Why strong workforce control matters more than ever in the NHS

The coordination of temporary staffing in the NHS has not always looked the way it does today.

Before Liaison introduced Direct Engagement as a concept, the landscape was vastly different. While agencies worked hard to support Providers, and clinicians stepped in wherever needed, the system itself often lacked the grip, control and compliance required to operate efficiently at scale.

Liaison’s introduction of Direct Engagement didn’t just save the NHS millions of pounds in costs, it fundamentally changed how Providers could manage visibility, governance and confidence in their temporary workforce, and marked a turning point in how staffing could be on the front foot.

But every so often, it’s worth pausing to reflect on what came before.

A well-intentioned, but unstructured past

Anyone who worked in NHS staffing a decade or more ago will remember it as fast-paced, noisy, and full of agencies who were always keen to help. It was a lively and memorable chapter in NHS workforce history, driven by good intentions, but not always underpinned by structure.

At that time, agencies often followed their own processes, and within Providers, almost anyone could make a locum booking if the need arose. Decisions were frequently based on who could supply a doctor the quickest, and clear visibility and consistent control were difficult to achieve.

Pay rates and commission rates could drift over time, compliance status wasn’t always obvious, and it wasn’t always clear which suppliers were operating on framework. Workers might arrive unexpectedly, and temp-to-perm fees could catch even the most experienced staffing teams by surprise.

Phones rang constantly with agencies politely checking whether CVs had been seen, sometimes followed by animated discussions about who had sent the same candidate first. Invoices arrived in volume, not all of them accurate, and agencies quite understandably chased payments that were outstanding.

It built resilience and character, certainly, but it wasn’t the calmest or most consistent way to run a modern workforce.

From activity to assurance

When TempRE arrived, a quiet transformation began. It didn’t remove agencies from the picture, instead, it created a fair, transparent and structured environment where everyone could operate more effectively.

Suddenly, Providers had clear sight of every booking. Placement lengths, pay rates and commission rates could all be viewed in one place. Pay and commission caps could be applied consistently. Reporting became meaningful rather than manual, and benchmarking allowed Providers to compare like-for-like, bringing clarity where there had once been uncertainty.

With TempRE’s centralised agency invoicing, the volume of calls and emails was dramatically reduced, disbursement support eased administrative burden, and tiering helped Providers manage suppliers effectively, with framework advice always available. Where needed, Liaison’s Agency Engagement Team stepped in to resolve queries or even organise dedicated agency days.

Importantly, workers engaged under ADE arrangements could continue to access NHS Pensions, preserving those benefits that matter to clinicians.

The result wasn’t just a tidier process – it was collaborative transformation. Staffing moved to being more proactive, and became calmer, fairer, and far more manageable.

Why grip, control and compliance matter more than ever

Today’s NHS faces pressures that make grip and control not just desirable, but essential. Financial scrutiny is tighter, workforce demand is more complex, and governance expectations continue to rise. In that environment, reverting to fragmented, reactive staffing models simply isn’t viable.

Liaison’s leadership in Direct Engagement and TempRE has shown that strong control doesn’t mean reduced flexibility. In fact, it enables flexibility to exist safely, sustainably, and transparently – for Providers, agencies, and workers alike.

Agencies remain valued partners. Providers retain autonomy. Workers are supported. And everything sits within a framework that delivers visibility, consistency and value.

Do we really want to go back(wards)?

Looking back, the old days feel almost nostalgic, full of stories, energy and experience. But nostalgia isn’t a workforce strategy.

TempRE, and the Direct Engagement model behind it, brought order where there was once noise, and assurance where there was once uncertainty. That’s why NHS Providers continue to rely on it, and why Liaison remains an innovative leader in this space.

Because once you’ve experienced true grip, control and compliance – why would you ever choose to go back?