Ensuring available budgets stretch across every need is one of the greatest challenges of 2018’s NHS. A challenge exacerbated by all the other well-known issues of today’s lifestyles and an ever-increasing, ageing population. Nowhere is the latter better summed up than in the hard-hitting ONS statistic that in 1948, males aged 65 could expect to live a further 12 years and females 15 years. By 2016 this had risen to 21 and 23 years, respectively. The rise in longevity accompanied by the sobering prospect from ONS that around 20% of life will be spent in poor health.

So, the cost of literally living is rising - and it is the NHS that is picking up much of the bill. But these costs are not just pills and potions, they are the costs of ensuring that nurses, doctors, healthcare assistants, allied health professionals, cleaners and porters are there, right when and where they are needed most.

As the NHS launches its biggest recruitment drive ever, in the same week that it is 70, one-hundred thousand vacancies remain unfilled. It is little wonder that the NHS relies on agency workers to make-up the shortfall. Yet as vital a resource as agency workers are, this approach can be an expensive solution. Media reports in the last 6 weeks alone have detailed costs of around 6% of a Trust’s total budget with an overall cost of £3 billion for NHS England.

Whilst many recruitment agencies supplying temporary staff deliver an excellent service for a fair price, there are also providers in the marketplace who charge disproportionately inflated fees. GRI works with NHS Trusts to renegotiate fairer standard charge rates for the provision of agency staff using our position of influence with over 3,750 agencies in the UK. We’re incredibly proud to save up to 12% on recruitment costs for NHS Trusts, which in turn diverts much needed budget away from paying for recruitment agency fees to other initiatives that support better patient outcomes.

How do we do this? 
When we start talking to a new Trust about their current position in terms of agency recruitment we analyse their current agency invoices to discover a true, overarching picture of costs from all their suppliers. Typically, this will reveal a huge differential of up to 21% in the charge rates from the various agencies supplying the same band of nurse for exactly the same position. Put simply we generally discover that the “finders-fee” agencies demand can vary by as much as 20% between the highest and lowest charge.

This analysis helps to move the balance of power away from the recruitment agency in a candidate short marketplace by giving Trusts true visibility. What next? Well, our neutral vendor, managed service solutions have been judged award-winning multiple times and are tried and tested by Trusts up and down the country.

Most recently our work with Bridgewater NHS, a community foundation NHS Trust in the North West of England has been shortlisted by the Chartered Institute of Procurement & Supply for best procurement consultancy project. The same partnership has already won prestigious Health Service Journal’s Partnership Award, thanks to our delivery of 10% cost savings on agency recruitment, whilst simultaneously driving up standards of service amongst supplying recruitment agencies and achieving fulfilment rates of 90% plus. 

Mark Duffy, Bridgewater Community Healthcare NHS Foundation Trust, said:

“I would highly recommend the approach to any NHS Trust or healthcare operation with a high dependency on temporary staff, wishing to gain greater control, transparency and quality whilst ensuring best overall value.”

Our approach is simple but highly effective. In just 12 weeks the following initiatives are all achieved:

1)     Existing costs of supply are audited by the GRI analysis team. There is no charge for this initial investigation and our findings and recommendations are presented back in a whitepaper, which clearly details the position and the savings that are available.

2)    If GRI is brought on board, we will then assess the quality of a Trust’s existing recruitment supply to ensure it is meeting standards. High performing, well-regarded recruitment agencies are then invited to join a new recruitment supply panel but must sign up to robust service level agreements, regular audits and fairer commercial charge rates. Typically, we have a track record of converting over 90% of existing agencies onto our new terms, but where existing suppliers may refuse to charge a fairer rate, we can supplement their supply from our tried and trusted panel of over 3,000 agencies. We can achieve this thanks to our position as a neutral vendor. The term neutral vendor means we are independent, we do not own any recruitment agencies nor are we part of one ourselves. With no vested interests in which agency is chosen we can judge all agencies equally, on the only thing that matters – performance rather than profits. Thanks to our influence and strength in numbers approach Trusts can tap into even greater bargaining power with their existing agencies and add additional, quality agencies to bolster supply.

3)    Our easy to use web portal e-tips® (an ordering and invoicing system) is then implemented with agency and Trust users trained by our team. It takes a trained user around a minute to request agency supply staff via the e-tips® system and the system will only allow those workers with full compliance to be proposed by those agencies who have agreed to the fairer commercial rates. Essentially rates of pay, charge rates and compliance items are locked down as requirements in the system giving hiring managers the freedom to choose who they wish from those candidates proposed, safe in the knowledge that they are within agency rate caps, trust budgets and patient safety requirements.

Peter Russell, University Bristol NHS Foundation Trust, comments:

“When temporary staff are required, they offer a simple and effective solution to ensure that partner agencies focus on delivering quality candidates rather than charging a premium to provide nursing staff.”

4)    We can also offer Trusts the support of our 24/7/365 fulfilment team at the ordering stage. Based at our HQ in Cheshire this team can be called with hiring requirements and then will manage the booking process via e-tips® so that a hiring manager can turn full attention to patient rather than recruitment.

5)    Partnering with GRI delivers extra people resource too. Each new Trust we work with is allocated a contract and performance team whose sole job is to manage the successful fulfilment of your hiring requirements via your agency panel. This saves a great deal of administrative time, again ensuring delivering front line services can be your hiring managers’ main priority. 

6)    This same GRI contract and performance team delivers continuous management information, reporting on fulfilment, compliance, performance every week and actively trouble-shooting any supply issues. Detailed reports reveal the number of agency staff hours worked, where, in what role, why, the agency supplying, the costs and the savings being made under the new commercial agreements. GRI also help Trusts navigate new employment legislation from IR35 changes to GDPR, the Apprenticeship Levy to AWR.

As the NHS celebrates its 70th birthday, there is much discussion about what the future holds both from those working within the NHS to those looking inside from the outside. There are many solutions being proposed from the simple to the radical (a key reason that GRI has been a sponsor of the highly-regarded HSJ Awards for a number of years, as this helps recognise and reward these ideas). Both our CEO, Andrew Preston, and the majority of our NHS contract and performance management teams are ex-NHS so we have an absolute understanding of the changes that can make a real difference.

Everyone at GRI is both incredibly proud of the NHS and proud that our solutions support the NHS. We will be spending the anniversary day raising funds for our local NHS charity, The Christie.

Happy Birthday #NHS70

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