Wes Streeting’s letter instructing NHS providers to reduce agency overspending and move to bank staff is welcome, however it won’t pack a punch to fix the NHS.  Agency overspending, along with other major challenges such as bank staff reliance, staff burnout, inefficiencies, and winter pressures are all adverse effects of a fundamental issue within the NHS.

The NHS does not understand its workforce well enough to utilise it effectively.

During a session at HLTH, Sunday Times Health Editor, Shaun Lintern, referred to the NHS as a 77-year old ‘patient’ with complex multi-comorbidities.  In a similar way, SARD likens it to ‘patient’ with a gut health issue which is causing multiple symptoms, and they are trying to fix it with layers and layers of ‘sticking plasters’.  However, as their doctor will highlight, the root cause needs to be addressed, otherwise symptoms like agency and bank staff over reliance will endure.

The symptoms of an unhealthy NHS that the government is prioritising – overspending and productivity – are largely all down to the fundamental issue of limited workforce understanding and planning. But how do healthcare providers begin to tackle this persistent challenge?

Dynamic two-phased approach 
Driving meaningful change, must happen in two stages.  Firstly, by making workforce planning more accountable with increased engagement, support and collaboration to nurture shared ownership and fully understand capacity.

Workforce planning then needs to transcend accountability.  Effective workforce planning can only take a trust part of the way towards solving overspending and productivity issues. The key to solving the NHS’s core health and ridding it of the burdensome ‘sticking plasters’ once and for all is closing the gap between workforce planning and operational management.

Only by really understanding the level of demand on a service, and the capacity that is available to meet that demand in a forensic data-led way, will providers be able to plan properly and get to grips with the patient flow.

Transformation from the inside out
A shift to operational workforce planning has the potential to release widespread benefits and transform the system from the inside out.   Crucially, it will promote ethical planning across whole organisations which addresses moral injury, safe staffing and manageable workloads to ensure clinicians can provide safe, fast and effective patient care.

This planning approach ensures wellbeing and mental health are prioritised in workforce strategies which will reduce instances of staff sickness and the slow and extremely unfortunate path to burnout.  In turn, staff retention will increase and help to drive down agency and bank staff reliance, along with recruitment spending.

Accurate planning and forecasts will prevent overstaffing during less busy periods and understaffing during peaks, which will increase efficiency and productivity and, most importantly, contribute to reducing the waiting list backlog. Cost savings would organically occur because there would be less need to defer patients to costly private providers to deliver elective care sooner.

Effective allocation of resources, reduced sickness and less vacant roles will have a cumulative impact on the need for agency and bank staff and help to reduce major issues with associated overspending. As the agency opportunities begin to reduce there will be less incentive to do sporadic agency work and instead health professionals will opt for job security and clear work patterns in a supportive working environment.   In time, effective operational workforce planning will extend to gradually build a substantial NHS workforce capable of leading the charge to recovery.

Recovery and reform are possible with the right prioritisation
Currently, the NHS is in a vicious cycle of solving damaging effects caused by overlooking workforce planning.  Effective workforce planning is no longer an annual, administrative task or simply filling gaps.  It’s time to reimagine it as a dynamic, operational tool to create a system where every staff member is supported, every patient receives excellent care, and every organisation operates at its best with minimal reliance on agency and bank staff.  It’s possible for the NHS to recover and lay the groundwork for a more sustainable future.  It just needs to refocus on the right cause of ill-health to succeed.

Disclaimer: This information is provided for general guidance only. It may not reflect the most up-to-date NHS policies or local Trust practices. Always refer to current NHS guidance and your organisation’s policies for definitive information.