Overview of the solution
All healthcare providers are considering their workforce management strategies. The nursing population is reducing annually and therefore a workforce in short supply, where demand is increasing, uplifts the market rates, and thus the spend for agency temporary workers. as agency spend is increasing, framework popularity is reducing as the capability of supply becomes a major driver in the choice of agency. recognising this, our solution seeks to shift the focus of resourcing vacancies from agency to bank to permanent recruits. The concept is straightforward, but delivering it is less so, in part because it must follow two key principles to work:
It can only work if there is a single partner organisation delivering all three. In such a strong “sellers’ market”, any attempt to split the functions, or to deliver the model inhouse, is likely to end up with the third party agencies back in control.
The commercial arrangement with the partner must build in incentives to make it more attractive to deliver permanent or bank resources rather than agency resources (at the moment the reverse is true).
Without both of these set at reasonable levels, the model is fundamentally flawed. there is, in addition, the requirement to invest in building workforce management processes and disciplines around the permanent and bank components of the service, as well as working in partnership with the client to ensure retention of the existing workforce is improved and supported.
The below diagram sets out a simplified view of how the approach works.
Aim: To shift resource fulfillment from agency to bank
Key issues: Recent pressures to increase nurse staffing levels have resulted in a rush to agency providers. This has meant significant utilisation of off-framework providers, with very high rates charged for the scarcest skills in a 'sellers market'. Clinical staff have become incentivised to move from Bank to Agency.
Our solution: Single agency partner manages provision of all agency staff to drive down agency costs. However, critically, this same partner is also provider of Bank services, and is incentivised to provide Bank staff over Agency.
Key issues: Insufficient focus on building and managing Bank leaves it under-resourced. Bank will often have too great a focus on admin staff and too few clinical staff. In particular, it will have very limited ability to provide the most scarce (and therefore most expensive) clinical specialities.
Our solution: Invest in building and proactively managing the right profile of Bank resources. Actively engage and incentivise to encourage staff to use Bank rather than Agency. Branding and engagement to encourage recruits.
Key issues: Little early visibility of when a role will be created or vacated, restricting the potential for early start to recruitment processes. Permanent recruitment processes take too long to complete. Incentives are greater for staff to work on an Agency basis.
Our solution: Invest in workforce management processes and technology to give early warning of vacancies. Invest in streamlining recruitment process, and in particular shortening timescales for checks and authorisations. Branding and engagement to encourage recruits.
KEY POINTS: For the model to work it is vital that the components above are addressed as one, and that this is done with a single workforce management partner in a commercial arrangement that incentivises Bank over Agency.
The variation to the above would be where there is no formal bank arrangement in place, so we will deliver a combined Recruitment Process Outsource (RPO) and Agency Management. This builds on work we have done for central government in our personal independent payments contract that we manage on behalf of the department for work and pensions. The RPO is an investment whereas the agency management represents a saving, so combined it should be possible to deliver an early cost balance across the two.
For our NHS community services client we have developed something more akin to a “work alongside” model which involves us putting staff into their organisation to assist them in deploying the new service models. Alongside this, our agency business, Team24, has taken on the role of managing all temporary agency spend with a remit to deliver savings.