Provider collaboratives: the shift from competition to collaboration
Dr Ahmed Shahrabani,
Co-Founder
Collaborative staff banks have historically been perceived as a risk. The concept of multiple Trusts merging their workforce to create a larger staff pool was an uncomfortable thought for many, particularly with growing challenges faced around retainment and staff shortages. However, in the face of a global pandemic, NHS organisations were compelled to work together, looking at collaborative ways to tackle various challenges arising from the fight against the virus.
“Collaboration between providers across many settings has been at the heart of the NHS response and core to serving our communities and patients effectively during the pandemic.” — Bill McCarthy, North West regional director, NHS England and NHS Improvement.
At Locum’s Nest, we strongly believe in the power of a collaborative workforce, having enabled NHS Trusts across the country to consistently achieve shift fill rates of over 90%, generating dramatic cost savings and empowering their employees through our suite of products.
Here we share more about this important shift and how, by embracing this change, NHS providers can become leaders in the continuously evolving healthcare landscape.
A shift in mindset for collaborative staff bank
The NHS staffing crisis is a long term issue that was heightened during the peak of the pandemic. The challenge to retain and recruit healthcare professionals skyrocketed as pressures on staff culminated and a lack of flexibility continued. A recent survey from NHS Providers found a large proportion of Trust leaders have seen staff leave due to early retirement or side effects from working through the coronavirus pandemic.
Saffron Cordery, Deputy Chief Executive at NHS Providers, notes: “I think one of the key challenges is amongst the NHS workforce, which is incredibly tired. Our survey found nearly half of trusts had evidence of staff leaving the NHS because of either early retirement, burnout, or the impact of working in a pandemic environment. And we know that there's more of that really tough work to come.”
We strongly believe one of the most sustainable ways to address this challenge face on, is to welcome a collaborative approach and continue to deepen cooperation within the NHS.
Prior to the outbreak, some Trusts would rather have avoided sharing their workforce, concerned about their own organisation’s staff retention. However, this viewpoint only worsened the situation. By restricting healthcare professionals’ mobility in an attempt to retain their best talent, providers were limiting workforce capacity, flexible working and instilling a competitive environment between organisations. As more bodies were needed to fight Covid-19, whilst others were limited to remote working or isolation, Trusts who’d previously foregone collaborative staff banks were faced with no choice but to forge new initiatives.
In recent years, the NHS national policy has begun moving away from competition to collaboration and the success seen during the pandemic has inspired a nationwide shift in perspective and practice. NHS Providers’ new support programme, ‘Collaborating for Better Care’ highlights the significant changes happening and marks the beginning of what will be a key opportunity for providers to be the engine room for transformation within the NHS.
A core foundation of the focus on moving towards better collaboration is the Integrated Care System (ICS) Design Framework which was published by NHS England and NHS Improvement earlier this month (June 2021). This briefing clarifies how Trusts will be expected to continue developing ICSs in line with leading technology providers to bolster a ‘one workforce’ approach and improve quality of care.
“From April 2022, all trusts providing acute and/or mental health services are expected to be part of one or more provider collaborative. NHSE/I now states that community trusts, ambulance trusts and non-NHS providers should participate in these collaboratives where it makes sense for patients/the system. Provider collaboratives will be expected to agree specific objectives in line with the ICS’s strategic priorities and help facilitate the work of alliances and clinical networks. The ICS NHS body and provider collaboratives will be expected to define their working relationships and governance arrangements, which will include their participation in committees through partner members as well as other local arrangements.” — NHS Providers - Integrated Care System Design Framework
Transparency in collaboration is key
To reach the goals of the NHS Long Term Plan, which states a ‘duty to collaborate’, we must recognise the value of transparency as well as the value of freedom of movement for doctors, the NHS and their patients.
When multiple Trusts post vacant shifts across multiple sites and specialities, transparency becomes key to optimising the organisation and its workforce needs as well as unlocking hidden efficiencies that wouldn’t otherwise be a top priority - such as reducing admin time, lessening reliance on recruitment agencies, significantly increase shift filled rate as well as enabling healthcare professionals to have autonomous control over their schedules.
However, in most NHS settings, admin teams typically have little to no visibility over vacant shifts and tend to spend the majority of their time focusing on last-minute or urgent shifts. This lack of transparency limits long term sustainable management and impacts a huge scope of factors including the total number of vacancies available, who can post vacant shifts, rates at which shifts are being posted, the rules in place to approve rates of pay and the ability to onboard external doctors. This is a huge challenge for Trusts who want to create a collaborative workforce and can be a bottleneck problem when merging with other staff banks.
As much as moving towards collaboration is a huge step forward, and one that will make the NHS the best healthcare system it can be, we believe, and have seen, that healthcare technology has a vast role to play in the success of transparency. By adopting an open collaborative model, the group of Trusts in question will be able to digitise their processes, with the required administrative tasks being quicker, automated and more transparent, allowing for better planning.
In a recent case study published by NHS Providers, about the North West London ICS and its new rapid response services across the 8 boroughs, Andrew Ridley, Chief Executive of Central London Community Healthcare NHS Trust, and the local care senior responsible officer for the ICS highlighted:
“If you take it to its core principles of collaboration and transparency rather than competition it is discernibly much better. I think the melting away of competition is quite significant for the NHS staff because it allows them to focus on delivering services to their populations, and not have to worry about losing their contracts”
At Locum’s Nest, transparency is the core of our approach to collaborative working and is the reason why those using our technology are able to better resource plan, increase staff engagement and ultimately fill more shifts. By combining Locum’s Nest Match and our Digital Passport with the Digital Collaborative Bank (the largest collaborative staff bank for UK medics), 10 NHS Trusts spanning across 6 ICSs, have been able to create a much wider staff pool, improving their bank-only fill rate from 72% to 91% at the height of the pandemic. This model ultimately results in better staffing, greater continuity of care and safety for patients and local communities alike.
What to consider when working with a neighbouring Trust
The first step to collaboration is choosing a staff bank strategy that’s right for your workforce needs. We have a whole library of resources dedicated to helping providers create a collaborative staff bank. Below are a series of questions, part of our ‘readiness checklist’ to get you started:
Do you have a staff bank in place?
Do you have an established recruitment team in place to onboard flexible workers of any profession (including medics) when they request to join your Trust?
Do you have established Trust rates of pay for bank workers with escalation processes in place?
Does the Trust currently electronically roster their healthcare staff?
Does the Trust run weekly or monthly payroll cycles?
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If you would like to know how Locum’s Nest can help you set up your own collaborative staff bank, please get in touch with our co-founder, Dr Ahmed Shahrabani at ahmed@locumsnest.co.uk or contact the team here.