As the upcoming end-of-year and winter cost pressures bite across the system, we’re seeing lots of focus on system efficiencies, with reduction of agency and high-cost agency spend being a real area of priority. So as a system, how do integrated care systems (ICSs) best work together to optimise this?
What role can integrated care boards (ICBs), provider collaboratives and ICSs play in supporting reduction of agency spend?
The focus on reduction of agency and high-cost agency spend is not new. Providers have already spent lots of time and energy over a number of years exploring this, but the drivers for temporary staffing needs that lead to high agency spend are complex and maintaining transformation in this space takes lots of energy and persistence.
So where is best to focus the start of a conversation on working across a system around this?
Firstly, have system partners agreed to the focus of collaborative work? What is the purpose of the collaboration? Is it:
- to optimise efficiencies by doing things once at scale across the system
- to share and learn good practices across the system
- to support in amplifying and delivering existing plans and actions within providers
- or to lean into new spaces for innovation where providers do not have the capacity or capability to venture?
Creating a clear and aligned vision that can be clearly communicated across all system partners is key for ensuring buy-in, which ultimately helps secure prioritisation, sufficient resources and achievement of the desired change. Without clear buy-in and support from the system partners, moving large transformational change like this forward will be difficult.
Alongside a clear vision and purpose, another key tool for ensuring effective buy-in is understanding the priorities, locally and collectively, and the business cases around them. This requires quite a lot of in-depth understanding coming up from a local level around what is already being undertaken and, in addition, the local drivers for temporary staffing use. This may include the reason for hotspots, cultural challenges in different wards or teams and local management, leadership and governance practices that are driving the needs. Often there will be organisational noise and narrative that may indicate where to look, but further deep dives are often required into local data and management practices to unpick what is driving need.
The final lens I always recommend, given the ongoing and repetitive cycle of high agency spend, is whatever plans you are building now, build them in a way that future-proofs for your long-term needs. This can be applied to all elements of the work – from taking a longer-term view of the vision and purpose to planning robust dashboards and data reporting that can provide continued support for the future rather than a point-in-time data capture. Organisations will always need a flexible workforce, so let's make sure to acknowledge that, and starting from now build our plans to help our future selves.
If you would like to know more about how we can support you to explore reducing agency spend and reducing high-cost agency spend, please
