Case Studies

17th April 2018 in Workforce Management

Manchester University NHS Foundation Trust

Manchester University NHS Foundation Trust (Wythenshawe) saving 64% of agency medical locum spend in one year

NHS spending on contingent labour is always under the spotlight. Annual costs have now reached billions of pounds yet despite the scale of this spending, many NHS organisations still have difficulty managing their temporary staff usage, especially the medical locum spend where demand outstrips supply in many areas. Lord Carter’s review of NHS efficiency and NHS Improvement rate caps highlight best practice targets and many trusts and boards are pursuing a path towards the model hospital best practice. With 60% of locum doctors already substantively employed by the NHS, it makes sense to become more self-sufficient by growing medical staff banks.

Liaison know there is a medical locum agency savings potential of £400 million from a £1.1 billion 2016/2017 spend, if every trust followed suit with what the best trusts do now. NHSI are targeting a £150m reduction in 2017/2018.

Liaison have been working with Manchester University NHS Foundation Trust – Wythenshawe hospital since 2014 to become one of the best performing trusts in this area of spend.

Three years ago, Manchester University NHS Foundation Trust (MFT) – Wythenshawe was in a very different place. A lack of resource, divided process and no formal route for vacancy release meant something needed to change to enable the trust to see the reduction in cost and demand that they so desperately needed to realise. By the end of 2016 the Trust had delivered a £570,000 saving – all as a result of TempRE.

“We knew there was a lot of work to be done, and that automating vacancies would make things easier for the team. We had a distinct lack of policies and procedures and no controls around the authorisation of procuring medical locums, which meant anyone in the Trust could request a locum. Our finance team were keen to reduce agency spend and get a paperless process in place – something we’d previously not been able to achieve. Medical Staffing and HR wanted to build a medical bank to reduce our reliance on agencies and offer shifts to bank workers instead.”

The start of the journey

The introduction of a new HR team in 2014 brought with it the recommendation that the Trust look at STAFFflow for direct engagement; “It proved to be a real success and a key stepping stone to take us to where we are now. During the course of the implementation of STAFFflow, our team developed strong and trusting relationships with the Liaison team. When Liaison then broadened their portfolio to include TempRE Direct Engagement, we quickly realised that MFT – Wythenshawe shared Liaison’s vision for improved workforce management and we upgraded to the new service.”

“We upgraded in January 2016 to further explore our options for improving control, bringing down costs, and allowing us to be self-sufficient. The neutrality of TempRE’s approach appealed to us, as well as the future scalability of the service to other professions, not just doctors, which meant there was a scope for processes to be replicated allowing us to work consistently. Our move paid off, and by the end of 2016 we had delivered a £570,000 saving for the Trust as a result of using TempRE.”

Introducing TempRE Bank at MFT – Wythenshawe

MFT – Wythenshawe’s journey towards greater efficiency and control continues with the use of TempRE Bank and ultimately TempRE Collaborative Bank; “We have already rolled out TempRE Bank to 20 departments who have access to a bank profile of 85 substantive doctors, 56 doctors on rotation and 47 bank-only doctors, totalling 188 live bank workers. We’re now seeing a reduction in cost per placement thanks to reporting that allows us to focus on how we effectively achieve this. We’re not just swapping the cost from agency to bank.”

But the Trust found that to make real savings you have to work to change behaviours and ensure everyone involved in the process is committed to the same journey; “Our Medical Staffing Manager has led the charge for taking control in ensuring everyone works in the same, accountable way, following the formality of TempRE tiers so that our process is consistent and has a formalised structure. It’s all to do with the relationships that our team, supported by Liaison, have with consultants and directorate managers, and how they work with them to inform fill rates and cost improvements.

We’re lucky that the medical staffing team are really strong and are good at utilising relationships and lines of communication for effective internal co-operation – this is fundamental in how we’ve been able to achieve the results we’re now seeing.”

The team at MFT – Wythenshawe engaged with all of their key stakeholders, including agencies, in terms of ensuring consistent and effective use of the service from all sides; “We now have a formalised route for communications with our agencies, as everything is managed through the TempRE service, which means we have more transparency over what we’re paying in commission to them than we did before TempRE.”

“The introduction of TempRE at MFT – Wythenshawe has led to a more structured way of working. The team seemingly feel less pressured and are more assured of getting good quality doctors thanks to functionality allowing them to sense check them first. This leads to security in knowing that quality of care to our patients is ensured through TempRE. We’ve now got a good level of transparency around agency and bank – allowing us the control we’ve strived for.”

Onsite support

MFT – Wythenshawe’s reduction in agency spend has been bolstered by the provision of full-time, onsite support provided by Liaison which aided the Trust to put the processes in place, formalise a robust route to market and ultimately help the team to mandate direct engagement.

