Eliminating agency spend on healthcare support workers at East Lancashire Hospitals NHS Trust

To address financial pressures and concerns around care quality, East Lancashire Hospitals NHS Trust set themselves the ambitious goal of entirely eliminating agency spend on healthcare support workers.

What was the problem?

The trust’s agency spend on healthcare support workers (HCSWs) was high and rising. This caused not only financial pressures but concerns about care quality. The trust set itself the ambitious aim of eliminating agency spend on HCSWs entirely.

What was the solution?

The trust’s strategy involved:

• executive commitment

team approach – a multidisciplinary team, including the senior nursing team, recruitment team and learning and development team created a plan with input from all related areas

• recruitment to bank – the trust encouraged agency HCSWs to join the bank and made this easier by developing assessment centres for block interviews; it met student nurses to tell them about the benefits of working as an HCSW while studying, using social media to promote these changes

• six-month temporary contracts – appointing HCSWs on six-month temporary contracts where agency HCSWs were used most, with support and guidance from finance colleagues to avoid overspend

professional judgement review – the team consulted in-house experts in finance, recruitment, etc to ensure their strategy would succeed and be sustainable

• recruiting substantively – the trust recruited over 100 substantive HCSWs by advertising internally and recruiting directly from the bank; recruiting substantively from the trust’s own bank HCSWs became an ongoing strategy

• roster performance – by examining rostering data the trust could target particularly challenged divisions; this data formed the basis of regular meetings to discuss and measure progress.

What were the challenges?

The team identified potential risks early and as a result did not experience any major challenges. It was imperative to get the right people together to represent multiple perspectives. Rigorous programme planning and strict deadlines helped avoid major slippage. The trust had some difficulties getting clinical input in some aspects, but this was mitigated without significant impact.

What were the results?

The trust recruited the HCSWs needed to eliminate agency spend entirely.

To find out more, understand lessons learnt and sustainability plans visit https://improvement.nhs.uk/res... or read the attachments.

Alternatively, you can contact Dee Staveley, Head of Temporary Staffing via [email protected]


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