Delivering £10m in-year savings and reshaping workforce efficiency

Provided invaluable support and strategic guidance, helping us to implement change without compromising workforce stability. The results achieved are exceptional and demonstrate their ability to drive impactful operational change with care, and realise significant cost savings.

 

CEO, Mid and South Essex NHS Foundation Trust

The Challenge

Mid and South Essex NHS Foundation Trust is one of the largest in the country, with around 15,000 staff serving a population of more than 1.2 million. In 2024, facing a significant deficit, the Trust entered NHS England's Recovery Support Programme, the highest tier of national oversight, with demanding targets to bring spending under control.

Our managed service teams (contracted under Medacs Healthcare's sister brand, Litmus Workforce Solutions) were brought in during December 2024 to transform staffing management and deliver significant and sustainable reductions in workforce costs. The commitment was to cut over £7.5m within a year, supported by two core goals:

• A 50% reduction in temporary staffing use, through better rota management, improved resource utilisation and permanent recruitment into hard-to-fill roles.
• Substantial rate savings, by standardising bank and agency pay rates across the region and driving stronger rate card adherence, Direct Engagement and IR35 compliance.

Strategic Workforce Planning Support

Implementation activities included a detailed analysis of both temporary and permanent staffing operations, and the compilation of a comprehensive pay rate benchmarking dataset covering the average bank and agency rates paid by neighbouring trusts. With accurate data insights clearly evidencing the case for change, our teams worked in partnership with the Trust's executive team to plan how rate adjustments could be applied, modelling and risk-assessing different scenarios. The sensitive process of communicating the proposed changes to managers and workers was then carefully planned to ensure their understanding and acceptance. The Trust's temporary staffing team was also strengthened with extra resource and training, so new processes could be adopted while keeping the service responsive.

Results

Despite implementation during winter, one of the most challenging times to change staffing arrangements, a structured programme to reshape workforce management and control rates resulted in a £10m saving in the first year, with no perceived impact on fill rates or service levels. That figure sat well above the £7.5m target, with every monthly milestone outperformed.

Tighter rate control was a key aspect, with 100% adherence to bank rate cards, the NHS England nursing agency rate card, and new pay rate, break and supplier commission policies. Direct Engagement throughput was also uplifted by 30%, generating DE savings of over £900,000, with all new bookings DE-compliant. The model was also extended to less commonly included non-medical staffing groups, adding further in-year savings.

Over the first 12 months, agency spend was reduced by a total of 48%, and 93% of temporary staffing was filled through the Trust's own staff banks. Together, these results supported the Trust's financial recovery and its move out of the most intensive level of NHS England scrutiny.

Partnership note: The formal contracting entity for the service at Mid and South Essex NHS Foundation Trust is Litmus Workforce Solutions, a sister brand to Medacs Healthcare that shares the same central services and governance within the MGG Health family of staffing brands.