Background
United Lincolnshire Hospitals NHS Trust are the largest acute NHS Trust in the UK. For many years their temporary staffing spend had been increasing and the Trust struggled with the resources needed to gain visibility, grip and control to start to make real change to this.
In 2015 the Trust was in contract with a Neutral Vendor agreement, but decided to partner with neighbouring organisations' Doncaster and Bassetlaw Teaching Hospital and Northern Lincolnshire and Goole NHS Trust to look at a more cost effective solution and a partner that could support the Trust on a journey to reduce reliance on agency staffing.
Whilst moving provider in such a big organisation felt like a significant undertaking, the Trust felt that a change in solution was required in order to achieve their organisational goals.
The Trust embarked on a competitive tender exercise under the Workforce Alliance framework to seek a Master Vendor and Direct Engagement provider and following the results of this awarded Holt Doctors Ltd as the new provider of the service.
Key aims
- To gain visibility of all medic temporary staffing spend across the Trust
- To have one point of contact to manage temporary staffing spend for the Trust
- To eradicate off framework supply and gain control of suppliers used within the Trust
- To achieve high fill rates
- To ensure compliance for all workers
- To drive DE uptake for Medics
- To set targets on spend reductions and make savings in supplier fees
The solution
In 2015 ULHT entered into partnership for a master vendor arrangement for medics with Holt Doctors Ltd. The transition from the existing provider was seamless and the trust quickly started to yield the benefits of having one provider to manage all the spend across the trust.
The introduction of their IT platform 'Locum Management System' meant that the trust could introduce controls and approvals for jobs to be issued to agency, and ensure the right sign off had been sought for the spend. The system also enacted the 'force DE' setting which meant that the trust quickly saw their DE uptake improve significantly.
Strong supplier engagement meant that fill rates increased quickly and the Trust no longer needed to engage with off framework agencies for supply, or to try and source cover for themselves. Holt's Client Managers leant on their strong supply chain relationships and knowledge to fill even those 'Hard to fill' roles with relative ease.
All files are manually vetted by Holt's 30+ Compliance Team ensuring that all candidates engaged for work within the Trust are fully compliant, and ongoing compliance requirements are managed by the Holt team.
Holt introduced a commission rate card that made quick win savings for the Trust by ensuring all suppliers were charging the same fees to the Trust. Additional savings were made through Holt's dedicated Client Managers acting as gate keepers for rates and ensuring negotiation on every role to achieve the best rate for the Trust.
Holt's Head of Managed Services, Stuart Gant, has worked in partnership with the Trust now for a 10 year period, sharing cost reductions initiatives such as rate card reductions, mandatory break deductions and sharing of market intelligence from other Holt client's to ensure that ULHT can be assured that they are getting the possible rates when filling their roles.
Holt, over the 10 years we have been in contract for, has supported the trust through many challenging times, such as NHSI capped rate introduction, IR35 legislation changes, industrial action challenges, and the instruction of regulation 8 requirements. Holt has reacted quickly and made process and system changes where needed to support the Trust when they have needed it most.
Continuous improvement and evolvement
The market and the requirements have changed significantly over the course of the contract, and ULHT's needs have evolved. Holt has therefore looked at ways to evolve and offer additional services that meet the changing needs of the Trust:
- Allowing the use of the LMS technology for the Trust to manage their own bank resources
- Formation of a regional bank model to allow movement of candidates across the region
- Introduction of a Managed Bank function when the Trust needed more support in growing and increasing the numbers of their internal bank
- Introducing flight path rates initiatives to support staggered reductions in charge rates for the Trust
- Developing API and RPA functions within our system to support integration with the Trusts rostering platforms
- Changing reporting requirements to meet the needs of the Trust's board, ICB and NHS England
Results
- 98% average fill rates
- 97% DE uptake
- 1500 shifts a month filled
- 70%+ roles filled by Holt supply
- £500k agency spend reducing in the last 12 months
- 2800 bank shifts filled per month
For more information on Holt Doctors, either call 0208 099 06943 or email [email protected]