Guide
Maximising
workforce capacity
A helpful summary of meaningful tips to overcome obstacles and elevate your shift fill rate.
About this guide
This guide aims to provide temporary staffing teams, rota teams and other HR staff with best practices from across the NHS of how Trusts have succeeded in overcoming obstacles to maximise shift fill rates. You will find concise information about each obstacle, which can be used to increase awareness and support your team.
The guide complements NHS Trusts' use of the Locum's Nest platform, offering short-term suggestions and long-term planning strategies, such as addressing workplace culture. It incorporates insights from a survey published to healthcare professionals using our app, enhancing our understanding of their mental health and wellbeing needs.
About Locum’s Nest
Locum’s Nest, the workforce technology company listed in The Telegraph’s “Top 5 ideas to save the NHS” is on a mission to solve the NHS staffing puzzle. Our flagship product Locum’s Nest Match, connects 50,000+ healthcare professionals to vacant work in 50 NHS Trusts and hundreds of GP practices. Our software is used by NHS Trusts, to digitally advertise and fill bank shifts in addition to e-timesheet submission. The Trust remains the employer and is responsible for the payment of timesheets submitted via the app.
Flexible rostering
Backlog of annual leave accumulation
The forever-changing circumstances of the NHS, such as the effects of Covid-19, can prevent staff from taking all their annual leave allowance, meaning more staff members will be carrying over annual leave. It is best to address the issue by having a process in advance of the year-end and arrangements agreed upon, to enable staff to carry over the remaining annual leave. It is important to plan these arrangements at the earliest point possible, which will give more time to find suitable replacements and ensure patient safety and continuity of care. This stems from good rostering processes which help manage demand.
With Christmas and summer holiday periods being times when NHS staff taking annual leave is more prominent, it becomes increasingly important to encourage planning of annual leave, so when there are gaps in rotas, replacements can be found for vacant shifts via the use of staff banks.
Staff sickness
NHS Staff sickness has grown by an average of 1.3% per year from 2019 to 2022, from 4.4% to 5.7%. Although Covid-19 has been a major factor since its emergence in 2020, the stress and burnout of healthcare professionals have “cost the NHS in England more than £15m lost working days since March 2020, about 50% more than the days lost to Covid infections and self-isolation”, an analysis of official figures by the Observer reveals.
There are some top tips NHS organisations can utilise to be more preventative in decreasing burnout, including but limited to overcoming the stigma of mental health conversations at work, upskilling managers to support staff more effectively, and encouraging passionate leadership. Direct changes that can have a positive influence on burnout and the overall health of the workforce will impact directly on the staff available to complete shifts, benefiting shift fill rate.
Planning shifts in advance, combined with increasing efforts to look after the well-being of healthcare professionals in your NHS Trust will be key in helping reduce sickness due to stress and burnout, which the above data highlights as a major factor in influencing patient quality and continuity of care. You can also refer to the Locum’s Nest best practice guidebook to help you maximise your use of the Locum’s Nest platform - with effective shift planning being key to combating staff sickness.
Collaborative working
Working collaboratively with other NHS Trusts is a great way for NHS Trusts to increase their pool of bank workers which can help cover periods where more annual leave is typically taken. The Digital Collaborative Bank, the biggest workforce coalition of NHS Trusts in the country, sees 9 Trusts and over 9,000 doctors come together. Positively, for 1 extra shift a healthcare professional works collaboratively, they work an additional 3 at their own Trust. This can also improve shift fill rate by between 5-10%. and is a sustainable way to find replacements, increase the size of your staff bank, and go from an obstacle to improving your shift fill rate.
Making life easier for staff
Payment schedules
Being paid on time and weekly as opposed to monthly is popular with NHS staff as it gives them greater flexibility and control over their finances. Weekly payment is often one of the key reasons healthcare professionals join a staff bank as it matches an individual's cash flow needs more.
Having a weekly payment schedule makes for better planning and instead of scrambling around at the end of the month, the payroll team can complete this weekly. It can become more consistent and easier to plan the working schedule around other job responsibilities, meaning it's beneficial for all parties involved. By doing so weekly, the reduction of this end-of-month pressure can result in fewer payroll errors to ensure staff are paid on time.
Staff accommodation
Some NHS Trusts have staff accommodation, for example, Chesterfield Royal NHS Foundation Trust. You can expand your pool of workers by having this option for staff. It could be that a staff member having to travel many hours to and from work doesn’t apply to a set of shifts, but if the staff member had the option of staff accommodation, they are likely to apply to more shifts. The option of accommodation caters for their well-being and time management research by The Nursing Times stresses accommodation should be explored as a way of retaining NHS staff and a great way to maintain/improve shift fill rate. This finding can be applied to all healthcare professional groups.
