Tackling the temporary workforce challenge together. 20 June 2018 HFMA Brighter Together: Workforce Forum

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1 Tackling the temporary workforce challenge together 20 June 2018 HFMA Brighter Together: Workforce Forum

2 Today Liaison Booking Rate Index Case Study Weekly Trust Reports Real Savings Benchmarking Reports Other Considerations and Support

3 Liaison Who are we? 26 years serving the NHS 80% of Trusts and CCG s use one or more of Liaisons services Deep knowledge and understanding of the The Temporary workforce space Cash recovery Contract compliance, Double payments, credit recovery. VAT compliance and recovery Growing knowledge of the Substantive Workforce.

4 Liaison Management Information Background 6 years of collecting Medical locum and AHP booking and rates data from 70 Trusts all over England Data Warehouse built and developed to hold all data in a standard format Executive suite of reports developed for Chief Execs Case studies that show MI has helped materially reduced costs

5 Booking Rate Index NHS South East/Central Purpose is to: Improve the Regions understanding of spend as part of the National Programme Allow up to the minute Regional, STP and Trust comparisons on spend Use booking data to allow Directors to challenge and make changes Provide information for potential requirements on a collaborative bank/s Provide current regional gap analysis and trends for HEE to consider

6 Agency Spend as a % of Pay Bill in South 16/17 National Ranking Agency Spend as % of Total Gross Pay Source: NHS Trust and Foundation Trust Annual Accounts Agency as % Agency as % of of Total Gross Total Gross Pay Pay Rank Rank (2016/17) (2015/16) YOY Rank Movement Trust Gross Pay Spend Agency Spend 2015/ /17 Agency Spend as % Gross Pay Gross Pay Spend Agency Spend Agency Spend as % Gross Pay Agency Spend % Difference University Hospital Southampton NHS Foundation Trust 413,106,000 26,441, % 435,498,000 13,964, % % Hampshire Hospitals NHS Foundation Trust 233,548,000 7,022, % 245,806,000 8,357, % 19.01% Solent NHS Trust 118,911,000 5,345, % 117,846,000 4,706, % % Southern Health NHS Foundation Trust 240,198,998 11,620, % 227,781,000 12,747, % 9.70% Isle of Wight NHS Trust 121,333,000 8,732, % 123,782,000 7,617, % % Portsmouth Hospitals NHS Trust 293,052,000 32,040, % 305,500,000 34,330, % 7.15%

7 Hampshire and Isle of Wight STP Size of the rate control prize 82m spend on agency in STP, c50% on med locums. 20% reduction with good rate control removing unwarranted variation. 8m prize for making the project work 1.33m agency cost reduction per trust

8 It Can be Done The Director Effect Southport and Ormskirk

9 Director of Finance Effect Southport & Ormskirk Case Study Improved Rate Control Breaches flagged to DoF Consultant maximum rate set at 105 not 120 Rate cap functionality applied to all grades Authoriser tiers applied Medical staffing centralised Coastal trust not used as an excuse for high rates

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13 Examples of Weekly Break Glass Analysis Bookings made week commencing 19 th February 2018 Please note figures within this report relate to Medical Locums only and do not include Off Site On Call bookings.

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17 Real Savings Achieved Weekly Nudge Effect replacement worker Medical Note from the Booking Index rate team As with last week there is one single booking that contributes the majority of the amount over the break glass values. The trust should review this booking to see if better rates can be obtained (current worker pay cost per hour) or if an alternative consultant is available at more favourable rates. Outcome Reduction in booking cost by 25% within 24 hours Update regarding the locum consultant who was highlighted in NHSI locum booking rate index today as a high cost locum. Am glad to say after further investigation and discussion with the department this doctor has now been replaced with another locum at per hour total charge. Saving 21,000 (25%)

18 Real Savings Achieved Weekly Nudge Effect reduced agency commission Medical Note from the Booking Index rate team on both the Historic and weekly returns you have a number of shifts where the commission rate is shown as the trust is paying the top commission rate in the region. Outcome Reduction in agency commission (60%) Trust confirmed verbally that agency commission with this agency has now been reduced for this grade of worker and is below the break glass commission amount. Saving c 16,000pa (9%)

19 Real Savings Achieved Weekly Nudge Effect reduced total rates (every little counts!) Medical Note from the Booking Index rate team total breach came to only 49, and were two bookings in neurosurgery and two in neurology that caused the excess. If the trust could address and adjust these bookings slightly then they will be in line with break glass. Outcome Reduction in booking cost by 22% in 24 hours Just to let you know that the 4 bookings for w/c 14 May which were 49 over the cap were all renegotiated with the agencies to under the total charge rate cap Saving 49 (1%)

20 Monthly Break Glass Analysis Bookings made Quarter Ended April 2018 Please note figures within this report relate to Medical Locums only and do not include Off Site On Call bookings.

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33 How the HRD s and DOF s can help in 2 simple ways. 1. If interested, ask to be cc d in and use reports at the Board. 2. Ask your Trust to get engaged it will help them!!!

34 Simple Trust Input Simple excel spreadsheet with drop down menus to keep data consistent for the data warehouse, will be sent out tomorrow. Weekly Booking input on Monday for the previous week reports and observations to Directors on Wednesday STP and regional benchmarking reports sent Friday. STP Monthly report and trends at the end of week 1. Simple instructions on how to fill in, data SHOULD be readily available. Any queries contact Zoe Topping on

35 Best practice from high performing trusts will analysed and shared Areas to consider. Booking process Staff training Contract management Director involvement Break glass management System assistance Bank alternative Amongst others

36 Programme Scope Initially Medical Locums and AHP s booked through agencies Next possible steps Bank bookings and management Overtime or additional basic booked/used WLI s booked Other staff groups

37 Questions? Other considerations: Bank Collaborative Bank Worker retention Ian Child Procurement and Performance Director

38 Answers 70 Jeremy Hunt, Secretary of State for Health and Social Care 20bn 3.4% pa 52,302m 2,407m 1,205,814