Reducing agency usage by co-designing an agency conversion framework with London North West University Healthcare NHS Trust


Est. £250,000 saved on agency premiums for every 10 agency locums converted to the staff bank

500% staff bank growth in the first 6 months

Onboarding lead time reduced from 8 weeks to 1 week in 20 month period

£64,000+ saved per annum via Patchwork’s automated agency replacement tool

40% of shifts released 6 weeks in advance up from 0% in line with NHSI targets

81% average shift fill rate with over 1,300 shifts filled monthly over a 19 month period

The Challenge

Temporary staffing management had become an ever-increasing challenge at LNW; spend was high due to a overreliance on agency workers and escalated pay rates, vacancies were being released late due to the burden of manual intervention and admin, and staff turnover was high. To manage the process of transferring clinicians and shifts from agency to the Trust’s staff bank, LNW implemented Patchwork’s Agency-Bank Conversion service to streamline processes, achieve substantial financial savings, and maintain safe staffing levels.

The Solution

Patchwork’s Agency-Bank Conversion is comprised of two core concepts:

Agency Shift Replacement Tool
Converts agency shifts to bank shifts.

Agency Worker Conversion Service
Converts agency workers to the LNW Staff Bank

Agency Shift Replacement Tool

Using Patchwork’s Agency Shift Replacement Tool, LNW is able to automatically recall agency shifts when a bank worker overrides the booking, saving LNW over £64,000 per annum.

How does it work?

  1. LNW departments request a shift vacancy via Patchwork’s Employer Hub, which broadcasts to the staff bank workers who can instantly book the shift.
  2. If the vacancy is not filled by a bank worker, the shift can then be assigned to an agency worker.
  3. During the period from when the shift is assigned to an agency worker to when it is due to be worked, a bank worker can still apply to work the shift directly via the Patchwork app.
  4. If the department chooses to approve a bank worker’s application, the agency worker is automatically cancelled out of the shift and the relevant parties are notified via email.
  5. The bank worker can apply up until a certain cut-off point (which is completely configurable by department).
  6. If a bank worker does not apply for the shift before the cut-off point, then the shift is filled by the agency worker.

 Agency Worker Conversion Service

Patchwork provides LNW with a dedicated support service for the entire Agency Transfer process. Patchwork’s Customer Success team works directly with the Trust to ensure that all the clinicians who are transferring from agency to their staff bank experience a smooth onboarding.

An estimated £250,000 is saved on agency premiums for every 10 agency locums converted to the staff bank, onboarding lead time was reduced from 8 weeks to 1 in a 20 month period, and the staff bank grew by 500% in the first 6 months.

Step 1: Identifying agency workers

Patchwork works with LNW to identify agency workers to onboard to the staff bank, including workers who account for the highest agency expenditure.

Step 2: Contacting the worker

LNW then contacts the worker, explaining the process and benefits of joining Patchwork, and to obtain confirmation that the worker is happy to give notice to the agency and join the bank. To support this process, Patchwork provides LNW with useful collateral, including bespoke email templates to use when contacting agency workers.

Step 3: Informing the agency

The LNW staff bank team informs the agency via email that the agency worker intends to join the staff bank and they officially serve their notice.

Step 4: Worker downloads the Patchwork app

Within minutes workers are able to register to the LNW staff bank via the Patchwork App.

Step 5: LNW onboards the worker

The staff bank and/or recruitment team review the worker’s application on the Patchwork Hub and begin the bank onboarding process.



I’ve found Patchwork to be very effective, in particular their expertise, knowledge of the market and opportunities for savings and especially, customer responsiveness. The support they offer to implement Patchwork in Trusts is clearly fundamental in success and sets them apart from other companies. The product overall is excellent and has clear results – it’s very clear to link saving to the system. A massive added benefit is the access to information which really provides extra benefits above other systems

Andy Small North West London CCG Commissioner (former)

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