Workforce Efficiencies Improvement Programme
Summary
South Yorkshire and Bassetlaw NHS organisations, alongside Chesterfield Royal Hospital NHS Foundation Trust, implemented a system-wide workforce efficiency programme to reduce reliance on bank and agency staffing while maintaining safe, high-quality patient care. Supported by South Yorkshire ICB, trusts introduced shared workforce controls, collaborative staffing approaches, and improved operational oversight to strengthen workforce deployment and financial resilience.
The programme delivered sustained reductions in temporary staffing usage across all Agenda for Change groups, with several trusts eliminating nursing and midwifery agency usage entirely through improved workforce planning, rostering, and substantive workforce utilisation.
The Challenge
The system faced significant productivity and workforce challenges driven by rising demand, workforce shortages, and increasing financial pressure. Reliance on bank and agency staffing, particularly within nursing and midwifery, had become unsustainable, placing strain on operational performance, workforce stability, and financial resilience. Although cost controls had historically been effective, existing approaches were no longer sufficient to meet tightening targets while maintaining safe, high-quality patient care.
Fragmented practices, inconsistent operational controls, and limited workforce supply led to premium staffing costs, rota instability, and increased pressure on clinical and managerial teams. This diverted time and focus away from patient care and service improvement activity, while also impacting staff morale and organisational resilience.
The key challenge was to reduce dependency on temporary staffing safely and at scale without compromising care quality. This required stronger workforce planning, improved deployment of substantive staff, and consistent operational controls across organisations. The objective was to move from reactive short-term mitigation towards a sustainable, system-led workforce model that improved productivity, strengthened resilience, and protected frontline services.
The Solution
South Yorkshire, Bassetlaw, and Chesterfield Royal Hospital NHS Foundation Trust implemented a coordinated, system-wide workforce improvement approach supported by South Yorkshire ICB. Workforce, finance, operational, and clinical leaders worked collaboratively to strengthen workforce controls, improve staffing deployment, and reduce reliance on temporary staffing across organisations.
The programme introduced shared workforce reporting, improved data quality, and real-time oversight of agency usage to support more consistent operational decision-making. Key interventions included standardised bank and agency rates, collaborative staff banks, strengthened establishment controls, and improved eRoster utilisation to maximise internal workforce capacity and reduce premium staffing costs.
Trusts also supported the transition of agency workers into staff bank arrangements while strengthening recruitment, retention, and workforce planning processes to improve substantive fill rates and rota stability. Consistent governance, escalation processes, and shared operational standards helped embed sustainable workforce management practices across the system, improving productivity, workforce resilience, and financial control while maintaining safe, high-quality patient care.
Results & Next Steps
The programme delivered significant operational and financial improvements across all provider trusts through strong collaboration, shared accountability, and disciplined workforce management. Across all provider trusts, agency usage and associated costs were reduced by 50%, alongside a £3 million reduction in bank expenditure, generating substantial recurring savings while maintaining safe, high-quality patient care.
At organisational level, results were equally significant. One of the region’s largest trusts achieved a 97% reduction in agency use, while Sheffield Teaching Hospitals eliminated agency staffing entirely, sustaining zero agency usage for eight consecutive months across a complex tertiary care environment. These improvements reflected a major shift towards workforce self-sufficiency and more sustainable staffing models.
The programme also delivered wider operational benefits, including improved rota stability, increased substantive workforce fill rates, stronger continuity of care, and reduced administrative burden for managers. Investment in eRoster optimisation, collaborative staff banks, and agency-to-bank migration strengthened internal workforce capacity and improved productivity. Real-time oversight, shared workforce data, and consistent operational controls ensured that improvements were sustained over time.
Overall, the programme created a more resilient, efficient, and productive workforce system capable of meeting rising demand while protecting quality, safety, and financial sustainability.
