£3.4 Million Saved Through Staff Bank and Agency Transformation at Hillingdon Hospitals

Rapidly transformed our staffing operation, consistently exceeding all KPI targets. The detailed business insights they provide are enabling us to better manage risk and reduce staffing costs.

Associate Director of HR Operations

Background

The Hillingdon Hospitals NHS Foundation Trust (THH) delivers services to a population of over 350,000 with services run from two hospital sites. 
Our managed service teams (contracted under Medacs Healthcare's sister brand, Litmus Workforce Solutions) were awarded a contract in March 2023 to manage the Trust’s Staff Bank and Temporary Staffing operations across all staffing groups. The contract officially went live on 2 May 2023, following an efficient eight-week implementation. 

Key goals were to embed a ‘bank first’ strategy, improve fill rates and reduce spiralling staffing costs. In the face of chronic staffing shortages, particularly for RMNs, knee-jerk booking behaviours (offering escalated rates and booking directly with off-framework agencies) had become prevalent. The Trust needed to strictly enforce new processes and rate policies, without impacting safe staffing levels.

The Approach

Implementation began with the development of an enhanced onsite bank and temporary staffing team, incorporating tupe'd members of the existing Trust team. New temporary staffing processes, rate cards and rostering best practices were then agreed and rolled out to all departments. Existing systems were also optimised, leveraging our Managed Services teams’ advanced expertise with Allocate and Patchwork, with the latter already used across the wider ICS. Work then began to embed a ‘bank first’ approach, securing managerial buy-in and providing proactive support to follow new rate policies. Targeted bank recruitment campaigns and a dedicated microsite were also launched to promote the benefits of bank work and strengthen internal resource pools. 

The Outcome

Over two years, our teams consistently outperformed monthly savings forecasts and realised a total net cost saving of £3.4 million for the Trust, equivalent to 164% of target. Notable successes included:  

• Transitioning bank and agency workers to reduced rate cards (Pan-London and One-London)
• Eliminating all off-framework agency use
• Fulfilling 20% of prior agency bookings with bank workers
• Reducing medical agency use to just one rate and DE- compliant locum doctor
• Reducing agency spend by 51% across all staffing groups
• Reducing medical bank spend by 17% and halving medical bank rate breaches with stricter authorisation and more advanced rota planning
• Increasing payroll cost-efficiencies with 100% of agency workers employed via Direct Engagement
• Consistently maintaining fill rates of at least 95% across all staffing groups

Recruitment campaigns for the Trust's staff banks generated well over 1000 new applicants, with our teams also supporting to expedite the interviewing and onboarding of new recruits and optimise bank resource use. Recruitment activities to address the chronic staffing shortages in mental health nursing were particularly successful, and as a result 100% of the Trust’s temporary mental health staffing needs are now met via the bank and framework agencies.

The Trust now operates a more sustainable and future-proof staffing model, achieved through strong partnership working, featuring harmonised rates, reduced temporary staffing costs, aligned systems with the North West London Collaborative Bank, and an expanded, strengthened pool of bank workers. 
 

Partnership note: The formal contracting entity for the service at The Hillingdon Hospitals 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.