The University Hospitals of Morecambe Bay (UHMB) NHS Foundation Trust operates three main acute hospitals across rural Lancashire and South Cumbria. Resourcing was difficult due to the complexity of the region, and, since the 2015 Kirkup Report, attracting staff is more challenging with agency spend increasing.

Requirement

A sustainable and flexible workforce model is crucial to serving an ageing local community with a seasonal influx of some 15 million tourists each year. Agency nurse and locum supply were each controlled by key suppliers, which resulted in rate inflation over time. 

Managing control and transparency rates and agency charges was difficult due to a lack of accurate financial and workforce planning information. Additional costs were incurred through the use of non-framework agencies to fill last-minute bookings.

Besides resolving challenges with locum fill rates across five clinical divisions, the Trust needed to limit their exposure to cost, quality, and compliance risks due to non-framework agency usage.

Solution

Retinue delivered a client care team on-site to act as an extension of the Trust’s teams. They were supported by off-site resourcing and supply chain management. Retinue implemented proprietary management software customised for UHMB.

By implementing dynamic supplier tiering in subgroups (theatres, midwifery, general and critical), each nursing subgroup benefited from its own optimised supply chain. This ensured that challenging specialist sub-groups weren’t left behind either in quality and fill or cost improvement.  This has transformed agency spend and compliance with NHS Improvement price caps across Nursing and Midwifery, Medical Locums and AHPs.

All supply chain bookings were shaped by MS Power BI data analytics that analysed crucial data pinch points to measure success and inform strategic decision-making.

Results 

UHMB has benefited from year-on-year savings for the past six years. Results include: 

• 100% of timesheets and invoicing are completed electronically for all categories.
• new agencies introduced, promoted and regulated to support niche and hard-to-fill roles.
• theatre nurses migrated from tier 2 to tier 1 agencies, retaining 95% on reduced rates.
• nursing fill rates improved from 60% pre-contract in some locations to >95% overall.
• 100% compliance secured. 
• a 98% locum fill rate with the most advantageous locum rate card regionally. 
• £13.9m in released cash savings.

Retinue’s proprietary VMS technology enables the Trust to use electronic bookings, time sheeting, and invoicing, and to compare and rank locums and agency staff by individual cost and quality. This includes highlighting costs against agency cap pre-booking. The powerful workflows manage budgets and compliance, putting control back in the hands of the Trust.

“Retinue has worked with us to drive down locum spend, resulting in significant savings. They are understanding of the pressures facing the local area, and are knowledgeable about the industry. As a result of our close relationship with Retinue, we maintain high fill rates at a stable rate, reducing department pressure as and when rota gaps arise.”

 Assistant Service Manager, Morecambe Bay

“Our partnership with Retinue provides an invaluable platform to control and perpetually

reduce agency spend through scrutiny and standardisation. The recruitment and supply

chain management teams ensure quality and compliance are never compromised.” 

Aaron Cummings, CEO, University Hospitals of Morecambe Bay NHS Foundation

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