CCS Health Sector Resourcing (HSR) Webinar: 3 May 2018

1. CCS Health Sector Resourcing (HSR) Webinar: 3 May 2018

2. CCS Health Sector Resourcing (HSR) team Maggie Tonge – Senior Commercial Specialist (Director) Clemmie Smith – Senior Category Lead, Workforce Angela Donohue – Category Lead, Health Workforce CC CCS Lucy Upton – Commercial Agreement Lead, Health Workforce 2 2

3. HSR introductory supplier webinar: agenda Agenda Welcome and session objectives Where are we now? Proposed new model, scope and commercial strategy Your feedback and input • Overall thoughts • Have we missed anything • Top 3 make or break points we need to consider Next steps and timeline 3

4. Webinar objectives

5. Objectives for the session operations team Strategic category team • Provide suppliers with feedback on where we are now with the HSR strategy and progress to date • Discuss the current landscape, proposed new model and next steps from here • Offer an opportunity for suppliers to provide further feedback on the HSR strategy and proposed model 3

6. CCS Workforce What is Health Sector Resourcing (HSR)? Permanent recruitment (common roles) New Permanent Recruitment Framework Contingent workers: teachers New Supply Teachers Framework Contingent workers: central government New Public Sector Resourcing (PSR) Contingent workers health and permanent recruitment (specialist clinical roles) New Health Sector Resourcing (HSR) • New CCS agreement to replace the existing agency and bank staffing agreements which expire summer 2019 • Clinical and non clinical temporary staff and new resourcing approaches • Current CCS commercial agreements that will be replaced by HSR are: • RM3711 Multidisciplinary Temporary Healthcare Workers (expires 31/08/19) • RM1072 Workforce Management (expires 14/06/19) • RM971 Non Medical Non Clinical (expires 30/06/19) • A Prior Information Notice (PIN) has been published on TED: http://ted.europa.eu/udl?uri=TED:NOTICE:159661-2018:TEXT:EN:HTML&src=0 4

7. Current landscape

8. Current landscape for health resourcing: spend • The total paybill for the NHS in England is forecast at £51.2bn for 17/18, a 1.2% growth on 16/17 • Agency and bank staff spend represents £5.2bn or 10% of this 17/18 paybill. The trend for agency and bank spend is down, with a £110m reduction on 16/17 • There has been a significant shift in the last two years from agency to bank spend for NHS contingent resourcing: *Data source: NHS Improvement Quarterly Performance of the NHS Provider Sector: Q3 17/18 5

9. Current landscape for health resourcing: vacancies • There are 1.1 million whole time equivalent (WTE) staff in the NHS • NHS WTE vacancies are around 100,000 • 36,000 nursing vacancies, 65% filled by bank and 35% by agency • 9,500 medical vacancies, 35% filled by bank and 65% by agency *Data source: NHS Improvement Quarterly Performance of the NHS Provider Sector: Q3 17/18 6

10. Current landscape for health resourcing: CCS data • Total spend through CCS health workforce frameworks in 17/18 was £659m • 77% of this spend was with NHS customers • Total spend via CCS health workforce frameworks has been fairly static over last 3 years (£0.66bn to £0.70bn) • As with national picture, CCS frameworks have seen a shift in spend from agency towards bank CCS Health Workforce Framework spend 17/18 by sector Data source: CCS MISO data from framework suppliers 7

11. Current landscape: summary of factors *Data source: NHS Digital Factor Impact NHS vacancies increase to around 100,000. More nurses leaving NHS (16/17 33,530 leavers, outnumbering joiners by 3,000). Number of EU nurses coming to work in NHS dropped by 96%* High vacancies across nursing, medical, AHP and non clinical leads to increased reliance on bank and agency staff to plug gaps. Shortage of supply results in escalated rates for agency staff (especially medical and specialist nursing) NHS Improvement Agency Rules implemented 15/16, mandating ‘approved’ frameworks and establishing price caps Reduction in agency spend of £1.2bn, from £3.6bn 15/16 to £2.4bn 17/18. Price caps have significant impact in nursing, with medical slower to take hold Expansion of bank (in house and managed) within trusts and 17/18 NHS Improvement targets around medical and collaborative banks Migration of spend from agency to bank, with bank spend up from £2.4bn 15/16 to £2.8bn 17/18. Large numbers of trusts expanding existing nursing & medical banks, establishing new medical banks and working with neighbouring trusts on collaborative banks Increased availability and uptake of workforce technology, including e-rostering software and shift booking apps Trusts adopting new technology, including e-rostering and shift booking apps to improve optimisation of existing workers and increase access flexible workers. Technology also being used to support collaboration and sharing of flexible resources Initial movement from transactional to more strategic workforce models by some trusts. DHSC flexible working pilots 18/19 support trialling of new models Some trusts trialling/adopting more strategic resourcing models, including managed service for medical, workforce planning SOW approaches, combined bank and agency managed service and/or technology-enabled solutions 8

12. Health landscape change management 2019 onwards HSR enables health customers to move towards more strategic total talent approaches and innovative approaches trialed in DHSC pilots 2018 DHSC flexible working pilots trial new models 2017 NHSI record 700m in savings on agency staffing spend at £2.9bn Francis Inquiry Mid Staffordshire intro to safe staffing levels drives up agency staffing costs 2022 Market share gained, control of market rates 2023 Total resourcing solutions integrated 2013 2016 NHSI caps introduced to agency staffing market spend at £3.6bn 2019 CCS HSR framework launched, with integration of resourcing solutions and total talent approach Consolidation of spend through single supply route Transactional shift fill models dominant in the health market 9

