1.0 Introduction With the NHS being challenged to achieve £20bn of efficiency savings by 2015, finding value for money without adversely affecting the quality of care experienced by patients is a serious challenge faced by NHS trusts. In line with the Government’s ‘Better Procurement, Better Value, Better Care’ strategy, which sought to find more than £1.5bn of procurement efficiencies over the next three years, there is a real drive to improve practices across the health service by making intelligent choices about procurement. A major area of procurement for all trusts is temporary staff, such as locum doctors, nurses and allied health professionals. The £2bn the NHS spends on agency staff is often unbudgeted and purchased at a premium cost. As a result, every trust and health board in the UK is trying hard to better control this spend. Despite this, the number and cost of these staff is increasing. The national spend on locum doctors has risen by 8% since 2011 (The Telegraph 2013). The Nursing Standard recently investigated the rising cost of nursing agency staff. Agency costs at 100 NHS organisations were reported to have increased by 22% in one year.
As a result, as part of its wider efficiency drive, the Government has committed to help the NHS reduce its non-permanent staff bill by 25% by the end of 2015-16. To achieve this objective, given that the demand for the use of temporary staff is not going to reduce, trusts face a challenge: how do they engage and manage cost-effective, yet high quality staff? The answer has to be a more efficient way of procuring and managing them. Historically, most have been recruited through employment agencies. Often the process of procurement is uncoordinated, there is little transparency on agency costs making them difficult to manage, there can be a lack of control and this leads to less efficiency. As this paper argues, there is a better way. Through trusts directly employing these staff and centralising their procurement and management there are considerable efficiency gains and cost savings. We set out below how this system works as a model, and demonstrate how trusts are already using it to achieve real improvements in their hiring of temporary staff.
The Case for Smarter Procurement of Locums
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