“The team at Liaison are incredibly responsive and we’ve had a great amount of support at every stage of our journey from implementation; process mapping; systems training; full scale reporting; communication of the purpose of TempRE across the Trust as well as constant service and process review with our MFT – Wythenshawe stakeholders.

We have an excellent working relationship with our Liaison Account Manager and benefit from his presence at regular monitoring meetings with our Director of Finance and HR team. Further to this we also benefit from having full-time onsite support from our Liaison Client Services Administrator, Amy, who is always contactable and who we know we can rely on for a response at any time.

Amy also helps us produce data for our board reports. She goes above and beyond to give us what we need; her knowledge means that there’s nothing she can’t help us with. She has a strong rapport with the team and although she works for Liaison she’s essentially part of our team.

Liaison go out of their way to understand what we need and how we work and it’s this level of consistent, solid, reliable support and knowledge that makes the difference to us. We know that technology alone doesn’t make the difference, and Liaison proves it.”

Full scale reporting and demand control

MFT – Wythenshawe’s reduction in agency spend has been bolstered by the provision of full-time, onsite support provided by Liaison which aided the Trust to put the processes in place, formalise a robust route to market and ultimately help the team to mandate direct engagement.

“The team at Liaison are incredibly responsive and we’ve had a great amount of support at every stage of our journey from implementation; process mapping; systems training; full scale reporting; communication of the purpose of TempRE across the Trust as well as constant service and process review with our MFT – Wythenshawe stakeholders.

We have an excellent working relationship with our Liaison Account Manager and benefit from his presence at regular monitoring meetings with our Director of Finance and HR team. Further to this we also benefit from having full-time onsite support from our Liaison Client Services Administrator, Amy, who is always contactable and who we know we can rely on for a response at any time.

Amy also helps us produce data for our board reports. She goes above and beyond to give us what we need; her knowledge means that there’s nothing she can’t help us with. She has a strong rapport with the team and although she works for Liaison she’s essentially part of our team.

Liaison go out of their way to understand what we need and how we work and it’s this level of consistent, solid, reliable support and knowledKnown not only for delivering savings, greater control and cost efficiencies, TempRE is also well known for providing management information – unparalleled in the market. With management information that is actionable, detailed and comprehensive, MFT – Wythenshawe were able to assemble information that can create change for the better.

“Liaison’s reporting suite is very powerful and for the reporting alone TempRE is a no brainer. Liaison have done the work to identify what trusts are required to provide to NHSI meaning we don’t need to utilise resource on it. All of the information that we need to report on already sits within the reporting suite ready for us to access. TempRE’s functionality to automate our NHSI return for medical locums alleviates so much pressure on the team. It means we don’t need to worry because we know Liaison, and their service, is responsive to the changes that NHSI issue regarding their reporting requirements.

We use Liaison’s reporting suite to make a difference in our Trust every single day – the reports are invaluable. The visibility and control that the reports provide help us to not only fill a gap but control costs, drive down demand and identify the long term for the Trust’s workforce planning process, meaning we can always be one step ahead.

Where demand control is concerned, we now have clear sight on where our demands are and what the issues are. We have the information so can manage the problem. We know where there are long term issues are and where our problem divisions are. There is now an expectation on better demand management because, as a trust, we know we have no excuse because we have the information, we’re informed.”
We

The future for MFT – Wythenshawe

“Throughout this process a key learning for us has been that technology alone never makes a difference, it’s about the people and the processes that go with it. As a trust, we know you need to have the technology to really improve process and work smarter and that’s where, for us, Liaison made the difference. They have steered us from implementation right through to where we are now. Liaison have supported and guided us to impact change in processes, control demand as well as cost, and shape a new way of working for the Trust, and for that we couldn’t be more grateful.”

“We work with Liaison as a partnership and we’re thrilled with what that partnership has enabled us to achieve at MFT – Wythenshawe so far, and moving forward we don’t want to lose that. We want to work with Liaison to help us better understand behaviours and trends of staff. We’re not just interested in getting staff in place, but making sure we control the whole process and we know Liaison can take us there. As a trust we’re now actively looking at Liaison’s workforce analytics services which will be key to helping us realise this goal, and having the rationale to support our board reporting with a predicative element to workforce management. We also want to ensure we’re using the best quality staff and benefitting from further collaboration with local trusts. The next step in our journey to cutting costs and reducing demand will be with TempRE Collaborative Bank which will lead to local collaboration by allowing us to offer more bank vacancies through a shared bank, giving us access to more of the best skillsets and knowledge within the NHS.”