One of the most prominent challenges the NHS faces is its workforce: under-staffing that increases pressure on already-stretched staff, which impacts on patient care.
It is estimated the NHS is spending £3 billion a year on temporary staffing – hundreds of millions of which is spent in locum agency commission.
Founded by two junior doctors believing in the imperative need to find a solution, Locum’s Nest is a digital platform enabling hospitals to access their own staff easily for extra shifts, dramatically reducing agency dependence.
Working on the frontline, they had valuable first-hand knowledge of the detriment to patient safety from staff shortages, and the ensuing fiscal and workforce inefficiency of traditional attempts at managing this. Using their passion for technology, faithfully informed by these clinical experiences, the app was created.
After piloting in November 2016, Locum’s Nest is now used today in a number of Trusts and GP Federations, with over 5000 registered doctors. Partner Trusts are rapidly seeing concrete benefits, with one recording savings of £1.3 million in its opening 10 months. Through a combination of cost savings and an augmented workforce, Locum’s Nest is on the trajectory to achieving significant accomplishments in healthcare.
NHS trusts are over-dependant on locum agencies who charge premium fees to provide doctors for hospital shortages. There are no guarantees of quality or fill-rates, and importantly, no accountability for these agencies to provide the service they promise. Combine this inconsistency in service provision with an already understaffed and overstretched workforce and this creates an unstable environment, ultimately impacting on the care patients receive.
The spurring factor for Locum’s Nest was the recognition of tangible points for improvement that were not being exploited. Namely, these were a disconnect between hospitals being able to contact, and so utilise, their own already-employed staff to fill these rota gaps internally, and the isolation of NHS Trusts from each other such that there was no possibility of linking geographically similar but administratively disparate workforces. Saving money, enabling employment from within, and uniting Trusts for a common staff bank is the solution Locum’s Nest provides.
“Effortless, easy and takes the stress out of filling vacant shifts”
ZW, Specialty Manager in Oncology
The solution was the creation of a digital workforce app which connects doctors and hospitals, cutting out the middleman (agencies) to enable hospitals and doctors to fill their own rota gaps at minimal cost compared to the past.
The product for doctors is a mobile-first platform – with the kind of intrinsic user insight gained from being developed by doctors for doctors – and is completely free to download. The product for hospitals provides a web platform for managers to advertise their vacant shifts, becoming instantly visible to thousands of doctors looking for shifts on the app through their phone. Additionally, it provides tools for hospitals to combine their workforces to have instant access to thousands of suitable doctors.
As such, the product drives forward the work and aims of the Sustainability and Transformation Partnerships in integrating models of care and collaborative working, to maintain and improve patient services.
Kent Surrey Sussex Academic Health Science Network (KSS AHSN) has offered invaluable advice to the Locum’s Nest team on how to gain traction within the NHS, helping them to frame the app’s relevance to STP priorities. Additionally, KSS AHSN secured Locum’s Nest a presence at the Surrey Heartlands Expo, where the product was exposed to more than 300 delegates from across health and social care. It has also connected Locums Nest with the wider AHSN Network, introducing the team to Digital and Information Leads.
“Time saving booking system with endless potential.”
HK, Medicine Rota Coordinator
- In its second year, Locum’s Nest is successfully in eight NHS trusts and GP federations across the UK, and is achieving significant cost savings already. Beyond the numbers, it is enhancing the morale of the staff who are integral to the NHS by providing them with integrated, fully-staffed shifts, and therefore better patient care and greater healthcare provider satisfaction.
- Of note, Locum’s Nest has launched the first virtual NHS Medical Collaborative Staff Bank, with over 1000 doctors available between two Trusts with no added administration. This success is projected to be replicable across any trust in any area, and as such, these achievements have been recognised in publicised case studies undertaken by NHS Employers, and most recently, Deloitte.
- 100% attendance rate of all doctors matched to shifts via the app – significant benefit to patient care and continuity of care.
- 100 hours saved each month within specialty departments. Assuming a £15 hourly rate, that equates to £1,500 per month saved in each department, of which there are typically around 20 in a foundation trust, totalling a £30,000 saving across the trust each month.
- 40 hours saved each month within the payroll department. Assuming a £15 hourly rate, that equates to £600 per month in payroll.
- £3 million net savings in temporary medical spend by Ashford & St Peter’s NHS Foundation Trust in their first 10 months of using Locum’s Nest
- Ashford & St Peter’s NHS Foundation Trust increased their internal fill-rate from 17% to 87% in their first year of using Locum’s Nest.
- Ashford & St Peter’s NHS Foundation Trust General Medicine department have stopped using agencies in any capacity.
- It took two months from concept to being functional when launching the NHS first digital medical collaborative staff bank between the Royal Surrey NHS Foundation Trust & Ashford & St Peter’s Foundation Trust.
- This product has successfully shifted into primary care with North West Surrey Integrated Care Services, a GP Federation of 41 practices, the latest to subscribe. They have already seen over 200 vacant sessions successfully occupied in their opening month, and fill-rates have boosted from 59% to 86% and climbing.
“We have freed up our days by no longer needing to constantly call, email and message doctors and agencies.”
ME, Specialty Manager in General Medicine
The initial target is to integrate into every trust, and for an encompassing collaboration between trusts and between primary and secondary care. The first collaborative bank has now grown to also include Hampshire Hospitals NHS Trust and Salisbury NHS Trust – a fifth trust is soon to join.
Short term, Locum’s Nest are already facilitating GP practices to work at scale as federations, bridging gaps into extended hours services, A&E provisions, and between regions.
Long term, Locum’s Nest plan diversifying into Allied Health Professionals as a significant sector with similar structuring needs and care impacts to doctors, where they are already proving themselves, always with the goal of generating improvement in the NHS workforce for translation into better patient care.
“It’s great to see that our previous doctors who would have never previously heard of the shift, now hear about it and apply!”
NH, HR Director