Northumbria master vendor implementation

Background

Our relationship with Northumbria Healthcare NHS Foundation Trust spans over eight years. Due to our market expertise and excellent reputation we were successfully awarded the role of master vendor in 2015 for the supply of general, mental health, paediatric, A&E, theatres nurses and HCAs. Our contract was extended in July 2020 for a further 24 months.

Northumbria Healthcare delivers care from sites across Northumberland and North Tyneside including an emergency care hospital, general and community hospitals, an outpatient and diagnostic centre, an elderly care unit and an integrated health and social care facility. The Trust is recognised as one of the largest employees of the North East with over 12,000 dedicated staff, across 14 sites.

Northumbria NHSFT in numbers

Each year they:

  • Care for over 71,000 patients on their wards
  • Provide treatment to around 167,000 patients in their emergency department, urgent care centres and minor injuries units
  • Perform over 36,000 operations
  • Treat almost 47,000 people using day-case procedures
  • Carry out around 1.4 million appointments with patients outside of hospital
  • Provide 78,000 adult social care appointments including home visits

Implementation

During the implementation period we sought to gain an understanding of the Trust’s requirements. The overall aim was to implement a solution that reduced agency spend, controlled off-framework spend and managed the supply-chain, whilst continuing to deliver an excellent standard of service. Cost and quality improvements were to be made across all sites.

Key benefits of our service include:

  • Bespoke candidate attraction campaign
  • Recruitment of nursing, theatres and HCAs to NHS compliance standards
  • Recruitment & booking management
  • On-boarding
  • 24/7 service
  • Supply chain management of secondary agencies
  • Process & implementation support
  • Streamlined authorisation processes
  • Dedicated account management team who work closely with key stakeholders to understand the recruitment needs and demands
  • Reporting & Management Information

Our approach

We took a consultative approach with the Trust to ensure we met all their requirements. Our aim was to:

  • Reduce off-framework spend and migrate off-framework candidates to Pulse
  • Ensure we could supply a service at NHSI capped rates, increase our supply and provide a consistently strong fill rate to the Trust

To deliver the high standards of service required we appointed a dedicated team, including an account manager, overseen by an operational contact. We understood that in order to deliver a successful service we needed to build a strong relationship with the Trust and key stakeholders and to engage with their incumbent supplier.

It was identified during the implementation period that the Trust was using high-cost, off framework suppliers to meet their requirements. Upon contract award, we met with various stakeholders to compare current/historic and future/predicted requirements with our candidate database to perform a gap analysis. This analysis enabled us to define targeted recruitment and attraction campaigns, increasing the capacity of our database to meet the Trust’s demands.

Recruitment activity

A bespoke candidate attraction campaign was agreed with the Trust to ensure the workers attracted matched skills and experience required. This included the use of their Trust logo and a microsite developed within the Pulse website.

Supply chain management

We undertook a selection process to identify support agencies, gathering individual rates cards relevant to each type of worker supplied, to identify agencies which complied with both price and framework compliance. Using this data, we worked in partnership with the Trust to agree on set rules for engagement of contingent agencies to include the Trust’s preferred cascade structure.

Technology

We recommended the investigation and use of innovative ideas and systems, proven to increase efficiency. We implemented ipoint, our bespoke system, to provide an end-to-end booking process. Processes with appropriate and robust mechanisms were agreed and built into our systems and policies to ensure that all bookings are managed correctly, with the greatest chance of filling.

By introducing Northumbria Healthcare NHS Foundation Trust to our innovative technology at point of entry, the Trust was able to reap the benefits which included:

  • Improved candidate attraction
  • Nurse usability
  • Efficiency gains

Compliance

In 2015 we agreed pricing pre-caps with the Trust which was immediately implemented without any breaches. General supply was at the NHSI caps immediately; however, it was identified that critical care and theatres facilitated break-glass provision.

We worked with the Trust to implement a tiered rate approach:

  • Tier 1: Capped rates for all staffing groups with 28 days shift notice
  • Tier 2: With 2 weeks’ notice with a slightly higher charge rate
  • Tier 3: For immediate and next day shifts with an escalated rate

Workers chose whether they wanted advance notice of shifts for less money or a higher rate shift with very little notice. This process identified that the workers were reluctant to book shifts in advance.

Working collaboratively with the Trust it was agreed during implementation that:

  • All margins were fixed as per the framework requirements
  • Agency cascade tiers were to those agencies who worked within caps set by the Trust, and met bank compliance

Our governance team carried out regular unannounced audits to ensure adherence to agreed rates, for NHSI reporting.

Contract management and savings delivery

Barriers faced:

  • High off-framework agency usage, driven by a shortage of Nurses and Support Workers available across all specialities
  • Incumbent candidates from local agencies initially not keen to transfer from their original agency
  • Nurses had to be re-educated that rates would be brought in line with the NHSi agency rules, and that there would be no exceptions to the rules at this Trust

We mitigated these through:

  • A dedicated budget to generate new candidates via web-based advertising, Google PPC, SEO, our own website, and Facebook campaigns to drive traffic
  • A decrease in the availability of off-framework shifts, with these shifts picked up by Pulse Nurses within agreed capped rates
  • Support from the Trust communicating that from the agreed and specified date, there would be no off-framework agency usage throughout the Trust

Achievements

We are delighted that the aims of the master vendor solution have been, and continue to be, achieved. Within the past 12 months, all supply has been at NHS capped rates and no break glass rates invoked. Aims were met through the support of the Trust and our dedicated team leading the project, and significant savings were made early in the relationship with the Trust.

Time to Hire: The time-to-hire initially reduced our capability to supply; through increasing the use of our internal system ipoint, along with personnel improvements, we significantly reduced time-to-hire from 4-5 weeks to 20 days, increasing the speed at which candidates are vetted and confirmed as 100% compliant.

Savings: We contributed to a 51% reduction in demand and subsequent direct cost savings due to working with the Trust to implement better workforce planning, and drive nurses to the nurse bank, despite this reducing our own margins.

  • Apr-Dec 2015: £556,344 hours requested by Trust
  • Jan-Dec 2016: £2,035,787 hours requested by Trust (+174%)
  • Jan-Dec 2017: £941,538 hours requested by Trust (-46%)
  • Jan-Dec 2018: £303,151 hours requested by Trust (-32%)
  • Jan-Dec 2019: £177,995 hours requested by Trust (-59%)

"The implementation of the Master Vendor Contract has added great value to our temporary staffing initiative, ensuring a high-quality service which meets the Trusts values, standardisation and consistency with supply; together with the ability to receive robust management information based on usage. This service provides efficiency to the temporary staffing team, as they can engage with and provide specialist nurses, build relationships with second-tier agencies on our behalf whilst at the same time ensuring that the Trusts quality control is enhanced.   The tightly controlled invoice and validation service that Pulse provides has demonstrated financial savings by reducing over-payments. The relationship assists in sustaining the Trusts focus on temporary staffing spend, and through the monthly managed information service, it helps to explain the high demand areas and enables the consideration of national metrics to track and benchmark this activity."

Julie Hogarth Manager of Temporary Staffing

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