Reducing reliance on agency staff
In the 12 months prior to implementing the intervention, in April/May 2023 the trust used on average 282 agency off framework shifts per month. In the first three to six months of implementing the 'break glass rate' that had reduced to 47. In recent months this number has reduced further to three on average. This has resulted in savings of £3.9m.
During the pandemic there was a steady increase in the use of general agency staff culminating in 1,519 agency filled requests in June 2023. Due to the work of the team and their intervention, this has dropped to nine agency filled requests in April 2024, a 99.4% decrease.
Benefits for patients and staff
This project has delivered key benefits in terms of care quality and staff wellbeing. As a result of the introduction of 'break glass' shifts, trust nurses started to return to doing bank work in their own provider rather than travelling significant distances to other providers across the region. This benefits care quality directly because they are more familiar with patients' individual cases as well as other staff supporting their care. The introduction of the higher rate makes specialist nurses feel valued and compensated fairly for their skills and experience. There has been a reduction in vacancies and turnover, resulting in a more stable workforce and a reduction in the number of complaints about agency staff.
North Bristol NHS Trust has the highest NHS staff survey results in the Southwest region and one of the best in the NHS from a nursing and midwifery perspective. The following three indicators all show positive results in the high 90s:
- Do I think my job makes a difference?
- Do I like working with my team?
- Would I recommend care?