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Onsite Managed Service

Company Background

In 2015, with ambitious plans to deliver challenging financial targets, Swansea Bay University Health Board asked their Master Vendor partner, Medacs Healthcare to help them reduce temporary staffing costs with a comprehensive onsite Managed Service.

The Challenge

Without a thorough and centrally managed approach to temporary staffing, the Health Board was incurring unsustainable levels of agency spend. Individual departments were booking locums directly, via both on and off-framework agencies, with little knowledge or understanding of the costs.

The Health Board needed much firmer procedures and control, along with detailed management information reports to help them understand what they were spending and why across each department.

There was also a need to implement a Direct Engagement model to realise valuable additional VAT savings and efficiencies.

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The Solution

Medacs Healthcare deployed a dedicated on-site Managed Service team to work closely with the Health Board to gain control of their locum spend and introduce new stringent booking and authorisation procedures. Activities included a review of all existing processes to identify inefficiencies, including in-depth analysis of junior doctor and consultant rotas.

Booking procedures were redesigned to improve rate control, the supply chain was improved and consolidated, and a new direct engagement model was introduced to realise VAT savings. Detailed monthly MI reports and data insights were prepared to provide the visibility the Health Board needed to understand what is driving demand and identify further potential staffing savings.

By the end of the first year, the onsite Managed Service had delivered savings of over £1 million and was subsequently expanded to incorporate Allied Health Professionals. Annual savings currently exceed £2.4million, with average fill rates at 97% across both staffing groups.

The Result

A new centrally managed booking function and a three-tiered authorisation process which gives the Health Board complete visibility and control overall requests, ensuring escalated rates are only approved in exceptional circumstances.

Highly granular MI reports which allow Medical Directors from each individual unit to drill down into the detail and see which bookings breached caps and why, on a month-by-month basis. These reports are combined with market insights showing average rates paid for different grades and specialties across the whole of Wales, so executive teams can make informed decisions on workforce strategy, based on regional trends.

Workforce Planning and Reduce or Replace’ protocols, which ensure that every booking is challenged at the point of request, with all reasons and rates subject to continual review. Proactive permanent recruitment, by using data showing regularly recurring contract extensions and long-standing locum bookings to identify potential substantive vacancies and recruit into them.

To date Medacs Healthcare has sourced 24 substantive clinicians for the Health Board, many across hard-to-fill consultant-grade specialties. An effective Direct Engagement model, with 100% of medical and AHP bookings processed in a VAT-efficient way, delivering substantial cost savings for the Health Board.

Improved supply chain management, which has freed up valuable time for the Health Board’s finance and procurement teams and improved the continuity of care, ensuring that the same familiar locums are used where possible.

"We trust Medacs Healthcare implicitly to efficiently oversee our temporary staffing operations, over the past few years they have reliably maintained fill and consistently delivered savings."

Assistant Director of Workforce & OD

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