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December 2017

Cheshire and Merseyside collaborative bank journey: Optimising workforce capacity

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Part 1: Overview

Part 2: Defining the aim

Part 3: Getting started

Part 4: Governance

Part 5: The collaborative bank, the lead employer model and streamlining

Part 6: Lessons learnt

Annex: Resources

Contents

NHS Improvement

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Part 1: Overview

Part 1: Overview of Cheshire and Merseyside collaborative bank

1. Scope

The Cheshire and Merseyside Collaborative Bank project spans 18

trusts across a 50 mile radius. There is a mixture of acute, mental

health and specialist trusts and at this stage there are no community

or ambulance trusts. It initially covers 6 trusts and all staff groups,

including nursing, medical, allied health professionals (AHPs),

administrative and scientific professionals. The bank will go live in Q4.

2. The model

Each trust has its own bank and will continue to directly employ its

own pool of bank workers but there is a cloud-based platform

enabling the individual banks and pools to connect as part of a

collaborative bank.

In practice this means that where an individual trust bank cannot fill a

bank shift, the shift will be pushed out electronically to staff on other

banks via an app. Any worker can then choose to accept the shift.

The worker will continue to be paid by the host trust with whom they

hold their contract. The host trust will then invoice the trust at which

their bank worker filled a shift via the collaborative bank.

The bank workers can either be substantive employees of the

constituent trusts or have a ‘bank contract’ solely (ie not work

substantively at any of the constituent trusts). This is an important

part of the strategy to encourage agency staff to return to bank work and provide staff with a compelling flexible working offer.

Cheshire and Merseyside Sustainability and Transformation Partnership

Collaborative bank

Agency

Individual internal banks

Direct engagement

Cheshire and Merseyside: four stages of filling a shift

NB Trusts may still use overtime where this is the

most financially and clinically appropriate option.

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Overview: next steps

Part 1: Overview

Extending across the region

The initial proof of concept pilot is sponsored by the HR directors from Cheshire and Merseyside Sustainability and

Transformation Partnership (STP) and covers a subsection of the trusts. There are now early conversations across

the North West region about potential region-wide collaboration in the future.

Alignment of rates

Three years ago, the STP tried to align bank pay rates (without collaborative provision) but this broke down when

trusts proved reluctant to share pay rates. This project has therefore changed approach and focused on setting up a

collaborative approach to bank provision in phase 1 before considering rates in phase 2. It was felt that leaving rates

to phase 2 would help build trust and collaborative working (including data-sharing protocols) before considering

sensitive issues around pay rates. The pay alignment phase of the project will kick off in early 2018 involving directors

of finance, HR directors, medical directors and directors of nursing at a regional level.

Advancing the interoperability of systems

Not all trusts are on the same IT systems so the project needed to allow for a variety of systems within individual

trusts. The project therefore took a multi system ‘no one size fits all’ approach by using a cloud software system (in

this case Allocate during the proof of concept) to connect different systems and different trusts. Cheshire and

Merseyside is working with a variety of systems to explore opportunities for integration and interoperability across the

patch. The pilot has been governed by agreements to ensure procurement and competition rules are not breached.

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Part 2: Defining the aim

The vision

“Applying streamlining principles to create a collaborative bank of high quality staff who can be utilised across the region to maximum capacity and so ensure safe effective care for patients and reduced agency spend.”

Part 2: Defining the aim

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Optimising workforce capacity

Part 2: Defining the aim

Systems/process •Streamlining

•Rostering systems benefits realisation

•Bank systems benefits realisation

•Workforce planning

•Safe care

•Lead employer model

•Data sharing

•Business intelligence

Cost/productivity •Reduction in overall pay bill

•Reduction in agency spend

•Waiting list initiatives (reduce extra duty payments for medical staff)

•Increased shift fill rate

•Occupational health efficiency

•Disclosure and Barring Service checks

•Mandatory and statutory training

•Employment checks

Quality •Improved retention

•Improved safety – staff working extra duty shifts in their own trusts

•Patient experience

•Improved staff survey

•Team unity

•Agreed competencies

•Improved capability

Employee experience •Workforce satisfaction

•Retention

•Morale

•Reduction in burnout

•Improved team working

•Sickness absence

•Health and wellbeing

Optimising workforce capacity

Cheshire and Merseyside STP has established a collaborative bank as part of a broad strategy to optimise

workforce capacity across the footprint. They identified four key dimensions and objectives to this work.

