The Introduction of a Flexible Workforce Department

Bradford Teaching Hospitals NHS Foundation Trust

Rachel Pyrah, Flexible Workforce Services Manager

The aim of the centralised Flexible Workforce Department was to increase the flexibility of the substantive workforce and increase the number of internal bank staff thereby reducing reliance on agency staff. This would ensure that the processes for temporary staffing recruitment are quality assured, that the outcome is ‘value for money’ and improves patient care. The Trust has seen a reduction of £9.4 million in agency spend, the nurse bank membership rose by 30% in 12 months and fill rates for bank HCAs went from being 57% to 87% on average and from 37% to 47% for registered nurses.

Key points:

  • Direct Engagement Model (for medical locums and AHPs) including improved cost control
  • Introduction of a Bank and Agency electronic booking system
  • The Flexible Workforce Team comprises of a Locum Booking Team, a Nurse Bank Team, and an e-Rostering Team
  • One department to manage temporary staffing and the increase in nurse bank.

Judges’ views:

The panel were extremely impressed by this truly collaborative and patient outcome focussed initiative. There was substantial financial savings, significant improvements in bank recruitment and fill rates, as well as strong partnership working between departments.



NHS LPP Clinical Agency and Staff Bank Demand + Cost Management Dashboard

NHS London Procurement Partnership

Andrew Mumby, Workforce Director

Levente Fazekas, Ass. Director of Business Intelligence

NHS LPP recognised the need for smarter working through enhanced visualisation of amalgamated supplier and NHS spend data to drive greater collaboration by revealing trends and behaviours which help manage demand. Compliance, cost, rate cap breaches and the NHSI impetus motivated the shift from agencies to internal banks.

Key points:

  • £200m spend through 365 agencies: huge volumes of data
  • Developed dashboard to make data more manageable and easier to analyse
  • Managers trained to use dashboard, developing culture of open data sharing
  • Resulted in reduction in agency spend, greater use of the staff bank, improved patient care.

Judges’ view

An excellent example of working smarter, using innovative and data driven approaches as well as delivering substantial benefits. The system had achieved significant financial savings whilst also contributing positively to quality issues such as fair worker pay and openness and transparency in contracting.


Working smarter to enhance patient care through delegation

Aneurin Bevan University Health Board

Sarah Simmonds, Assistant Director or Workforce and Organisational Development

Angela Palfrey, Senior Workforce Business Partner

The workforce team collaborated with nursing and health care support worker colleagues to review delegation practices and identify opportunities to work smarter and enrich employee and patient experience, building on valued existing skills and experience of health care support workers.

Key points:

  • Reinforced practices supporting patient care by having the right people and skills undertaking the right tasks at the right time.
  • Increased delegation of minor wound dressings released registered nursing time to ensure that skills could be efficiently deployed.
  • Freed up the scarce resource of registered nursing time with positive impact on overall staff wellbeing
  • Cost savings linked to reduction in sickness absence and the avoidance of variable pay.

Judges’ view

An effective example of a ward-based initiative, enhancing patient care through the promotion of delegation. Good evidence of how, through staff engagement and focused action, the team were able to ensure that they had the right staff undertaking the right tasks in line with their roles.


Established on 1 October 2018, Health Education and Improvement Wales (HEIW) is the only Special Health Authority within NHS Wales. We sit alongside Health Boards and Trusts, and have a leading role in the education, training, development, and shaping of the healthcare workforce in Wales, in order to ensure high-quality care for the people of Wales.

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