Implementing a trust-wide integrated bank and agency solution

Before Patchwork

In mid-2023, Homerton Healthcare NHS Foundation Trust adopted Patchwork Bank and Agency Manager to manage medical temporary staffing trust-wide. Below, we share the story of our partnership so far and how workforce technology has supported a large integrated care trust in East London.

Medical workers and temporary staffing teams faced two key challenges prior to adopting Patchwork, both of which resulted in increased workforce spend for the organisation. 

1. Manual, time-consuming processes

Without user-friendly bank and agency technology in place, filling rota gaps relied on a range of admin-heavy processes. Onboarding new workers, broadcasting shift vacancies and managing pay were all resource-intensive tasks for temporary staffing teams, leading to a high workload and a focus on day-to-day firefighting to keep wards safely staffed.

Similarly, locum workers were forced to use a range of platforms, from WhatsApp to email, to book shifts, manage timesheet sign-off and keep track of their pay. The time-consuming back-and-forth communication with temporary staffing teams contributed to a poor worker experience, and disincentivised staff to pick up bank shifts – often driving up agency reliance as a result.

2. Limited temporary staffing visibility

These manual out-of-system ways of working had a knock-on impact on temporary staffing visibility, restricting the trust’s ability to deliver cost-effective and cohesive workforce management across the trust.

A number of issues were raised in relation to this, including:

• Medical departments and the Medical Temporary Staffing team used various siloed systems to manage workforce activities, meaning there was no central oversight of bank and agency usage. Without effective integration, double shift bookings, shift irregularities and data duplication were common occurrences, causing frustration for both clinicians and managers.
• As a result of these siloed systems and ways of working, ensuring all departments consistently enforced the trust’s workforce policies and governance requirements was challenging.
• With multiple ways of working in operation, staffing teams understandably struggled to stay up-to-date with rota gaps and areas where additional staffing resource was required. This made it difficult to efficiently advertise vacancies trust-wide and deploy necessary bank staff, often leading to a greater reliance on last-minute (and more costly) agency bookings.
• Pay rates were also not clearly visible between departments – although this was not initially surfaced as an issue, significant rate card variance and a lack of control over medical temporary staffing spend were identified during the scoping process.
• Ultimately, without visibility of staffing activity, access to data and robust reporting was limited, often resulting in assumption-based rather than data-driven decision-making. This had a direct impact on the trust’s ability to accurately forecast where resources should be deployed in line with previous requirements and NHSEI guidelines.

The implementation of Patchwork’s solution

To overcome the challenges above, stakeholders at Homerton agreed that an integrated staff bank and agency platform for medics was necessary, and selected Patchwork as the best solution to meet the trust’s specific requirements.

In close collaboration, Patchwork and Homerton implemented our medic-founded bank system and integrated agency management technology, with Direct Engagement (DE) delivered via a joint partnership with workforce service provider PlusUs.

As part of our commitment to delivering a sustainable and effective solution, a comprehensive implementation and change management process was collectively agreed on and delivered, involving two key components:

1. Engagement and training – support provided by Patchwork’s implementation team, both virtually and on-site, ensured teams were fully supported to transition from previous ways of working and are now equipped to use the new technology effectively.
2. Rate control standardisation – during the scoping phase of our partnership, it was discovered that there was variation in departmental pay rates due to a lack of system visibility (as referenced above). To tackle this, a standardisation process was implemented to control and streamline rates, with Patchwork Insights playing a crucial role in surfacing the necessary data to make this a success.

Staffing success stories

Determining the success of any workforce solution lies in the data. During the first few months of our partnership (from go-live in November 2023 to Spring 2024), Homerton has achieved the following results:

• Impressive staff bank growth with 200 workers onboarded
• External workers joining the bank doubled to over 100
• Unfilled shifts decreased by 16.5%
• Shift fill rates have exceeded 78% since go-live
• 86% of Direct Engagement demand has been filled

Alesia Waterman, Deputy Director of People at the Trust, comments:

“The implementation of Patchwork has been a key factor in allowing the Trust to reach its temporary staffing workforce target. This has contributed to our overall Trust CIP target and has allowed us to collaborate at a system level to be able to implement the necessary oversight and controls.

The partnership and support from Patchwork were paramount to achieving this implementation successfully. Patchwork worked very collaboratively with me and various colleagues. No challenges or requests were too much and I simply could not have achieved this without them and their kind, flexible and supportive approach.

We continue to work closely with Patchwork, which is allowing us to further embed the system and new ways of working. Their continued support and partnership is a key factor for our new reformed Temporary Staffing Workforce Programme, where we are now able to work through some complex legacy Medical and Dental staffing issues.”