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Collaborative bank: end-to-end process

Part 2: Defining the aim

E-rostering

Vacancy

release

E-booking and

e-timesheets

Payroll and

invoicing

Enhanced

reporting Bank growth

Seamless

technology Cost control

Informed decisions

and insights

Fully integrated rostering solution with ESR and other

critical systems interfaces

Integrated home bank, collaborative bank and direct

engagement staffing solutions

Benefits realisation mapped via real-time reporting

Standardised rates of pay with integrated payment processes

Integrated multi-platform ‘app’-enabled booking and

deployment systems to allow sharing of staff across trusts

App-enabled

technology to

support

attraction to

grow NHS local

banks

To realise the opportunities of the streamlining and collaborative bank programmes, Cheshire and Merseyside has

prioritised making sure the IT systems architecture which underpin them is interoperable (ie the systems can connect to

one another electronically) across the ‘end-to-end’ process, from rostering and the electronic staff record (ESR) to shift

booking and payroll. The diagram below illustrates the different components and opportunities.

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Part 3: Getting started Scoping the project

Part 3: Getting started

When setting out to optimise workforce capacity across Cheshire and Merseyside, the

project began by exploring the challenges and opportunities ahead and how in

practice a collaborative bank could be best implemented. This approach is

summarised in the questions below.

1. What is working well and we can do more of?

2. What is inefficient or against the principles of

streamlining?

3. What could we stop doing?

4. What opportunities have we not yet explored?

5. Where/who can we learn from?

6. What is preventing us from progressing?

7. Who are the key stakeholders?

8. How can we remove any blocks?

9. Who can help?

10. How do we get started?

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Checklist for getting started

Part 3: Getting started

1 STP HR directors and directors of finance sign up to the project

2 Resource allocation

3 Agree terms of reference (ToR)/memorandum of understanding (MoU)/project governance

4 Diagnostic: current state assessment and analysis

5 Options appraisal: identify opportunities

6 Review and refine ToR/MoU/project governance / escalation points

7 Kickstart pilots/proof of concept

8 Benefits realisation – What is the end game? What does success look like?

9 Do, learn, review

Ongoing

stakeholder

engagement

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Part 4: Governance Aligning the collaborative bank project with the North West Streamlining programme

Part 4: Governance

Cheshire and Merseyside’s collaborative bank project emerged from the North West regional streamlining programme

and its governance structure, so close alignment between the two projects was seen as key. The HR Deputy Director

and Director networks provided a forum through which both projects could be discussed and joined up. See Section 5 for

more details.

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Collaborative bank project governance structures

Part 4: Governance

| Local workforce advisory board (LWAB) | Regional streamlining programme

| HR directors network| Directors of finance | HR deputy directors network |

Collaborative bank steering group

IT systems, processes and information governance

Procurement Terms and conditions

‘Grow your own bank’

Finance and benefits realisation

Direct engagement

Optimising systems capabilities

Communications, marketing and stakeholder engagement

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Core membership

Steering group chair

Project manager

Strategic project lead

Deputy HR director lead

Temporary staffing lead

Medical staffing lead

Recruitment lead

Terms and conditions lead

Information governance lead

Finance lead

Procurement lead

HR systems

ESR lead, regional team

Extra members

Occupational health lead

Medical workforce lead

Nursing and midwifery workforce lead

Allied health professional workforce lead

Communications and marketing lead

Director of medical education lead

LWAB/Health Education England representative

Staff side representative

Potential system suppliers for proof of concept

trials/pilots

NHS Employers representative

Lead employer representative

Programme manager Streamlining

Representative of HTE framework

Education and training lead

Information technology lead

Project steering group

Part 4: Governance

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Part 5: The collaborative bank, the lead employer model and streamlining

Collaborative banks depend on effective alignment of systems and processes between trusts. A key challenge for many collaborative banks, for example, is managing the different training and skills requirements between trusts.

Cheshire and Merseyside addressed these barriers through the North West streamlining programme which involves collective planning and processes to make it easier for staff to move between roles in different NHS organisations. This allows organisations in a particular region, and across the country, to realise benefits including cost savings, recruitment efficiencies and improved staff experience.

The streamlining pilot in the North West is exploring ways of harmonising and passporting training requirements between trusts. This includes exploring the role of the revalidation officer for doctors on the bank and the governance which will need to surround it.

Also as part of the collaborative bank proof of concept, Cheshire and Merseyside are identifying the most common roles filled by the bank and agreeing common naming conventions that can be expanded to include any staff group as the system develops. The bank staff system also allows for competencies, knowledge, skills and experience to be defined when the shift request is sent out.

