1. East of England agency staffing review
Daniel Cox
QIPP Procurement Programme Manager, East and Midlands SHA

2. Agency staffing review
Strategic analysis:
- Scope
- Findings
- Proof of concept
Summary and recommendations
Delivery and implementation

3. Agency staffing review
Scope:
Tasked with reviewing the use of agency staff across the East of England, identifying and quantifying cost savings scope included a review of agency staffing in all staff groups across the East of England region, including: - Medical locums - Nursing - Non Medical Non Clinical (including professional and Ancillary staff groups) - Allied Health Professionals (AHP) - Health Science Services (HSS)

4. Agency staffing review
Findings (1):
Trusts in the region spent over £70 million during the calendar year It is estimated that each trust can potentially save between 5 per cent and 15 per cent. However this is dependent upon a number of factors and will vary accordingly in each trust:   - Contractual position – use of framework suppliers? - Current rates including tier and volume banding level being offered by current providers - Level of collaboration with other trusts - Relationship with suppliers in the market and willingness to improve relationships - Willingness to collaborate - Willingness to agree signed SLA with preferred framework suppliers - Willingness to consolidate volumes with fewer suppliers - Willingness to improve internal processes to manage demand.

5. Agency staffing review
Findings (2):
Procurement strategies which can deliver such savings include:
- Price improvement
- Volume consolidation to maximise volume banding discount opportunities
- Collaborative approach to market to maximise volume banding opportunities
- Demand management
Further research and review will determine a more specific savings estimate for individual trusts as this can only be achieved with the following trust by trust information:
- Does the trust have signed SLA’s with suppliers for each staffing group?
- Has the trust undertaken a supplier selection exercise for each of the staff groups?
- Has the trust collaborated with any other trusts to consolidate volumes and achieve higher banding discounts?

6. Findings (3):

7. Agency staffing review
Proof of concept:
This concept was tested through a project managed on behalf of Peterborough and Stamford NHS Foundation Trust (spend approx £3.9 million on medical locums per annum, with a trend towards increasing spend). The project identified that cost savings can be achieved quickly through: - Identification of high spending trusts - Identification of local supplier ranking through pareto analysis - Undertaking a mini-competition under the GPS national framework agreement. The project outcomes were: - One Tier 1 SLA to Medacs, Tier 2 SLA’s to ID Medical and DRC Locums. - Annualised savings of £463,000 - Greater volume based discount than trust would have achieved based - Regional discount negotiated for all other trusts using Medacs.

8. Agency staffing review
Summary:
- Trusts in the region spent over £70 million on agency staffing during The current approach to the agency spend results in trusts paying more than their peers in other regions.
The ‘proof of concept’ project at Peterborough and Stamford NHS Foundation Trust has demonstrated the level of savings that be achieved through market management.
Recommendations:
Identify further trusts willing to work with the project lead to implement tiered or managed service SLA’s through mini-competitions.
Negotiate a regional discount structure with top suppliers. This will be achieved more easily if trusts are willing to collaborate.
Consider the potential for collaborative supplier selection to achieve maximum benefit from frameworks and local negotiation.

9. Agency staffing review
Delivery and implementation:
- Currently working with 15 trusts in East of England in partnership with the East of England Central Procurement Hub ‘mini-competitions’ completed delivering over £1,000,000 over savings based on 2011 spend and demand. - Shortly to commence work with trusts across the East Midlands and West Midlands.

10. Contact details
Daniel Cox
QIPP Procurement Programme Manager