Taking advantage of August changeover to build a successful staff bank (2020 Guide)
Rhonda Hennagan,
Customer Solutions Lead
We all know that the purpose of a hospital staff bank is to provide essential cover for unfilled shifts and posts. By filling these vacancies, hospitals have the ability to provide a safe and effective service to their patients and staff 24 hours a day, 7 days a week. Without an effective bank, hospitals struggle to function; no wonder reforming staff banks is a key aim of the newly released NHS People Plan.
Before joining Locum’s Nest, the technology company transforming staff banks across the country, I was managing complex rota design for doctors... for all departments at the same time, across a whole hospital! My current Locum’s Nest team and I, work up and down the country helping NHS organisations transform their banks into digital exemplars, a key tool in providing a much-needed rota cover to all hospitals in the NHS. Over the years we’ve become experts in applying and evaluating best practices when it comes to managing staff banks.
In this article, however, we’re going to explore specific techniques to allow rapid bank growth and engagement over the August Changeover period.
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Part 1: Understanding what’s at stake and how to track progress
Before embarking on any staff bank growth project, it is important to clearly communicate with all stakeholders the importance of the project, to ensure adequate support from your colleagues and executives alike. Temporary staffing operations can often be neglected, however, over the years, we’ve seen a renewed appreciation for the life-saving (literally) work that staff bank teams do, perhaps out of even more appreciation for the adverse effects of having an ineffective bank.
What are the consequences of having an ineffective staff bank?
A staff bank unable to fulfil its purpose of providing that all-important essential cover can have far-reaching consequences. Put bluntly, an ineffective bank puts patients’ and healthcare professionals’ safety at risk. As the rota gap remains, the ward, if kept open, is left understaffed. Those doctors and nurses already on the wards get overworked, tired and demoralised and the risk of a clinical mistake increases exponentially. Of course, productivity on that day and in the future also drops significantly. Let’s not forget that the reliance on external agencies increases, adversely impacting continuity of care and deteriorating the hospital's financial position.
All these lead to one tragic consequence: the hospital’s whole workforce and patient population suffers as a result!
What are the two essential ingredients to an effective Staff Bank?
A large and ever-growing bank
An engaged bank
The reality is that the bigger the bank the higher the chances of filling those vacant shifts. One should not expect every member of the staff bank to be active but should strive towards improving engagement. In fact, those staff bank departments which are fine-tuned, track what we refer to as staff bank engagement rates, defined as the percentage of staff bank members who have worked a shift in the last three to six months.
One should not expect every member of the staff bank to be active but should strive towards improving engagement.
A typical decent engagement rate hovers at around 30% of the staff bank size. In absolute numbers this means that if, say, you have 1,000 healthcare professionals on your bank 300 of them will actively be working shifts. If you have 2,000 on your bank, the number of active members also doubles to 600. Given your shift requirements remain roughly the same, that is enough to take an organisation to near 100% vacant shift fill rates!
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Part 2: The great staff bank opportunity — August Changeover
August changeover is when an estimated 50,000 medics across the UK move into new posts in hospitals to train in alternative specialties. This is a very challenging time for doctors, administration staff and the hospital. With the shortage of doctors in certain specialties more locum doctors are required to fill vacant posts.
But it’s also a golden opportunity for working on those two ingredients: growing the bank and improving its engagement.
>> Aim 1: Building a bigger bank (the 4 Rs)
Retain the outgoing doctors
Recruit the new substantive doctors
Remove only when necessary
Ramp up growth with collaboration
Overarching principles
It’s very important to make it very easy for a doctor to join the bank, especially when they are or have recently been substantive members of staff. We’ve all heard the horror stories where one day they’re a fully competent member of staff and as soon as they leave the Trust, they’re judged as unsafe and need to complete pre-employment checks from scratch (needless to say some healthcare professionals get really offended by this).
The teams handling recruitment should not lose sight of the all-important aim: to grow an effective bank.
1. Retain the outgoing doctors
Retention of the outgoing doctors can be an extremely effective tool in growing an effective bank. Often these doctors, having spent at least a whole year in a hospital they’ve grown accustomed to, with colleagues they’ve worked with through challenging pandemic times, want to keep some ties with the workplace they’ve grown fond of. They not only know how the hospital functions but often know the patients too. So, as long as you make it easy for them to join the bank, chances are they will gladly do so and come back to help!
Good practice:
Consider the possible models of transferring outgoing doctors onto the bank. The opt-out model, where all doctors will be transferred onto the staff bank unless they request not to, has a far higher success rate than the opt-in model, where the doctors have to actively request to be on-boarded onto the staff bank before leaving. If you choose to adopt the opt-out model, we recommend to send two or three reminder emails to the outgoing staff to give them plenty of time to opt-out if they want to. If you wish to go down the opt-in route please consider making it extremely easy for them to opt-in e.g. asking them to respond with just a ‘Yes’ (and nothing more) to your email
Define a grace period where this transition can take place. In other words, you don’t need to rush into completing the retention of your outgoing doctors before they rotate out. You can run this project up to a period of, say, 3 months after the August rotation day.
Do not ask them to fill many forms. Bureaucracy will create a high attrition rate and the project will likely be of limited success. If, despite the above, you still need them to complete any forms, make them online so they can do that even if they’re not physically present in your premises.