“Provide free accommodation for people working nights so they don’t have to drive” — Locum’s Nest HCP Mental Health and Wellbeing Survey 2023
Car parking charges
Positively, as of recently,” 94% of NHS Trusts who charge for car parking have fully implemented free car parking for those with the greatest need.” However, this does not take into account the economic climate we live in, adding additional financial pressures to many NHS staff. Car parking was made free during Covid-19 and helped boost morale across the NHS when needed most. But as of April 2022, paid parking was reintroduced, with a total cost of approximately £90 million per year for the NHS, causing more healthcare professionals to consider leaving their positions and the NHS altogether. GMB Union found that hospital staff were paying up to £1,300 a year to park at work.
93% of NHS trusts that charge for car parking have now “implemented free parking for those in greatest need, including NHS staff working overnight.” This will benefit the mental and financial well-being of some individuals. However, if this was made true for every NHS staff member it would increase morale and well-being, meaning staff are more likely to want to pick up additional shifts, positively influencing shift fill rate.
Culture
Staff canteens
Having your staff canteens open vs closed on night shifts can influence whether healthcare professionals apply to vacant shifts. By keeping them open, more is being done to cater for their wellbeing, ensuring they have an enjoyable and relaxing break to enjoy a meal. This is a factor that encourages staff to apply for night bank shifts.
“Improve canteen services by allowing access to more franchises and focus on healthier food options” — Locum’s Nest HCP Mental Health and Wellbeing Survey 2023
Staff feedback
Informal staff feedback through conversation, or formally through surveys is a great way of learning about your NHS staff’s experience of your Trust and gathering thoughts and feelings about how NHS staff find working at the Trust. One of the best examples of this is the NHS Staff Survey. It is important to gather the opinions of the entire NHS workforce including bank staff. This was reformed in 2022, as NHS bank staff were invited to complete a tailored version of the NHS Staff Survey which focuses on all things bank working, providing a fairer reflection of the NHS’ culture.
By compiling the opinions of all NHS staff, decisions can be made to enhance the culture, making applying for vacant shifts more likely.
“Ensure staffing is commensurate with demand. Listen to concerns and ensure they are acknowledged and even if unable to solve then logging it as in issue” — Locum’s Nest HCP Mental Health and Wellbeing Survey 2023
“If the organisation was more proactive at supporting trainees. I.e. it shouldn’t be the trainee that seeks support but the employer that makes a better working environment which is open non-judgmental and supportive” — Locum’s Nest HCP Mental Health and Wellbeing Survey 2023
NHS Trust culture and reputation
It is important to understand the overall culture and reputation of your NHS Trust, but also those of different healthcare communities, such as doctors, nurses or paramedics. The King’s Fund provides quality information on improving NHS culture including 6 characteristics that are important to a healthy culture:
Improving vision and values
Goals and performance
Support and compassion
Learning and innovation
Effective teamwork
Collective leadership
This further demonstrates that the higher the levels of satisfaction and commitment that staff report, the higher the levels of satisfaction reported by patients. If leaders and managers create positive, supportive environments for staff, they in turn create caring, supportive environments and deliver high-quality care for patients. Compassionate leadership culture encourages staff engagement.
Educational benefits
Healthcare professionals are keen on having options to learn and develop through working in different hospital settings, departments and across specialities, which can help them figure out whether to pursue an interest long-term, for example. NHS Trusts working together as part of a collaborative increase each Trust’s pool of bank staff, increasing the likelihood a shift will be filled, whilst offering more variety of shifts to healthcare professionals.
A great example of offering a wide variety of shifts, with educational benefits for healthcare professionals is the 10 Trusts part of the North Central London Collaborative Staff Bank. The collaboration includes a range of Mental Health Trusts such as Barnet, Enfield and Haringey Mental Health NHS Trust as well as an international centre of excellence in child healthcare with Great Ormond Street Hospital for Children NHS Foundation Trust. You can find out more about the educational benefits the collaborative is having in a recent Health Service Journal webinar.
“Assigning “mentors/clinical supervisors to long term bank doctors” — Locum’s Nest HCP Mental Health and Wellbeing Survey 2023
Additional resources
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Locum’s Nest best practice guidebook
A helpful summary of meaningful advice and tips to maximise your usage of the Locum’s Nest platform.
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How to create a collaborative staff bank the NHS way
Your step-by-step guide to forming a collaborative staff bank with neighbouring organisations, the NHS way.
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The People Behind Our NHS Workforce Technology
Discover our Customer Solutions Leads and what our NHS Partners have to say about the value they bring.
