Helping you grip and control your agency spend

A six-point plan for reducing agency spending to help meet NHSE targets.

1 February 2023

Staffing is one of the big issues keeping NHS leaders awake at night – and it consumes two-thirds of trusts’ spending.

Controls on the use of agencies were re-introduced last summer by NHS England, where Systems were set targets to reduce spending by at least 10%, and up to 30%, compared to 2021-22 levels. All ICSs are currently on course to exceed their agency spending cap.

NHSE has also published its priorities and operational planning guidance for 2023/24, which sets out national objectives for Trusts and ICSs and includes reducing agency spending across the NHS to 3.7% of the total pay bills in 2023/24.

This is clearly a substantial challenge for ICS leaders, workforce managers, and Finance and HR teams, and needs thoughtful management to ensure that staffing levels are maintained without surpassing the capped budget via agency use.

A unique framework exists to support workforce transformation, with six key areas which can be combined to support ICSs to meet the challenge of reducing agency spending, whilst also improving efficiency across their workforce at the same time.

The Countess of Chester Hospital Commercial Procurement Services (COCH CPS) provides a framework for a partnership with ICSs to achieve their workforce aims, using the following six-point plan…


1. Identify root causes for agency demand using advanced analytics with mii People Analytics

A Foundation Trust has used our NHS workforce-specific business tool to intelligently combine data from 11 different workforce systems to get a holistic view of their workforce on one screen, identifying root causes for demand by triangulating data sources and gaining actionable insights.

2. Improve demand management from actionable insights into future workforce demand with mii People Planning

Organisations in Lancashire and Greater Manchester are using our innovative digital tool to capture key data on future recruitment demand, retention risks and critical succession gaps. One Trust identified 114 future vacancies which were not recorded on any of its internal systems, gaining an average of 80 days additional lead time to recruit, which helped them to proactively avoid filling them with agency staff.

3. Improve agency spend controls, governance and visibility through an integrated flexible workforce management platform with mii Flexible Workforce

A Trust in the Midlands has delivered significant savings, reduced reliance on agency supply, increased bank utilisation, and reduced operating costs through the adoption of our robotic automation technology. Over 12 months, locum agency spending was reduced by £500,000 per month, and the solution produced a 61% reduction in agency commission breaches, from 66% to just 5%.

4. Reduce reliance on agencies through solutions that grow internal Banks and develop ICS Collaborative Banks

Trusts belonging to a collaborative bank in North East England built a bank of 1,250 active doctors in training across 73 specialities, with 50% of doctors rotating around the region and an increase in bookings via the bank by 30% year-on-year.

5. Recruit and retain more permanent and bank staff with Digital Marketing Support that delivers agile and impactful candidate attraction

Collaborative bank Trusts in South West England used a digital marketing support service to attract new candidates to their banks with effective and engaging recruitment campaigns, leading to hundreds of unique applications each week and a 197% increase in bank shifts filled.

6. Free up clinical capacity, improve efficiency and reduce risk with advanced digital task management

Each user at a South West England Foundation Trust’s out-of-hours team saved an average of 91 minutes per shift, with 85% of users reporting improved task allocation, using our task management solution.

These working examples all make use of innovative workforce efficiency tools designed to gain grip and control, and provide measurable improvements in all areas of workforce management. This helps you progress your workforce transformation journey using a platform that consists of interoperable technology and service modules, designed to digitise the NHS People Plan.

As ICSs and their constituent trusts are monitored on their performance against the agency spend ceiling this year, it can be seen that swift action to measure agency spending and improve workforce efficiency will be essential to increase confidence ahead of the control measures being implemented, allowing ICSs and ICBs to move focus to other key areas of improvement as their systems develop.

To find out more and discuss how this unique combination of transformation programmes can support meeting the agency spend reduction challenge set for your ICS, please contact us.