Circle Insights

Delivering agency staffing efficiencies across the NHS

Andrew Symonds

NHS Trusts face a number of staffing challenges for a multitude of reasons, from patient demand to effectively and efficiently utilising budgets to making use of agency staff to plug any gaps. Agency staff offer a vital support service to NHS Trusts in delivering key, frontline services, but how can they be utilised more efficiently to save costs and enhance service delivery?

Recruiting agency staff can be an expensive process as their per hour costs can far exceed those of bank staff. It is, therefore, crucial that NHS Trusts are able to make the most efficient use of their bank staff before calling upon agency staff. When agency staff are drafted in, they must also be utilised efficiently to maximise the benefit of the extra spend in recruiting them.

Monitoring their workload and communicating clearly with them is crucial to achieving this. They must be treated in the same manner as bank staff in order that they can help support your services effectively. After a 12-week period of working within your services, agency staff also assume the same benefits as bank staff in terms of holiday, sick pay, overtime and breaks. This needs to be factored in to how they are rostered onto jobs and the longer-term planning of your rostering.

Decreasing agency staff spend

There are a number of ways that NHS Trusts can reduce their reliance and spend on agency staff, from retaining existing staff to effectively recruiting new permanent members.

Training and career development can play a key role in this, offering existing staff the opportunity to improve their skillset. This carries the double benefit of offering them opportunities within your Trust and making them more flexible from a rostering perspective. With an expanded skillset, they can be utilised across a wider range of tasks, meaning that where short term gaps emerge, it becomes easier to re-jig existing rosters across your bank staff to fill in the gaps.

This dovetails with competency management, understanding the skills at your disposal in rostering staff for tasks. With improved training you can expand the competencies at your disposal and recruit from within for emerging vacancies. Mandatory ongoing training can be implemented, ensuring that everyone is up to date with their training.

Recruitment is also a key area for NHS Trusts. Keeping the right people performing the right tasks is easier when you can rely on bank staff, so bringing in the right people carries huge benefits. Finding more permanent solutions to emerging gaps is also preferable to mixing and matching with agency staff.

Investing in your staff with training opportunities, career progression and the provision of relevant working opportunities will not only help to keep existing staff members working for you, but will also help with recruiting new staff in demonstrating that you can offer career progression.

Managing agency staff

Where agency staff are necessary – and they always will be in certain circumstances – it is vital to maximise their efficiency and output. Effective communication from management is hugely beneficial, providing a clear roadmap for what is expected and making clear their responsibilities. Encouraging collaboration with your existing staff helps agency staff to settle in quickly and work towards the team’s goals.


Lord Carter’s 2016 and 2018 reports on operational productivity in the NHS recommend all NHS provider organisations use an e-rostering system for all clinical staff groups. His reviews found that organisations have not always used the full potential of e-rostering systems to maximise the productivity of their workforce and reduce administrative time spent planning rosters.

Furthermore, Lord Carter’s reports suggest that rosters should be approved six weeks in advance. Having this operational foresight is crucial for NHS Trusts in making efficient use of available staffing resources.

E-rostering solutions also facilitate a greater degree of automation throughout the scheduling process. This frees up the time of administrative staff to focus upon exceptions and further driving operational insight with staffing reports.

This can help to ensure that use of agency staff is necessary and applied appropriately. Is the requirement for agency staff being driven by actual demand, or by poor management? Creating operational insight from your rostering drives better decision making.

Joining the dots

Using a single system can bring together your training, competency management and rostering into one solution, making consideration of multiple factors easy and seamless. Generating operational insight, you can easily identify where staff shortages are likely to occur and make moves to rectify them.

Utilising e-rostering functionality further enhances decision making around agency staff and brings transparency to the process and the decision making. Moving from time consuming manual process makes the process of rostering, training and recruitment far easier and more transparent.

By joining the processes that govern your staffing requirements together, it is possible to create greater efficiencies in the use of your bank staff, reducing the need to employ agency staff to plug the gaps. And where agency staff are required, you can deliver greater insight and understanding as to why.

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Andrew Symonds