19th April 2018 in Workforce Management
Northern Devon Healthcare NHS Trust
Taking a step-by-step approach, Northern Devon Healthcare Trust implemented TempRE direct engagement and staff bank services during the spring and summer of 2017. By the end of the first full year of direct engagement, the Trust had beaten their initial savings target of £200,000. Increasing take-up of the more recently-introduced bank is now pushing savings levels steadily higher.
When Northern Devon first contacted Liaison, it was to talk about the possibility of setting up a TempRE staff bank. However, managers quickly recognised that there would be significant benefits in also bringing on board Liaison’s TempRE Direct Engagement service. The Trust was at that point using an alternative direct engagement service, but take-up had been disappointing. A further problem was the ongoing lack of clear data. The finance team were struggling to match invoices with bookings, and reports coming from multiple sources across different systems made it challenging for management to see the big picture.
In weighing up their options, Trust managers were therefore particularly attracted by two key Liaison benefits: the on-site presence to support utilisation, and the integrated data and reporting. In addition, they liked the idea that working with Liaison could be a journey starting with direct engagement and working towards an internal bank. The possibility of a future regional collaborative bank also appealed.
The Trust decided to make the switch, and a three-step approach was agreed: Step one, direct engagement for medical locums. Step two, direct engagement for AHPs, and step three, a locum staff bank covering both medical staff and AHPs.
Despite the extra complexity of switching from the previous supplier, medical locum direct engagement was up and running within eight weeks. Working closely with supportive Trust staff, the Liaison team made sure all the pieces of the jigsaw were in place before the launch date. This included setting up the technology, mapping and updating Trust processes, promoting engagement, running training, and helping move locums to direct engagement contracts. The team included a full time on-site Liaison Client Support Administrator, as well as regional support staff providing ongoing input and advice.
Once the TempRE processes were consolidated for medical locums, the Liaison team started to implement direct engagement for AHPs. Seeing the savings mount up, the Trust were then more than happy to give Liaison the go ahead for TempRE Bank. The new bank went live in July 2017 with an initial cohort of 13 doctors. Take-up increased rapidly, with 35% of individual workers working a bank shift during the following October to December period. Support from AHPs has been particularly strong, with peak weekly bank fill so far of 62% of shifts.
The visibility of booking detail has more than met Trust expectations. There’s no more guess work or wasted time around invoicing, and the range and depth of reporting is giving managers the integrated big picture spending information they had been missing.
TempRE daily and weekly reports list every booking made and flag high value bookings and any that exceed the rate cap. Staff use the reports routinely to identify high spending departments and take appropriate action. Further pinpoint detail is provided specifically for NHS Improvement submissions.
On top of this, monthly management reports bring in accounts payable data and so capture all locum agency spend both within and outside TempRE.
The Trust is also using Liaison’s pay rate data to compare the rates they pay against those paid by other members of Liaison’s 70 + client base and to drive rates down. During October-December 2017, for example, average Staff grade rates were a substantial 10.5% lower than at the start of the Liaison contract; during December 2017, ST3 rates were 6.1% lower.
Next steps are for Liaison and the trust to focus on growing the bank, moving towards greater self-sufficiency and reducing the need to turn to agencies.