With NHS providers spending more than £5bn a year on temporary staff, providers like Norfolk and Norwich University Hospitals Foundation Trust (NNUH) have partnered with NHS Shared Business Services (NHS SBS) to help modernise workforce processes and reduce staffing costs, while maintaining high standards of patient care.


Key benefits

  • Trust employees incentivised by flexibility of weekly payments
  • Number of employee bank hours doubled over 18 months
  • Spend on agency staff more than halved
  • Partnership supports Trust’s wider automation journey

“We regard our relationship with NHS SBS as a partnership –
one where both parties have a common interest
to improve services for our staff.”

Ashley Judd, Deputy Director of Workforce,
Norfolk and Norwich University Hospitals Foundation Trust

The Challenge

As one of the UK’s largest NHS Foundation Trusts, carrying out almost one million outpatient appointments, day case procedures and inpatient admissions every year, NNUH juggles the need for efficiency savings with the provision of high-quality care to the oldest local population of any teaching hospital in the UK.

And, in common with NHS hospitals all around the country, providing safe staffing levels on wards and in clinics often means using private sector recruitment agencies to help plug temporary gaps in its workforce. But while they can be relied upon to provide a registered nurse at short notice, this flexibility comes at a price.

Typically, agencies add as much as a 50 per cent mark-up on the hourly rate of the healthcare workers they supply. In some areas and specialisms, this can rise to as much as 100 per cent.

With NNUH spending over £20 million on agency, contract staff and locums in 2016/17, the Trust was keen to take steps to reduce its reliance on this form of premium pay.

After a shortlist of potential suppliers was identified, NHS SBS chaired bidder interviews and product demonstrations, prepared recommended bidder reports at PQQ (pre-qualification questionnaire) and ITT (invitation to tender) stage, drafted bidder debrief reports, and developed and published the contract award. The team also provided guidance on key regulatory and legal issues, such as TUPE (Transfer of Undertakings [Protection of Employment]) implications and compliance with complex procurement legislation.
The Solution

For many bank staff, one key advantage of working through an agency is the offer of weekly payments, instead of the monthly payments normally offered by most NHS trusts. With that in mind, NNUH turned to NHS SBS to help introduce a weekly payroll for bank workers, whether substantive staff or bank-only workers, incentivising its existing employees to join the hospital’s bank instead of working through an agency.

As part of the process, NHS SBS worked with NNUH to implement a new weekly payroll function – creating new weekly assignment records and terminating old monthly payment schedules as necessary – and ensured that weekly payment was the default for relevant staff.

As a result, each month there are more than 3,000 bank weekly payments for bank workers, in addition to the 8,500 employees that receive monthly payments.

The Result

This initiative – combined with a number of other measures implemented by the Trust – has been transformative.

The number of bank hours work carried out by registered nurses almost doubled over 18 months – at the same time that agency hours reduced. Indeed, the Trust’s total spend on agency staff more than halved to £9.6 million in 2017/18.

Whilst NNUH benefits from these significant savings and bank staff receive the weekly payments they prefer, the Trust is working with NHS SBS on a number of other automated improvements to its workforce processes and systems.

For Ashley Judd, Deputy Director of Workforce at NNUH, the partnership with NHS SBS has been an important step in supporting his organisation’s ‘pathway to paperless’. He explained:

“Like many hospitals, we still use paper for many of our transactions. For example, we have recently moved to e-payslips but we still have paper expense claims and many other pay instructions are paper based. Whilst we obviously want to transition to being almost entirely paperless, the process needs to be carefully managed. Culturally, we can’t do it all at once.

“NHS SBS has demonstrated it understands this and is helping us with our transition to more paper-free solutions. The team there has also been happy to develop workarounds that help us to integrate other systems – even ones NHS SBS doesn’t provide. Ensuring that everything works as seamlessly as possible is their priority and they really do work with us as a team, rather than simply service providers.

“We regard our relationship with NHS SBS as a partnership – one where both parties have a common interest to improve services for our staff.”


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