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Trust Tackles Rising Agency Costs and Saves £400,000 in Six Months

Doctors in front of a laptop

Discover how innovative e-rostering and staff deployment solutions designed to meet the needs of the health and social care sector today and tomorrow, helped to tackle rising agency costs and more effectively deploy resources.

Introduction

At the time of conducting this study, the cost of using agency staff had reached record highs, with £850 million spent in less than two years. While this was necessary during the Covid-19 pandemic, one of the main contributors to the rising costs was the inability to provide adequate staffing for frontline services.

Recruiting and retaining skilled physicians at all levels has become an ongoing challenge, plunging many trusts into financial hardship. However, there is one reason for optimism where a more efficient and effective rostering and resourcing solution has saved money and offered promising results for the long-term.

Up until 2018, this Trust witnessed its agency costs increasing year after year, but after overhauling its entire workforce management process for the accident and emergency department, and deploying the HealthRota e-rostering solution, the Trust reduced its reliance on agency staff and overtime hours, saving £400,000 in the first six months alone.

About this Healthcare Trust

This Trust is one of the largest integrated health (and social) care Trusts in the United Kingdom.

It delivers integrated health and social care to approximately 340,000 people and provides the majority of regional specialist services in its area. It has an annual budget of £1.3bn and a workforce over 20,000 (full time and part time). This Trust also comprises the major teaching and training hospitals in the region.

Challenges

  1. Soaring locum spending

    The Trust had seen agency costs rising consistently year on year, reaching over £2 million in 2017/18. In order to bring them under control, a comprehensive assessment of the entire staff deployment process was needed.

  2. Inadequate rota planning and resource management

    The primary issue for the Trust was that rota planning and resource management was carried out in isolation. This provided only part of the picture when deploying staff.

  3. Inability to match resources to demand

    Because rota planning and resource management was done in isolation – this provided only part of the picture when deploying staff and did not allow the Trust to assess or manage capacity or resource in accordance with demand.

  4. Compliance with Regulations

    Balancing contractual rules and regulations, such as the European Working Time Directive (EWTD) and the Working Time Regulations (WTR) in the UK, poses a significant challenge for rota coordinators. The absence of an automated system makes it challenging to monitor the regulations and ensure compliance for a sizable team of resident doctors.

Solution

A working group led by a Medical Workforce Service Improvement Manager, was set up to examine the detailed activities and determine where changes were needed. The Manager took responsibility for leading the implementation of an e-rostering system that could more effectively manage deployments in the Emergency Department (ED).

In December 2018, HealthRota was chosen as the preferred solution and the Trust quickly took steps to add all grades of both administrative and medical staff within the ED on to the HealthRota system, including consultants who were placed onto annualised rotas to manage their programmed activities (PAs) and maintain their job plans. In total, over 550 staff were registered on to the platform, encompassing more than 150 non-medical and administrative staff and over 400 doctors.

HealthRota Screen Shot
Over 550 staff were registered on the platform.

We were projecting on and on and on. And suddenly, we were able to look at the whole picture rather than somebody here looking at that, and somebody there looking at that… Using HealthRota to flex our rotas according to activity changed everything!

Emergency Department Medical Workforce Service Improvement Manager

  1. Automatic calculations of annual leave

    HealthRota enabled automatic calculations of annual leave entitlements according to each contract so that, regardless of time booked off and any swaps made, all annual leave calculations are accurate and require zero manual effort from the admin team.

  2. Ability to swap shifts

    HealthRota allows staff to change or ‘swap’ their shifts instead of having to book time off unnecessarily, saving time and effort for medical teams and offering greater flexibility. This gave staff a level of flexibility never previously experienced with the ability to select shifts to suit their other professional and lifestyle commitments.

  3. Mobile App for Accessibility

    HealthRota’s mobile app allows doctors to access and review their digital rotas in real-time, request leave, and check their remaining leave availability from the palm of their hand.

  4. Works for admin as well as medical staff

    The new system enabled the ED administrative team to be added to the HealthRota system, creating a seamless workforce management approach across the department with lunch and break times for non-medical staff automatically calculated.

  5. Manage, merge and view multiple rotas

    A team of five full-time administrators seamlessly manage 20 rotas made up of 550 staff across medicine and ED, with the ability to combine these for a full picture of the scheduling landscape.

  6. Simpler contract management and monitoring

    The system simplified the management of contractual requirements and provided the ability to filter information about staff who work less than full-time hours across the required monitoring period. This has proven to be extremely beneficial when deploying resident doctors and monitoring contracts.

Results

-£400,000
cost savings on locums in first 6 months

Shortly after switching to HealthRota, the Trust began to see substantial results – and within six months, they had already saved £400,000 by reducing the locum spend requirements.

This was the result of the Trusts ability to compare the number of arrivals into the hospital alongside the number of hours required to meet demand, and HealthRota’s ability to:

  • flex the rotas to meet the varying levels of demand and therefore, reduce the reliance on agency staff and overtime hours
  • view rotas as a single entity (rather than in isolation), enabling staff to be deployed in a more optimal manner in accordance with the needs of the department.
  • enable staff to select their own shifts around their personal and professional commitments, reducing unauthorised absences and providing greater flexibility.

Conclusion

With the cost of using agency staff spiralling – and the challenges of recruiting and retaining frontline staff across health and care services around the county, the team has demonstrated the advantages of e-rostering and smart deployments.

The implementation of the HealthRota has translated into considerable success for the Trust, with significant savings being seen within the first 6 months of use. Not only did the Trust manage to reduce their agency costs and save £400,000 over this period, but they also transformed the culture of the department by making the emergency department a great place to work.

After witnessing the benefits that the Emergency Department has seen from adopting HealthRota, other departments have also followed suit. Departments including imaging, anaesthetics, fractures, and the nephrology department have all since started using HealthRota to roster on-call staff.

This has further enabled a more comprehensive and cohesive approach to rostering and resource allocation across many parts of the Trust.

As a community-led provider, development work on the platform is directed by the HealthRota community. This helps to ensure that it always meets the needs of its users.

“We like the flexibility of being able to create and amend rotas, as required..”

Feedback from users

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