust. Demand for temporary staffing was at an all-time high and by March 2023, it had reached 413k hours per month resulting in agency spend of £3.1m per month and agency fill of 20%, with registered Bank fill being a particular concern.
The Solution
As a leading provider of managed service staffing solutions, NHS Professionals (NHSP) collaborated closely with NCA to implement numerous process changes and reduce agency use and spend. High usage areas were identified and targeted with tighter agency controls via systems and processes, such as:
- Limiting shift visibility via cascade management
- Direct bookings switch off
- Ongoing use of management information to track findings and guide strategy
- Replacing off-framework agencies with NHS England (NHSE) approved providers, working to agreed price caps
This work was underpinned by instilling a bank first approach to fulfilling shifts. This strategy focused on increasing bank fill and implementing effective agency management strategies.
The Results
By March 2024, agency use was reduced from 16.2% to 1.1%, well below the national cap, and registered bank fill achieved 76.6% (up from 44.9% at the beginning of the initiative). Additionally, off-framework agency usage was completely eradicated by April 2023.
A year on, we have continued to achieve success with under 1% agency usage into 2025. This has been achieved through the ongoing partnership approach, which is supported by:
- Using NHSP and Trust roster data
- Stringent system controls, including the integration between E-Rostering and NHSP
- Continued compliance with NHS England Agency Rules and Price Caps
- Demand forecasting, identifying areas at risk of utilising agency
- Maintaining a bank-first approach to fulfilling demand
By working collaboratively with NHS Professionals to eradicate our off-framework agency usage, we have achieved remarkable results. The NCA are proud to have achieved 0% off-framework agency usage and a more cost-effective agency cascade. Our partnership with NHS Professionals continues to support the Trust with the maintenance of a cost-effective approach to temporary staffing, while ensuring quality care and safe staffing levels.
Geoff Smith, Head of People, Locum & Temporary Strategic Resourcing at Northern Care Alliance NHS Foundation Trust