The financial challenges faced by the NHS have understandably been high on the agenda of late. In the face of ongoing pressures including ambulance delays, bed shortages and ever-rising waiting lists, ICSs have been set ambitious targets to significantly reduce their spend. On the surface, it may seem difficult for organisations to cut costs while at the same time maintaining high standards of care delivery. However, these do not have to be mutually exclusive. There is one area of spend in particular where financial savings can be made while simultaneously improving outcomes for both patients and clinicians: staffing.
With significant workforce shortages driving higher agency spend across the NHS, staffing is becoming one of the health service’s biggest costs. But it’s also a key area where costs can be streamlined, without impacting clinicians pay. Creating more efficient and sustainable staffing practices can help unlock more flexible, dynamic workforce planning, in turn boosting retention and reducing overall staffing spend.
Focusing on retention
While recruiting more staff is often seen as a priority to reduce vacancies and agency spend, the retention of existing employees should be given equal consideration. By holding onto existing staff, NHS organisations can reduce the need to take on, onboard and train new recruits, and minimise reliance on costly third-party agencies to fill vacant shifts. Existing pressures and inflexible workforce planning are leaving current NHS staff burnt out and considering leaving the healthcare system permanently. Providing greater flexibility is key to making NHS careers more sustainable and stemming the flow of healthcare workers leaving the system.
Giving clinicians greater choices over the shifts they work – without compromising on staffing levels – helps to improve workplace wellbeing by allowing staff to strike a balance with their personal and professional commitments. Introducing options for part-time work, wider learning and career development opportunities, and efficient payroll processes can also help boost retention. As a result, staff are more likely to remain in their roles, leaving workforce planning teams with fewer gaps to fill and subsequently, a lower reliance on costly external agencies.
Creating temporary NHS workforce banks
Where staffing gaps remain that need to be filled, building systems that enable managers to easily, safely and efficiently fill vacancies from an internal pool of temporary workers can further reduce agency spend. Digital staff banks can help support this by enabling workforce teams to broadcast vacant shifts to a vast number of available, pre-approved workers at the touch of a button. This staffing safety net then allows managers to more easily plug staffing gaps, without having to rely as frequently on external locum agencies.
For clinicians, having a centralised system through which to easily book the temporary shifts that suit them can help boost engagement. Building efficient, integrated payroll systems into the centralised staff bank will also make it easier for staff to manage their own financial wellbeing, and further drive retention. Maintaining a well-engaged network of internal temporary workers will help improve the continuity of care and reduce the cost that comes with outsourcing shifts.
Data insights
Data is another essential tool that organisations should prioritise to reduce staffing spend. Having access to real-time, aggregated data provides workforce teams with greater oversight, making long-term workforce planning much easier and more efficient.
Currently, a lot of NHS workforce planning has to be organised using outdated software such as Excel spreadsheets, which are inherently siloed and slow. Adopting more streamlined, centralised digital systems can help unlock a wealth of invaluable data which existing systems are unable to provide. This data can give insight into exactly where staffing spend is highest, and the areas in which it can be effectively reduced. With the increased capability to undertake detailed workforce data analysis, staffing teams can make evidence-based decisions concerning shift fill rates, staffing trends, and pay rate escalations. Comparing this with data from other organisations can also help standardise pay rates across each region and reduce spend across ICSs even further.
Improving professional development to increase flexibility
Improving access to professional development opportunities also has a key role to play. By safely enabling staff to upskill in different areas and provide care in a wider range of clinical settings, managers will be able to deploy staff more flexibly and meet service demand more effectively. This is especially important for reducing the pressure on acute care settings, where one Trust reported an average spend of £215 per day on each inpatient bed. By allowing staff to expand their skill sets in other departments, sites and organisations, we can unlock more collaborative, ICS-wide working to address this pressure and reduce spend across regions.
Improved access to training is also crucial for boosting staff wellbeing and retention, helping to minimise costly staffing gaps. Upskilling existing staff to complete different clinical roles will allow NHS organisations to plan rotas more flexibly and collaboratively. For example, pharmacist independent prescriber roles can be offered which enable pharmacists to prescribe medicines autonomously. This also reduces reliance on recruitment to fill staffing gaps through employing or training new staff from scratch. Enabling these opportunities for professional development can in turn have a positive impact on maintaining staff numbers.
Reducing NHS spend does not mean cutting corners, or risking a negative impact on patient care. In fact, by focusing on making staffing more sustainable, we can successfully reduce costs while improving quality of care for patients and wellbeing for staff. By working together to make NHS staffing more efficient, we can improve outcomes for all stakeholders, and help ease the pressure currently faced by the NHS in a holistic, sustainable way.
By Dr Anas Nader
