Transforming Workforce Efficiency and Financial Governance
Summary
Frimley Health NHS Foundation Trust introduced a comprehensive programme to improve workforce efficiency, strengthen financial governance, and optimise rostering. The initiative focused on reducing unnecessary expenditure, tightening approval processes, and supporting fairer staffing practices. With alignment between finance and rostering systems, and supported by regular dashboards and roster clinics, the Trust achieved significant improvements in workforce management. This work has delivered measurable savings, improved planning, and enhanced staff experience, resulting in a substantial reduction in net hours and greater organisational sustainability.
The Challenge
The Trust was experiencing workforce inefficiencies and rising costs linked to staffing practices. Net hours were high, agency spend was increasing, and reliance on higher-grade bank shifts added pressure. Limited visibility of rostering data and inconsistent use of system features made it difficult to identify and address inefficiencies. Approval processes were not always aligned to financial authority levels, and user access was inconsistent. These challenges contributed to last-minute staffing gaps, avoidable expenditure, and inequitable rostering, with senior leadership recognising the need for targeted action.
The Solution
The programme was built on three pillars: financial governance, rostering practice, and oversight. Roster clinics were introduced across divisions to review and improve practice. Band-based pay controls ensured bank shifts were aligned with staff pay grades. Shift approval protocols were tightened, requiring stronger justification for agency or higher-band shifts. Financial governance and user access were updated to align with authorisation levels. ESR and finance systems were connected to provide consistent data, while monthly dashboards tracked progress and highlighted outliers. Collaboration was central, with workforce, finance, operational, and clinical leaders working together. Senior nursing leaders supported changes to maintain safe practice, and executive sponsorship ensured the programme had authority, with staff feedback helping shape implementation.
Results & Next Steps
Within 18 months, the programme delivered significant improvements. Net hours reduced by 80%, agency hours by 82%, additional duties by 39%, and higher-grade bank shifts from 19% to 2%. Forward planning improved, with roster approval lead times reduced by 8 days and shifts booked in advance increasing from 73% to 80%. Staff feedback reported greater fairness and reduced last-minute pressures, supporting retention improvements. The approach is now embedded across the Trust as business as usual, with learning shared through the South East Temporary Staffing Collaborative. The Trust plans to continue building on this work and scaling the approach more widely.
