IN-DEPTH: COST EFFICIENCY


CHALLENGE TAKING THE FINANCIAL


T he need for cost


improvements has never been so great, with the Trust not able to balance its books this year and a growing financial challenge across the whole NHS.


One area identified nationally as having significant potential for releasing savings that can be reinvested back into patient care is reducing agency spend. While agency staff will always be important in helping us to provide great care every day and night, an over- reliance is very expensive – as we have to pay a premium – and it doesn’t enable the continuity of care that we have with permanent staff. In 2015/16, the Trust spent £51m on agency workers. We have been set an agency spending cap for 2016/17 of just under £35m and we are currently on plan to deliver. Michele Elliot, senior nurse in trauma, orthopaedics and reconstructive surgery, and Miriam Phillip, senior nurse for general surgery and vascular and ophthalmology, are looking at ways of reducing the use


We take a closer look at one initiative making a significant cost improvement in the Trust.


of bank and agency nurses across their services – primarily by speeding up recruitment to vacant posts and introducing new ways to retain staff. “We are looking at our staffing methods closely,” says Michele. “As nurses, we feel we are in the best position to do this, as we understand our clinical areas and can look at our rosters to ensure we always maintain safety.”


Michele and Miriam have a clearer accountability for making improvements to agency staffing following the Trust’s recent management restructure, and have wasted no time in taking on the task. “We have looked at ways to ensure most of the more expensive shifts, at


nights and weekends, are covered by permanent staff,” Miriam explains.


“We have created a template to help wards really understand what they need for safe staffing. So, before automatically requesting agency staff as a result of sickness or absence, ward managers are helped to assess how much support is actually required, taking into account real-time, specific information, such as the number of empty beds.”


And there is more to come, with improved recruitment processes and staff retention schemes – such as surgical rotations and the option of internal transfers for existing staff members to support career development also featuring in Michele and Miriam’s plans. “It’s a work in progress. The good news is that everyone is on board. Step by step we’re making changes that benefit both our finances and our patients,” concludes Michele.


Cost improvement champions


The Trust established a financial improvement programme earlier this year, as part of a national NHS initiative and with the support of external consultants PricewaterhouseCoopers. To help spread good practice, every week, each of our clinical divisions recognise their cost improvement plan (CIP) champions.


“We are looking at our staffing methods closely. As nurses, we feel we are in the best position to do this.”


Miriam Phillip, senior nurse general surgery and vascular and ophthalmology Autumn 2016


If you have any ideas for cost improvements, the programme support office – who co-ordinate the financial improvement programme – are always happy to provide support. You can email them at PSO@imperial.nhs.uk


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