Improving grip and control: Cardiff and Vale University Health Board saves £312,563 in just 6 months
Book a demoin agency savings, June to December 2025
bank workers approved on the system
primary bank fill rate achieved
shifts filled, equating to 430,000 hours
Overview
Like many organisations across the NHS, Cardiff and Vale University Health Board (CVUHB) faced the intricate balancing act of managing staffing gaps while maintaining financial control. The reliance on medical agencies is a common systemic pressure, driven not by a lack of desire to use internal staff, but by a lack of visibility and infrastructure.
A three-phase programme moved the Health Board from reactive filling to proactive workforce management: strengthening the internal bank, bringing agency activity under one system, then tightening the accuracy of the data behind every staffing decision.
Martyn Capel, Associate Director of Medical Workforce & Resourcing, shares an overview of our partnership
Navigating the complexity of workforce demand
The organisation identified that the primary obstacle wasn't just the cost of agency cover — it was the visibility of staffing data and the ability to use this to create a meaningful strategy for change.
From reactive filling to proactive planning
The goal was to transition temporary staff onto a robust internal bank, fixed term or substantive contracts, while ensuring that, when agency workers were still required, a unified system was in place to seamlessly control the process.
Technology clinicians would actually use
To achieve this, they required technology that offered clear insights, reduced manual workarounds, and, crucially, provided clinicians and staff with an intuitive experience they would actually want to use.
A three-phase route to grip and control
This phased approach enabled CVUHB to build a stable internal workforce, strengthen governance around agency use, and ensure accuracy of the data underpinning temporary staffing decisions, all while working in close collaboration with Patchwork's team.
Empowering the internal bank
Patchwork Bank provides clinicians with a straightforward way to view and book additional shifts in one place, while managers gain clearer visibility of emerging demand. The Board also introduced digital on-call functionality, ensuring on-call activity is captured accurately within the system rather than through sessional payments or manual escalations, which had previously risked distorting NROC reporting.
The impact: over 2,300 internal bank workers have registered with the Health Board's bank.
Strategic agency management
With a strengthened internal workforce, the next focus was external supply. Patchwork Agency Manager has provided real-time line of sight across agency activity, including usage, compliance, rates, and fulfilment. The Health Board also adopted PAM's structured escalation workflows, supporting more consistent governance around rate increases and enhancing control over spending.
Ongoing optimisation and data accuracy
Divisions began routinely reviewing shifts they had put out for staffing cover, and archiving those no longer needed, ensuring the system reflects true demand rather than residual or historical requests. The enforced breaks functionality ensures that mandated breaks are consistently recorded, supporting safe staffing while preventing unnecessary cost inflation.
The impact: over 50,000 shifts worked through the technology — around 430,000 hours of care delivery.
£312,563 saved and a shift in strategy
The results of this phased transformation have been tangible. From June to December 2025, the Health Board recorded £312,563 in agency savings.
A fundamental operational shift
This is more than a spreadsheet saving. The Health Board is now actively migrating staff into the internal bank and subsequently into substantive posts, creating a sustainable talent pipeline for the future.
The numbers behind the shift
Fill rates rose while rate escalation fell, with the overwhelming majority of bank shifts paid at base rate.
Primary bank fill rate achieved
Of bank shifts paid at base rate
Of care delivery worked through the technology, across more than 50,000 shifts
Of the 2,324 approved bank workers are using Patchwork
Granular control in one place
With features like full shift audit trails, configurable rate cards, and permission-based escalations, the team can now track the entire journey of a shift. This visibility has transformed cost control from a manual challenge into a straightforward, manageable process.
Building a sustainable talent pipeline
Underpinning this strategy is Patchwork's temporary staffing product suite, which provides the granular control CVUHB needed to manage both bank and agency effectively and in one place.
Migration into substantive posts
The Health Board is now actively migrating staff into the internal bank and subsequently into substantive posts, creating a sustainable talent pipeline for the future.
Keeping the data honest
Routine review and archiving of unfilled requests keeps the system reflecting true demand, so the insights driving staffing decisions stay accurate as services change.
Could a phased approach reduce your agency reliance?
Tell us how you fill shifts today and we'll walk you through what bank and agency in one system looks like for your organisation.