Insight kindly provided by Karl Westgarth (pictured below), Head of Medical Staffing, Cornwall Partnership NHS Foundation Trust
Fulfilling temporary staffing needs while staying in budget is a challenge that most busy NHS Trust healthcare managers can relate to.
The solution, we have discovered at Cornwall Partnership NHS Foundation, is to maintain oversight and control of the flexible workforce. Here I explore the journey that we’ve been on to regain control of our staffing supply chain.
A unique NHS environment
Cornwall Partnership NHS Foundation Trust provides community, mental health and learning disability services across Cornwall and the Isles of Scilly, serving a population of approximately 570,000 people.
Operating in a unique environment, covering 1,376 square miles, the Trust has to flex its workforce to accommodate winter pressures but also summer pressures due to the influx of holidaymakers.
In 2022/23, the Trust had up to 5,000 employees and engaged 228,975 hours of agency resources across 20 different sites. However, for sourcing and managing agency staff, we relied on methods that we recognised were out of date and inefficient.
Reliance on outdated processes
When recruiting temporary medical staff, we depended on spreadsheets, long email chains and multiple documents. Vital information — including contracts, who was working where and when, and the associated costs — was spread across several files and emails with no central hub.
We typically engaged with just three or four recruitment agencies, using email as the main form of communication. Added to this, 100% of workers were non-direct engagements (agency sourced), adding 
VAT to day rates and driving up costs.
These processes made finding information quickly and accurate reporting difficult. As a result, our staffing team and the broader Trust had limited visibility of its temporary medical workforce, with files and key information siloed across multiple email accounts and computers. This increased workload for the medical staffing team too.
In addition, sourcing talent was a challenge due to regular requests for specific roles based on the Trust’s existing workforce model. These roles were often difficult to fill due to high demand amidst a nationwide shortage of medical professionals.
Regaining control
After exploring various solutions, the Trust chose to use a workforce platform provider, Patchwork, and a consultancy, +Us, to help evolve their processes and approach to agency staffing.
Moving away from siloed spreadsheets enabled all temporary medical workforce job requirements to be accessed by the complete recruitment framework. This provided the Trust with access to a wider talent pool for each job, at more competitive day rates, via direct engagement.
Ongoing consultancy also helped to embed new ways of working in the Trust’s temporary staffing team, including diversifying the roles it was recruiting for, while still meeting its medical staffing needs.
Over just five months, this allowed the Trust to:
Along with the savings and efficiencies made, we were also able to dispel recruitment myths with our clinical colleagues and develop a more resilient workforce model to meet the ongoing needs of the busy Trust.
By taking a new approach to our flexible workforce sourcing and management, we’ve been able to embed new processes that have seen us secure significant savings while delivering the skills needed to run a busy Trust across multiple locations.
Matt Fryer, Managing Director of +Us and Brookson Group says “Karl and the team at Cornwall Partnership NHS Foundation Trust have demonstrated what is possible when resetting the agency staffing model with a focus on visibility and transparency.
“The long-term solution to the NHS staffing crisis is a plan to support current doctor and nurses working in the sector and encourage the next generation into the medical profession. In the meantime, by having more information and oversight, Trust managers can put a plan in place to regain control of agency staffing spend.”
