It comes back to what problem are you trying to fix? This was a specific tool for a specific problem.

Mel Murrell    Associate director of nursing workforce recovery

North Bristol NHS Trust agrees that ad-hoc agency usage does not present the best value for money and in some cases the best quality of care for patients. They sought to address two key issues:

  • A shortage of nurses on particular wards.
  • Ongoing and sustained use of a high number of agency shifts particularly off framework agency (OFA) nurses.

Ongoing challenges with bank fill and with the capacity from the contracted agency led to a cycle where the trust had to rely on high cost OFA nurses, particularly at tier 4, costing £1,000 per shift. This in turn meant that nurses were less likely to work through the contracted agency and even less likely to become bank workers.

Although a widespread issue, this was particularly acute in specialist services such as neonatal intensive care, emergency care and with registered mental health nurses.

To tackle this challenge, the team implemented a higher bank shift pay rate to compete with OFA rates, known locally as bank 'break glass' rate.


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