Part 5: The collaborative bank, the lead employer model and streamlining

Streamlining and the collaborative bank

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Enabler: lead employer model example

St Helens and Knowsley Teaching Hospitals NHS Trust’s lead employer model was implemented in November 2010. Before this there were six lead employer trusts; each responsible for different specialties. And before this each ‘rotational placement’ host was the employer.

Now there is one lead employer streamlined model for Cheshire and Merseyside. This has optimised the benefits realisation opportunities from ESR, Intrepid, BI oracle, Allocate and other technical solutions by automating transactional processes and avoiding duplication with a ‘one stop shop’ approach.

St Helens and Knowsley is also the GP lead employer for the West Midlands, East of England, East Midlands and provides HR advice telephone support for practice managers in Yorkshire and Humberside.

Part 5: The collaborative bank, the lead employer model and streamlining

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Efficiency

• No duplication of employment checks/costs

• No duplication of induction and mandatory training

and associated costs

• No duplication of occupational health checks

• Standardised bank worker contracts and rates of

pay

• Opt-in to collaborative bank from Foundation Year

1/2 recruitment stage onwards (one bank contract)

• No requirement for trusts to have their own locum

banks and the associated costs

Quality

• More robust information for Health Education

England on doctors in training European Working

Time Directive compliance

• Management information to support Annual

Review of Competence Progression process on

doctors working through aligned payroll

transactions

• Assurance through Guardian of safe working

• Robust governance arrangements

• Streamlined data sharing agreements aligned to

General Data Protection Regulations

• Supports retention and workforce satisfaction

How the lead employer model and streamlining support the development of collaborative banks

Part 5: The collaborative bank, the lead employer model and streamlining

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The lead employer model requires an integrated approach to IT systems

Part 5: The collaborative bank, the lead employer model and streamlining

E-expenses

Intrepid/

TIS

Trust

Website

Portal

OLM

ESR/Cohort

interface

BI Oracle

Reporting

E-SVLs

My ESS

ESRS Self

Service

(smart phone

access)

Payroll

e-payslips

TRAC

E-study

leave

E-DBS

Employee

relations

Case

management

Electronic

personal

Files

Exception

reporting

and work

schedules

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Streamlining in action: the lead employer model already acts a ‘workforce passport’

Under the lead employer model, trusts are already able to:

1. Download applicants from Intrepid/ESR pre-employment - √

2. Full use of automatic IAT pre-employment - √

3. Download of training profiles onto ESR - √

4. ID, GMC, Right to Work, etc, information into ESR - √

5. Occupational health information into ESR - (no) cohort √

6. Reference details into ESR - √

7. DBS details into ESR - √

8. E-DBS electronic system TRAC - √

9. In addition – ESR MSS for sickness and leave data - √

10. Mandatory training aligned and in OLM - √

Part 5: The collaborative bank, the lead employer model and streamlining

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Part 6: Lessons learnt

Part 6: Lessons learnt

Alignment to streamlining programme

Agreed STP approach to workforce

supply

Build on existing work

and being flexible to

extend scope as project

evolves and matures

One size may not fit all

Engagement and

commitment

Dedicated resource to

drive delivery

Technological investment

with integrated solutions

Early MOU and data sharing agreement

Benefits realisation

linked to Carter

Cross ‘corporate

function’ input required

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Annex: Resources

The following resources were created as part of the Cheshire and Merseyside Optimising Workforce Capacity project in collaboration with the North West Streamlining group.

They are designed to sit alongside this case study and help those just starting or who have already started similar work to establish a collaborative bank. While ‘one size may not fit all’, we hope sharing these lessons and approaches with others will be valuable.

Acknowledgements

With thanks to Claire Scrafton, Deputy Director of HR at St Helens and Knowsley Teaching Hospitals NHS Trust and Strategic Lead for the Cheshire and Merseyside collaborative bank, for producing this case study to be shared by NHS Improvement.

Annex: Resources

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Resources (1)

Annex: Resources

• Sets out overview including context, vision and aim, potential benefits realisation, total system overview, project structure and deliverables

1. Collaborative bank Introductory summary

• Includes aims and objectives for the workstream, project structure and meeting frequency

2. Terms of reference

• Agreement to formalise objectives of the project, principles for collaboration and roles and responsibilities

3. Memorandum of understanding

• Considers various aspects of the project to include operational management, reporting process, risk management, communication and stakeholder engagement and information governance

4. Project initiation document

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Resources (2)

Annex: Resources

• Supports the monitoring of project management risks and key deliverables

5. Project plan

• Provides oversight of interdependencies within project workstream

6. Interdependencies map

• Internal bank self-assessment form

7. ‘Grow your own bank’ status

• High level report to assess project risks and issues, as well as reporting key milestones

8. Summary and highlight report

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