Temporary Medical Workforce Improvement Programme
Summary
NHS South Yorkshire Integrated Care Board (ICB) led a system-wide programme to reduce reliance on temporary medical staffing, delivering a £5 million reduction in annual expenditure while maintaining clinical safety and staff wellbeing.
Bringing together seven NHS Foundation Trusts, the programme established a shared approach to workforce improvement, combining collective leadership with locally driven action. By improving oversight, enabling consistent data use, and strengthening workforce planning, organisations gained a clearer understanding of demand and variation.
The programme has enhanced financial control, improved operational consistency, and created a sustainable model for tackling complex workforce challenges across an integrated care system.
The Challenge
Across South Yorkshire, the use of temporary medical staffing had increased year-on-year, creating significant financial pressure and operational complexity. While influenced by external factors such as activity growth and industrial action, underlying issues in workforce planning limited the effectiveness of existing controls.
There was wide variation between organisations in how medical rotas were developed, approved, and managed. Workforce deployment was not always aligned with funded establishments or service demand, resulting in avoidable gaps that were frequently addressed through high-cost locum cover.
Approaches to governance and oversight were inconsistent, with different approval thresholds and limited system-wide visibility. In addition, workforce data was not always timely or standardised, making it difficult to understand the drivers of temporary staffing demand or take coordinated action.
The challenge was to bring greater consistency, transparency, and control across a complex provider landscape, improving financial sustainability while continuing to support safe care delivery and workforce wellbeing.
The Solution
The ICB established a structured, system-wide improvement programme, positioning itself as a strategic coordinator to align organisations around a shared objective while enabling locally relevant solutions.
Rather than introducing a single prescribed model, the programme created a common improvement framework supported by consistent governance, shared metrics, and regular system oversight. Within this, each organisation identified its own priority areas for improvement, reflecting local context and need.
Key elements of the approach included:
- System-wide oversight and governance, providing clarity and consistency
- Organisation-specific improvement plans, focused on areas such as rota design, temporary staffing demand, and workforce deployment
- Standardised data and reporting, enabling better visibility of workforce pressures
- Strengthened approval and control processes, ensuring appropriate use of temporary staffing
- Cross-system collaboration forums, enabling challenge, support, and rapid sharing of effective practice
This model created a balance between alignment and flexibility, allowing organisations to take ownership of change while benefiting from collective learning.
As improvements were identified, they were quickly shared across the system, helping to reduce variation and accelerate progress. Over time, this approach strengthened relationships, improved transparency, and established a more coordinated way of addressing workforce challenges.
Results & Next Steps
The programme has delivered measurable improvements in financial performance, workforce management, and system alignment:
- £5 million reduction in annual temporary workforce expenditure
- Decreased reliance on agency and locum staffing
- Improved consistency in rota management and workforce planning
- Greater visibility and use of workforce data
- Stronger governance and decision-making processes
These improvements have been achieved while maintaining patient safety and supporting staff wellbeing.
The programme has also changed how organisations work together, moving from separate approaches to a more coordinated, system-led model. Increased transparency and shared learning have reduced variation and strengthened collective capability.
Next steps include:
- Embedding the framework as a standard approach across the system
- Extending the model to other workforce groups
- Further improving data quality and insight
- Sustaining collaborative approaches to system-wide challenges
This work shows how coordinated system leadership and shared learning can deliver sustainable workforce improvement at scale, supporting both financial stability and high-quality patient care.
