72% reduction in agency spend within 10 months on TempRE Bank

These results were achieved using a multifaceted approach to the implementation project. Liaison’s Workforce team worked closely with the Trust to develop a plan which drew on their experience with other trusts implementing the bank service.

72% reduction in average monthly agency spend

76% increase in average monthly bank spend

£257k a month reduction in contingent staff costs overall

Overall monthly contingent staff spend down by 40%

Overall 34% reduction in total monthly hours worked

Overall hours reduced by 2,350 a month on average

As part of the planning for the launch of TempRE Bank at the Trust, the Liaison Workforce team produced a series of management information reports to help inform the process. These identified that the Trust’s current agency rates were nearly the most expensive in the region, for all grades of agency staff. The reporting was also able to clearly illustrate the difference between the Trust’s average bank rates compared to its agency rates. This clarity helped raise awareness of a need to develop and grow a trust bank and lent weight to internal discussions about the need to drive the project forward. The Trust’s bank recruitment initiatives were also reviewed at the same time.

The Trust took the initiative of auto enrolling all rotational doctors onto the bank with the ability to opt out if they chose. Other changes including moving responsibility for medical locum spend from HR Director to Medical Director and, after Liaison Workforce’s recommendation, combining the Trust’s partly decentralised booking team into a fully centralised team. This was based on similar approaches in other trusts delivering greater control and visibility over all bookings.

A new, robust internal authorisation process was also implemented. This required all agency spend to be signed off before jobs could be released to agencies, ensuring all jobs were first offered to the bank team before going out to agencies. Liaison Workforce also provided a weekly payroll facility to help make the bank an attractive option for locums.

Following the April 2017 IR35 rule changes, the Trust seized the opportunity to promote the drive to sign locums up to the bank. Using materials provided by Liaison Workforce, the Trust was able to provide evidence that locums with
Personal Service Companies or working via an Umbrella company would be worse off compared to locums working through PAYE.

When the first ten months of the project were reviewed, it was found that the Trust had achieved a 72% reduction in their average monthly agency spend, amounting to £360k of savings each month. Meanwhile, average monthly bank spend had increased by 76%. Overall the Trust managed to reduce its average total monthly spend on contingent medical locums by 40% – £257,000. This equates to an annual savings run rate of £3,084,000.

In terms of hours worked, overall the Trust achieved a 34% reduction in average total monthly hours worked. This comprised of 3,850 fewer agency hours worked each month,and an increase of 1,500 hours more bank hours each month.

TempRE’s management information showed us what was going wrong and gave us the evidence to push through a tough line on direct engagement. With the support of the Liaison Workforce team and the ongoing reporting provided, we have been able to take control of locum engagement and agency spending.

The first weekly report that showed we had achieved zero wasted medical locum spend was one of the best spreadsheets I have ever seen!

Dr Andy Morris

Chief Medical Officer, Walsall Healthcare NHS Trust

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Walsall Healthcare NHS Trust


Reducing agency spend


TempRE Bank