Fishing for staff in a small pool? A coastal trust discovers how to succeed – without paying more

Coastal trust Southport and Ormskirk is proof that that you can cut what you spend on locums and still reel in the right staff – even when you’re fishing in a small pool. The Trust’s sea-rious savings include a drop of more than 40% in overall medical locum spend within just twelve months of introducing new approaches.

Historically, Southport and Ormskirk had struggled to recruit temporary staff. The region in general isn’t heavily populated, and there’s absolutely no chance of finding locums anywhere to the west (seals don’t tend to have the relevant accreditations). On top of this, large hospitals in neighbouring Liverpool and Greater Manchester trawl across a wide area, netting in staff from all around. It seemed to be a seller’s market, with both hourly rates and agency fees creeping up steadily as a result.

But by early 2016, the Trust was heading into deep water. Rates and fees had reached unsustainable levels, too many above-cap contracts were being agreed, and too few bookings were being made through direct engagement. Trust managers recognised they couldn’t bury their heads in the sand: something had to change.

The Trust’s STP, Cheshire and Merseyside, had recently identified three mechanisms to help trusts achieve best practice in locum recruitment – an IT platform, data and reporting services, and invoice control.  So that’s exactly what managers put in place.

The introduction of a fully-integrated Agency Direct Employment platform and support service was one of the first steps, helping increase direct engagement savings by 44% year-on-year.

At the same time, the Trust started to use regional benchmarking data to drive down rates. Now staff can see what other trusts are paying both individuals and agencies, it’s easy to push back when anyone’s angling for higher rates. Key reductions include a 20% cut in core Consultant grade hourly rates and a 29% cut in unsocial hours rates.

With Agency Direct Employment going swimmingly, the Trust went on to add a locum bank to the system. All bookings now go through the same platform, giving complete control over pay. Rates are set within the system, and only the Director of Finance has the power to make exceptions.

What else has changed?

Saying no to excessive rates keeps costs down but isn’t enough on its own to hook staff in. What’s also made a big difference is that the integrated platform streamlines processes for locums and makes working for the Trust more attractive.

For agency direct employment workers, the simple-to-use system covers all activity and assignments; online contracts and timesheets mean no more manual paper-based systems, and there’s a helpline for queries. Easy Trust access to accurate details of each locum and what they’ve done means good workers get asked back – so fewer stressful sink-or-swim shifts in unfamiliar locations.

Increasingly, locums are flipping over to the locum bank, because it’s the easiest way to get shifts that suit. Once registered, people don’t need to leave home waters to find the hours they need. The system simply notifies them of vacancies that match where and when they want to work.

The addition of a weekly payroll service is also a big help.

The Trust has at last turned the tide of rising temporary staff spending. Managers are now running a tight ship, with costs under control, and processes shipshape!