Working together towards a reduced agency spend across a region

working together

Ben Chico, project manager for the Working Together Vanguard Programme, has written a blog on the partnership's initial experience in working across seven trusts to consider how they can reduce medical locum spend.

As the highest area of bank and agency costs, there has been focus upon how to mitigate medical agency spend in the South and Mid Yorkshire, Bassetlaw and North Derbyshire area for some time.

The Working Together Partnership sees seven acute trusts collaborating on a number of common issues. In 2015 it became one of the UK’s vanguard sites, which were created to act as a blueprint for the NHS moving forwards and an inspiration for the rest of the health and care system. 

Within this framework, the seven trusts agreed to adopt a collaborative regional approach to the reduction of agency spend through a memorandum of understanding. This sets out agreed commitments across the trusts in relation to escalation processes for approval of medical and dental locum / agency usage. It seeks to add value to local governance processes by providing a consistent guiding framework and increased transparency around agency usage.

Key to the approach across the Working Together Partnership and one thing I would recommend to colleagues is professional engagement / empowerment. Each project is led by a networked group of professionals from the seven trusts who work in the relevant profession (in this case, medical staffing leads). This is one of the most successful areas of the partnership’s work, because when we reach implementation we have full engagement and a solution that truly works in practice.  

The other key aspect is effective oversight. In our case, the process has been overseen by the Human Resources Directors Group and discussions about the topic pre-date the November 2016 Jeremy Hunt funding announcement. Indeed, in May 2016 the partnership trusts had already signed up to a shared memorandum of understanding, with common principles to which they would all adhere in agency approval processes. 

Finally, I work as part of an in-house project management office funded by the trusts. Our team supports co-ordination and delivery of projects, and we provide support to colleagues who might not otherwise have the capacity to engage. 

Having established the basics, including structures and protocols, the group developed recommendations for the delivery of this exercise. The group made recommendations that would reduce spend in the short term (under one year), medium term (one - three years) and longer term (three - five years). As well as the timescale within which actions should look to be implemented, the recommendations are also divided into themes: workforce planning;  recruitment and retention; policy and process; and business intelligence and contractual relationships, in recognition of the relationship between each area and medical agency usage. The recommendations from the HRDs were then shared with the chief executives of each of the trusts who give their approval. 

Trust agency spend has reduced in the last 12 months supported  by the exercise, however there is no magic bullet to resolving high agency spend and it remains part of a wider HR workplan for 2017/18 to ensure all partnership opportunities are exploited. This includes delivery of a case for collaborative medical bank which is in development.

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