Maximising Workforce Availability to Reduce Agency Usage
Summary
In response to the national directive announced in November 2024 to reduce agency staffing by 30% and bank staffing costs by 10% in 2025/26, Calderdale & Huddersfield NHS Foundation Trust established a focused programme to reduce temporary staffing reliance without compromising patient safety. Building on a strong track record in rostering and workforce management, the Trust introduced a Cost Improvement Programme (CIP) workstream, strengthened governance, and re-focused staffing meetings. These changes have delivered significant reductions in agency usage and improved the use of existing workforce capacity.
The Challenge
Following the Covid-19 pandemic, demand for registered nurse hours increased significantly. Agency staffing was relied upon heavily as bank usage remained static, leading to rising costs. Unfilled shifts cascaded automatically to agencies and were often booked instantly, making agency the default solution. Staffing meetings had shifted to focusing on budgeted establishments rather than actual care hours needed, reducing flexibility. Despite improving vacancy and headroom positions in 2024, agency and bank usage remained higher than before Covid, requiring a new approach.
The Solution
In January 2025, a Nursing and AHP CIP workstream was created with senior leaders from nursing, finance, workforce, and eRostering. Three key schemes were introduced: removal of the 20% bank incentive premium to align bank pay with substantive rates, introduction of payment at the required grade rather than the substantive grade to ensure cost control, and agency cost reduction through renegotiated rates, consolidation of tiers, and strengthened approval processes. Twice daily staffing meetings were re-focused under Associate Director of Nursing oversight, using live data from SafeCare and supporting professional judgement in decision-making.
Results & Next Steps
Between February and August 2025, agency usage reduced by 86% and overall temporary staffing demand reduced by 33.14%. Bank fill increased to meet demand even after the removal of the 20% premium, and higher band staff booking into Band 5 shifts fell by 72.8%. Renegotiated agency rates led to a £3.52 reduction in the average hourly rate. Governance structures and RLDatix reporting tools have ensured no adverse impact on patient safety indicators. Next steps include deep dives into unavailability and break compliance to identify further efficiencies, with the aim of releasing more workforce capacity while maintaining safe staffing and supporting staff wellbeing.
