The Spring Budget included the proposal of a new NHS staffing app and reignited discussions surrounding the persistent issue of overspending on temporary workers within the healthcare system.
Temporary staffing does indeed remain one of the most significant inefficiencies for the NHS and presents an unenviable challenge for those responsible for managing agency staff within trusts. So, Mr Hunt was right to identify that there are savings to be made by addressing the current overspend on agency workers, but is waiting for an inevitably expensive new staffing app really the way to solve the problem?
While a complete overhaul of the agency staffing model is necessary, the quickest solution lies not in reinventing the wheel but in optimising existing workforce management technologies and services. Equally as important though will be making these systems available to the decision makers in the NHS as well the support to help get the best out of the technology and start saving money.
Identifying the problem
The NHS faces unique challenges in sourcing temporary staff, exacerbated by the relentless pressures of frontline public service. This provides a climate for temporary sourcing costs to get out of control in a way that applies to few other industries. If there is a gap in frontline services, it’s not just targets that will be missed, lives will be on the line.
In the rush to fill shifts while under continuous pressure and ongoing operational challenges, the procurement of agency workers has become fragmented and inefficient in many NHS Trusts. This creates a supply and demand challenge that has led to a huge discrepancy in pay rates between substantive and agency workers.
High demand is driving up prices, but this gap needs to be closed if the overspend is going to be reduced. We’re also seeing temporary workers occupying positions for far longer than required – in some cases several years – due to restricted oversight of the temporary workforce, costing the NHS millions in unnecessary spending.
The challenges faced by decision makers are compounded by slow transition to, or a confusion of modern and streamlined workforce management systems. We regularly see disparate platforms and archaic methods of monitoring temporary staff hindering effective oversight of overspending.
The task of recruiting and managing the temporary workforce of a whole trust is hard enough, without having multiple different systems for doctors, nurses, caterers and cleaners, and very little time and resources to use them. Worse still, the continued existence of paper timesheets in some healthcare settings makes tracking the spend on temporary staff more difficult.
Understanding the problem
Without a workforce management solution that’s fit for purpose the money spent on agency staff has become unmanageable and damaging to the efficiency of the NHS as a whole. This has been exacerbated by financial and operational pressure building from years of austerity, the COVID-19 pandemic and frequent strike action.
The salary gap between substantive and agency workers is now huge, with some salaries four times that of the equivalent permanent position. This is the result of neighbouring trusts competing for the same temporary workers and driving up pay rates. It is made worse by inadequate systems and the intense pressure of healthcare recruitment. At the end of the day, decision makers are, of course, willing to pay these high costs to prevent a serious disruption to a frontline service. It’s an impossible choice, but there are ways of avoiding it.
What is the solution?
Clearly, the challenge that the NHS faces to cut down the overspend on agency staff won’t be easy to overcome, and doing so without impacting our vital healthcare services will be tall order.
But while this feels like a monumental task, it begins simply with better visibility. This means better visibility of workers – both full time and temporary – to ensure full oversight of the rota and potential gaps, and better visibility of how much and who money is being spent on and why. This will enable the critical awareness and time to negotiate the price for a worker and ensure they are only employed for as long as necessary. With this system in place, trusts will know exactly where overspend is happening and can put a plan in place to reduce it before it comes down to a life-or-death decision.
Most importantly, the technology and services required to implement an effective workforce management system to do this already exists, through companies such as Plus Us who partner with third party platforms to address this very challenge. To save on cost and time, it makes far more sense to utilise resources which have been proven to be effective, rather than starting from scratch and spending millions on a new NHS app that doesn’t guarantee success.
Embracing change
The battle to reduce agency staffing overspend isn’t going to be won overnight, and it’s likely that along the way, state of the art technologies like artificial intelligence will have a role to play in speeding up processes and maximising the efficiency of operations, as Mr Hunt has predicted. In the short term though, significant savings can be made by streamlining technology and adopting the right service provision so that decision makers are equipped with the right systems and support to manage the temporary workforce in the best possible way.
For those decision makers, and the wider NHS community involved in the mission to improve productivity and efficiency and reduce costs, the technology and expertise that is available in the private sector can be embraced in order to get right outcome. Behaviours, systems and ways of working that have been in place for years will need to change before progress can be made, but the technology and know-how is out there to help do this.
The first step: get rid of paper timesheets!