Real-life case:
Doctor A goes off sick at the last minute on August changeover day. The shift the doctor was scheduled to work is vital for the hospital night-team. Because the hospital has retained and given a grace period to leavers, a doctor who had rotated out of the hospital, applied and was available to work the urgent shift. This provided full hospital-at-night cover, keeping the staffing levels safe.
2. Recruit the new substantive doctors
Doctors need to know you are looking for locum doctors, how to join the bank, whom to contact, the process and steps involved. Typically, administration staff and the healthcare professionals are required to complete complex recruitment paperwork for the doctors to join the bank. Of course, singular internal locum banks are limited in their resources as for most of the year they are not handling such a big influx of applicants to join the bank.
Good practice:
Make the process of joining the staff bank straightforward and easy. An app is essential for ease of use for the doctor to express an interest in joining the bank through the Digital Passport. The recruitment process for the hospital administration staff should be straightforward and easy to use in order for the staff to access the documents the doctor has provided.
Consider going for the opt-out model, where all new members of staff are automatically enrolled onto the staff bank unless they opt-out. This might mean more upfront work for your team but the benefits far outweigh the additional workload as you can in some cases double your staff bank capacity overnight. Here, for that extra peace of mind, you can, of course, use additional administrative support from onboarding experts such as these.
Advertise your organisation using a staff bank technology platform which advocates fairness and openness. It’s the only way you can guarantee visibility across tens of thousands of doctors.
3. Remove only when necessary
You will undoubtedly come across the classic trade-off between the need for spotless governance versus the need for a big and effective bank. The initial tendency is to do a ‘clean-up’ and remove from the staff bank everyone who is not up-to-date with their non-essential documents according to your records. While clinical governance and safety should never be compromised, there are some handy techniques you can use to still meet your team’s objective of growing the bank.
Good practice:
While your own records might not be up to date, your organisation might indeed hold the required information you seek elsewhere. Remember that, in the case of both outgoing and incoming doctors, these professionals were/are in practice good enough to work as substantive members of your staff so, in the short term at least, they should be fully compliant to work with your organisation. So, it is a prudent action to not rush to remove them from your lists.
Don’t compromise on clinical governance and link with a system that automatically runs daily checks of their licence to practice against official databases such as the one held by the GMC.
Give a grace period of 3 or 6 months (our experience shows that 6 months is best) before removing anyone who does not have the required (non-essential) documentation from your staff bank.
Regarding those that are truly not compliant and you need to remove from your bank, please don’t just remove them! Try your best to speak with them and engage with them first as the work that these doctors can do for you might actually (and without exaggerating) be life-saving!
4. Ramp up your growth with collaboration
Imagine a scenario where your bank can reach exponential growth rates. Remember that the bigger the bank the bigger the chances of filling those vacant shifts rapidly and as a result improving quality of care. If your bank achieves exponential growth rates, you can reach near 100% fill rates of your vacant shifts with almost zero reliance on agencies. This may sound too good to be true but there’s actually a tried-and-tested method which is so successful that now more and more organisations are considering it.
True collaborative banks (of which the largest is the Digital Collaborative Bank, powered by our technology) work in the following way:
Each NHS Trust member of the collaborative maintains and grows their own bank
The workers on each bank can freely work shifts in all other members of the collaborative
Payment is done by the home staff bank and well-established cross-charging mechanisms take care of the cost
Compliance is managed through robust agreements between the collaborative member organisations
Exponential growth of everyone’s effective bank unlocks synergies greater than the sum of the individual bank as the workers are fully engaged and committed to the region as a whole.
Near 100% fill rates are observed universally
>> Aim 2: Improve engagement of the existing bank
The importance of engagement with staff cannot be overstated. It is well known that employee engagement strategies have been proven to reduce staff turnover, improve productivity and efficiency. Most importantly, engaged employees are happier, both at work and in their lives.
Engaged employees are happier, both at work and in their lives.
When the basics of employee engagement are applied to your staff bank - your contingent workforce - the results can be staggering. The reasons are now well understood.
Take, for example, the case where you have a decent-sized bank on paper but also a very high agency bill. When you look into it, you discover that staff bank engagement is pretty low - i.e most people do not work shifts. When you try to establish the root cause, you realise that individual departments tend to have their own ‘distribution’ email lists where only a small subset of your staff bank is being shown those available shifts.
In simple terms, if people can’t see the available shifts they can’t book to work them! With that in mind, here is the 5 point plan for successful engagement.
Engagement 5-point plan:
Broadcast your vacant shifts to everyone in your bank and beyond (we’ll come to that in a later piece) using advanced mobile technology.
Broadcast your shifts well into the future - people, in general, like to have some financial stability so they want to be able to plan their future income (in the form of booking shifts) as far in advance as possible.
Speak to your staff bank. Your staff bank is not just a long-forgotten excel list; it’s a dynamic pool, very much populated with real people! Try to get to know them, tell them about news in your organisation, collect their views through surveys.
Target those engaging the least - these staff bank members are literally the untapped potential of your bank. If you can unlock that potential you will discover that your shift fill rates skyrocket!
Host Staff Bank engagement days - people love their pizza and they are really keen to find out about additional income opportunities in your Trust. All you have to do is make it easy for them to discover what they are.
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Staying focussed on the objectives
By far, the most important step is to help all stakeholders understand the importance of having an effective staff bank and that to get to that stage, you need to grow it and keep it engaged with your vacant shifts.
After that, it’s a matter of successfully executing the 4R strategy (Recruit, Retain, Remove when necessary and Ramp up through collaboration) for growth and the 5-point plan for engagement!
