Time to get saving?

All eyes and ears are always on the NHS Providers conference, and this year was no exception.

Much focus was on broader performance of organisations and senior leaders, and future frameworks, but I was surprised that little was said directly about workforce.

Indirectly I guess, we heard from Amanda Pritchard that we should ‘Prepare for next year being harder than this year financially’.  Couple this with messages from the Secretary of State for Health and Social Care before and during the conference on changes to the way Trusts must reduce the usage of agency workers, it presents another real challenge for Chief People Officers, and Trust Boards over the next 12-24 months.

Additionally, those Trusts who are deemed to be high performing will get more of the money, and those who are less performing (who often need more help) will get little or no money to support transformation – with league tables to ‘evidence’ poor performance of executives and Chief Executives, leading to performance management and ultimately ‘the sack’.

Of course, reducing spend on agency isn’t a new initiative.  Most Trusts have made significant improvements in their volume and expenditure of agency spend – admittedly, much of this will have moved to bank work rather than substantive, but nevertheless, significant savings were made.  That said, with £3bn still spent across the NHS, there will big expectations on NHS organisations to further evidence robust plans to better manage these costs, whilst maintaining the focus on elective recovery, and dare I say, winter is coming.

There will also soon be limits on NHS workers leaving, and then re-joining the Trust as an agency worker.  This was something muted a few years ago, and whilst it sounds like the right thing to do, it will be difficult to control, especially in particular areas that rely heavily on bank and agency workers due to national shortages (and where off-framework usage is still in place).

I have often felt that focussing on agency spend alone, isn’t going to fix the underlying problem.  Organisations rely so heavily on temporary staffing for a number of reasons – primarily because, despite best efforts, they cant recruit enough of what and who they need, and/or cant retain them.  There are also issues relating to increases in demand and challenges with length of stay/flow which lead to subsequent increases in the need for staffing.

One of the things that we have looked at with NHS organisations over the last 12 months, is the ‘drivers of the workforce deficit’; this has generated significant financial savings for those Trusts.  This includes a review of temporary staffing, but through the lens of factors which influence the spend, rather than simply saying we need to spend less without a real plan.  The drivers of the deficit also supports clear, actionable tasks over the short, medium and long term, with the aim being that the plans are then sustainable.

 But, despite the challenges ahead, I believe that there are some solutions to consider, so here are my top 3 tips.

 1.      Consider the drivers of the workforce deficit, rather than see temporary staffing reduction as a simple cost cutting programme.

 2.      Cognitive Contract Management (CCM) – we know that many Trusts effectively overpay agencies due to misalignment between what is booked, and what is paid.  Our software can review thousands of invoices, and identify where these errors are occurring, with the aim of closing that issue.  This has resulted in millions of pounds worth of in-year savings and cost avoidance for NHS Trusts

 3.      Think about temporary staffing in the broader context of transformation. 

a.      Agency and bank often simply fills the gaps we currently have, with little consideration given to role redesign, implementation of digital solutions, or consideration about how AI might better support some tasks.

b.      What are the operational and financial efficiencies from scaling services across a provider collaborative, group model, or ICS, and how might this better support availability of temporary workers, but also support the development of preferred supplier lists

c.      Unless we see a reduction in agency spend as part of a focussed effort on strategic workforce planning, I fear we may be on a merry go round in a few years time, when the same demands are being asked of.  How effective, and aligned is your approach to workforce planning projections (workforce, finance and demand/activity).

How will you be responding to the things you heard at the conference this year?

Get in touch with our team (and view their linked profiles for case studies);

Drivers of the workforce deficit James Devine FCIPD

Cognitive Contract Management Rachel Flowerday Ankur Gupta

Strategic Workforce Planning James McKee Fayaz Tirmizi

Scaling Services/HR Transformation Michael Allen James Devine FCIPD

Financial Recovery/UEC Jenny Panes Robert Arthur Garth Gillham Animesh Mathur

Beccy Fenton Tamas Wood Emma MacLellan-Smith Gina Naguib-Roberts Karena Starkie-Gomez Moyo Fabule Priya Bange Kate Hardy Jason Parker HPMA Healthcare People Management Association

KPMGs healthcare practice has been rated GOLD for the last 5 consecutive years – based on feedback about what we do, and how we do it.   We have also been rated as DIAMOND for HR transformation.