Direct Engagement Efficiency
London North West University Healthcare NHS Trust
London North West needed a rapid reduction in umbrella workers to increase DE efficiency to the agreed target of 80% and mitigate the identified risks but knew implementing the required steps would be challenging.
If the critical culture change could not be adopted by all parties and the current methods of recording spend continued, there could be an adverse impact on fill rates.
Medacs Healthcare had also encountered issues on a similar project at a neighbouring trust, where doctors would only agree to change their pay type if rates were escalated.
If regular locum doctors could not be moved under the direct engagement model, there could also be a corresponding impact on the continuity of care delivered by the trust, as new workers would need to be brought in to replace them.
A comprehensive project control plan was created, specifically designed to avoid any impact on operations, with clear roles and responsibilities for escalating identified issues and a detailed risk register. It was tightly managed and jointly implemented in eight weeks, with the Medacs Healthcare team working in true partnership with key trust stakeholders.
Communications were thorough and led by the trust, including comprehensive FAQs for doctors, supply chain partners and off-contract agencies to support change management, with a clear cut-off date for non-compliance. Sharing successes achieved at other trusts also helped to convince key stakeholders that the project goals were achievable, and it could be delivered with no perceivable impact on overall fill rates.
In just four months, the DE-efficient hours filled had more than doubled, well exceeding the 80% target. Current DE-compliance is now 100% for AHPs and 95% for doctors. Total cost savings since project launch are currently £349,408 and the trust now has the highest rate of DE-compliance in their region.