Department of Health Bank Flexible Working Pilots
In October 2017, the Secretary of State announced that new flexible working arrangements will be offered to all NHS employees during this parliament.
As part of this commitment, the Department of Health and Social Care and NHS Improvement launched pilots in April 2018 to test a new app-based flexible working offer to their staff.
The pilots focus on supporting NHS staff to book shifts quickly and easily using the latest mobile app technology, get paid more quickly and make choices on their pension contributions. The intention is to generate evidence of best practice through the pilots, so that doctors, nurses and other NHS staff can be offered a seamless, modern and intuitive way to build their work around their commitments and be paid as they go. This in turn will enable trusts to improve the quality and continuity of patient care, to retain and deploy their staff more effectively and to reduce reliance and spending on agency workers.
Aims of the Bank Flexible Working Pilots
The aim of the bank flexible working pilots in 2018 is to test different bank flexible resourcing models on the experience of NHS staff. Through the pilots, trusts will set out to improve their bank working offer to staff through factors such as mobile app shift-booking, rapid payment and the ability for part-time staff to waive pension contributions on bank shifts. The pilots will also set out to improve the way the system functions through the interoperability of bank shift-booking technology with payroll and e-rostering, development of collaborative banks and culture, behaviours and bank management best practice.
Lancashire Care’s involvement
Trusts interested in taking part in the Bank Flexible Working Pilots were asked to develop and submit their proposals by 9th February 2018. Lancashire Care was chosen as one of 15 successful trusts.
Objectives of the Bank Flexible Working Pilots
- Improve the staff experience of working on bank, from the point of booking shifts, right through to payment
- Increase the participation of staff in trust banks, as opposed to agencies, whilst maintaining the level of substantive staff currently employed
- Increase bank fill rates, i.e. the ability to fill advertised temporary staffing shifts with bank over agency workers
The Dept. of Health and Social Care has appointed an external company, Traverse, to evaluate how trusts deliver on their proposals and to monitor changes in key outcomes such as bank fill rates, bank enrolment rates, agency spend and staff attitudes and experience. Through testing a range of measures across different trust types, regions and staff groups, the pilots should provide clear, relevant and actionable learning for trusts, as well as evidence required at national level to inform the roll-out of best practice bank flexible working to all NHS staff by the end of Parliament.
In achieving these objectives, the pilots are intended to contribute to and align with the broader work programmes addressing the long term workforce policy objectives as follows:
- Improve staff morale – The Department of Health and Social Care (DHSC), NHS Improvement (NHSI) and NHS Employers are supporting trusts to improve staff experience in the NHS; we want to ensure access to mobile shift booking platforms and prompt payment to help improve the experience of bank working and further improve the morale of NHS staff.
- Increase the retention of staff – The Secretary of State has publicly stated on numerous occasions that nurses, and all clinical staff, are the backbone of the NHS. Improving the offer for staff who want to work more flexibly should retain more staff in the NHS. We know that there are a number of factors which may incentivise NHS staff to work with agencies; by making bank working more attractive and receptive to bank worker needs, we aim to retain staff that may otherwise chose to work additional or core hours through an agency.
- Reducing spend on agency staff – in 2015 the Secretary of State introduced measures to reduce agency spending. As a result we have reduced agency expenditure by £700m in 2016/17, and we are on track to reduce agency expenditure to £2.5bn this year. The Secretary of State wants to go further in 2018/19 to encourage greater use of trust banks instead of agencies, and by attracting agency staff back into the NHS.
- Improving workforce productivity – NHSI is taking forward a major programme to improve operational productivity in the NHS. This includes improving workforce deployment through the installation and use of e-rostering tools that can work with bank IT solutions; this should enable trusts to vastly improve roster planning, while allowing staff members to choose when and where they work. NHSI is also working with trusts to help them collaborate with other trusts to share bank resource. An improved flexible working offer across regions will further increase the use of banks to fill rota gaps.
Lancashire Care’s Proposals
The Lancashire Care Bank is already one of the highest performing trust banks in the country. They receive around 12,000 shift requests each month and fill 80% of them with bank workers. Due to sustained bank worker recruitment combined with the roll out of HealthRoster and SafeCare by the eRostering team, agency usage has fallen from an average of 20% of bank shifts filled in 2014 to 8% in 2018. The team host regular drop-in sessions to meet with bank workers and work with networks to meet the needs of teams in a way that provides the best outcome for them and the trust as a whole.
Despite the achievements to date there are areas we would like to target for improvement and these formed the basis of our proposal:
- Increase the percentage of bank shifts self-booked via Employee Online or the Allocate ME app
- Investigate the potential to offer substantive staff the option to be paid weekly or monthly for bank shifts worked
- Expand the LCFT Medical Bank to decrease agency usage and spend and improve quality
Regular updates on progress are communicated via the Pulse, Lancashire Care’s weekly digital newsletter.