Five high impact actions


These actions are based on evidence from NHS organisations that have been successful in managing their agency workforce and show the key actions employers should undertake to ensure effectiveness. 

The five high impact actions

Under each of the high impact actions we have identified a number of specific activities that NHS trusts can do in order to help them optimise the productivity of their agency workforce. 

1. Increase understanding of the issue

  • Introduce e-Rostering within your organisation.
  • Ensure that all staff employed within the organisation are on a single template and IT system.
  • Introduce specialist rota coordinators to ensure that rosters are designed to best utilise the trust's resources.
  • Run a series of weekly reports, highlighting bank and agency usage and the number of staff working at any time.
  • Ensure that you have information systems in place that allow you to see the difference between the cost and usage of bank and agency staff.

Further information is available in the increase understanding of the issue section. 

2. Manage the process and take control

  • Establish rules within the organisation that mean senior sign off is required to book bank or agency staff.
  • Where appropriate try and centralise the responsibility for booking temporary staff.
  • Ensure that billing mechanisms are effective and give you full visibility of what you are paying for.

Further information is available in the manage the process and take control section. 

3. Manage your workforce, create a sustainable supply

  • Ensure that the substantive workforce is as productive as possible.
  • When vacancies do occur, consider whether a direct replacement is required and if it is, explore whether part-time staff would be interested in increasing their hours before bringing in temporary staff.
  • When a permanent vacancy does occur, explore the option of using the regional MoU to support the redeployment of staff.
  • Look at when you use your substantive staff, it can be more expensive to use temporary staff at evenings and weekends.
  • Ensure that you are not re-employing your own substantive staff back into the organisation to work on a part time basis.

Further information is available in the manage your workforce, create a sustainable supply section. 

4. Work Collaboratively

  • Develop productive working relationships with all your agency partners in order to ensure they know how they can best meet your requirements.
  • Work with regional procurement hubs to utilise the economies of scale that can be achieved through larger purchasing arrangements.
  • Work with other neighbouring trusts to explore the possibility of setting up joint staff banks.
  • Work collaboratively within your organisation to ensure that all relevant parties are involved in effectively procuring temporary staff.

Further information is available in the work collaboratively section. 

5. Engage with staff

  • As with any change process, ensure you effectively communicate policies and working practices to your staff.
  • Use groups such as social partnership forums and joint negotiating consultative committees to explore where processes could be further improved.

Further information is available in the engage with staff section. 

There are a number of case studies available which showcase good practice from within NHS organisations. They demonstrate how each of the high impact actions can be translated into practical steps that can lead to both a significant increase in the quality of patient care and a reduction in the organisation's expenditure on agency workers.

To get the most from our resources, we recommend that you view each of our how to guides and five high impact changes as a suite of materials and a comprehensive tool to aid workforce reform.


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