Reduction in Temporary Staffing Costs at Portsmouth Hospitals NHS Trust

1. Reduction in Temporary Staffing Costs at Portsmouth Hospitals NHS Trust Abi Williams Workforce Intelligence Lead Portsmouth Hospitals NHS Trust 28th February 2011

2. Portsmouth Hospitals NHS Trust Acute Trust covering Portsmouth and South East Hampshire Part of South Central SHA Employs 5,500 FTE substantive staff Major PFI Redevelopment opened 2009 Regional Centre for Renal Transplantation services Host of Newborn Intensive Care Transport Network for the region Cancer Beacon Status for Head & Neck Cancers One of the busiest Emergency departments in the UK, with over 100,000 attendances a year. Hosts the largest Ministry of Defence Hospital Unit (MDHU) in the UK with Military staff comprising approximately 2% of the workforce. Page 2

3. Page 3 Problem • High usage of expensive temporary staff • Not cost effective • Data not received quickly enough to respond to • Poor understanding of why temporary staff was being used • Managers not held to account • No clear authorisation procedure

4. Temporary Workforce Expenditure 2009/10 In the first 6 months of 2009/10 temporary workforce reached a peak of 9% of total monthly workforce expenditure 9.5% when Overtime & excess hours included Page 4 NB. Temporary Workforce % = temporary workforce costs as a percentage of total workforce costs

5. Aim To reduce expenditure on temporary staffing Maintain safe levels of staffing and quality of care Clear process for temporary staffing usage Gain robust control on booking and authorisation, challenging use as appropriate Page 5

6. Solution Investigation and analysis into reasons for expenditure Changes to requesting / authorisation process Action plan for reducing expenditure with clear targets for expenditure reduction Weekly meetings with all divisions and services Reporting mechanism for weekly analysis Robust workforce planning processes Page 6

7. Weekly Reporting Process Completed Weekly Completed by service managers Linked to central reporting tool Reported to Executive team weekly Reports produced for each division / clinical service centre Page 7

8. Performance Management Analysis of monthly expenditure against reported expenditure Reported to Executive team weekly Reports produced for each division / clinical service centre Variances flagged, challenged and managed appropriately Page 8

9. Supporting measures Identification of critical vacancies, with process to fill internally Flexible working for deployment to posts without change to T&Cs Better utilisation of temporary contracts rather than daily rates Review of unnecessary services / functions RAG rating of shift cover used in key areas Page 9

10. Problems encountered Tension between reducing costs and maintaining safety Degree of underreporting – challenged and improved upon Embedding process into the organisation culture Page 10

11. Outcome Implementation of controls on Workforce expenditure have resulted in a reduction to 4.7%. Decrease in substantive expenditure observed also. Expected peaks in April 2010 and January 2011. Page 11 NB. Temporary Workforce % = temporary workforce costs as a percentage of total workforce costs

12. Questions? Page 12