13. The opportunity for HSR • Capturemore of £2.4bn total agency spend via approved frameworks, reduce ‘off framework’ spend, increase visibility and tackle escalated rates • Introduce effective permanent recruitment solution for clinical workers to help address high vacancies • Introduce routes to workforce consultancy, workforce planning and change management support for health customers • Provide access to new workforce technology and support the embedding of this in resourcing solutions • Continue to assist growth of bank solutions, including managed bank, medical bank and collaborative bank models • Alongside traditional models, offer new and more strategic models for managed service and tailored solutions • Facilitate improved access to resources for customers and high quality service with assurance for patient safety • Support outputs of Department of Health and Social Care and NHS Improvement flexible resourcing pilots by offering new resourcing solutions 10

14. The opportunity for HSR • Capturemore of £2.4bn total agency spend via approved frameworks, reduce ‘off framework’ spend, increase visibility and tackle escalated rates • Introduce effective permanent recruitment solution for clinical workers to help address high vacancies • Introduce routes to workforce consultancy, workforce planning and change management support for health customers • Provide access to new workforce technology and support the embedding of this in resourcing solutions • Continue to assist growth of bank solutions, including managed bank, medical bank and collaborative bank models • Alongside traditional models, offer new and more strategic models for managed service and tailored solutions • Facilitate improved access to resources for customers and high quality service with assurance for patient safety • Support outputs of Department of Health and Social Care and NHS Improvement flexible resourcing pilots by offering new resourcing solutions 10

15. Polling Question Polling Question 1 Over the next 5 years, where do you see the biggest proportion of health resourcing spend being concentrated: • Permanent recruitment • Transactional agency activity • Staff bank (in house or managed) • Managed service solutions • Statement of work (SOW) • A mix of the above • Other CC CCS 20

16. Polling Question Polling Question 2 How much change do you envisage to resourcing approaches in the health and associated sectors in the next 5 years, on a scale of 1 to 5, where 1 is very minimal and 5 is very significant: • 1: very minimal • 2 • 3 • 4 • 5: very significant CC CCS 21

17. Customer feedback

18. What customers tell us they want from HSR agreement Supply Access Pricing Model • Simple call off and NHSI approved and compliant route to market • Single agreement, with lots, for simplicity, easy access and joined-up solutions • Direct award and further competition call-off options • Clear framework guidance and sharing of best practice • Change management support for users • Clear and transparent rate cards/pricing • Clear and consistent position on ancillary fees, e.g. transfer and cancellation fees • Alignment with NHSI price caps for agency, but facility to override and stay ‘on framework’ • Innovative pricing models for SOW, managed service and tailored models (e.g. gainshare) • Choice of suppliers: PSL model or managed service with strong supply chain for access to workers • High quality supply and robust supplier assurance • Access to suppliers covering full breadth of clinical and non clinical specialisms • Suppliers with strong experience of delivering in their specialisms • Different models required for different role types and customers – ‘one size does not fit all’ • Access to more traditional PSL model alongside managed service options • Solutions incorporated for permanent recruitment (clinical roles), including international recruitment, and workforce planning • Integrated technology systems as part of resourcing solutions 11

19. Polling Question Polling Question 3 Does the feedback on stakeholder requirements broadly meet with your experience? • Yes • No CC CCS 12

20. HSR scope, model and lotting structure

21. Proposed scope of HSR • Focused on health customers: • NHS trusts, ambulance trusts, CCGs, CSUs, GP surgeries, etc • Central government organisations with clinical requirements, e.g. MOD and DWP • Local authorities and central government for social workers • Requirement scope: • Multiple role types, clinical and non clinical • Agency and bank resourcing • Permanent recruitment for clinical roles and consultancy/SOW for workforce planning and optimisation • Industry best practice models: managed service, hybrid bank and agency, technology-enabled and tailored solutions CC CCS 13

22. HSR proposed model 3 year framework, plus extension options of 1 year + 1 year Framework with UK-wide reach Single agreement with 6 lots for full suite of options from agency (clinical and non clinical) to permanent recruitment, bank and tailored managed services 14

23. HSR proposed lotting structure Strategic category team 15

24. Polling Question Polling Question 4 Do you believe health sector’s key resourcing requirements could be met by the proposed lot structure? • Yes • No CC CCS 16

25. Polling Question Polling Question 6 Which of the proposed lots could your organisation service? (select all that apply) • Lot 1: Permanent recruitment (clinical) • Lot 2: Contingent labour (clinical) • Lot 3: Contingent labour (non clinical) • Lot 4: Flexible/bank • Lot 5: Workforce strategy/SOW • Lot 6: Hybrid/tailored solutions CC CCS 18

26. Polling Question Polling Question 5 Would you be interested in tendering for the proposed opportunity? • Yes • No CC CCS 17

27. HSR Timelines

28. Draft HSR timeline 19

29. Questions and feedback Webinar questions and comments • Final comments: provide top 3 ‘make or break’ points for us to consider • Questions from webinar will be consolidated in FAQs that will be published on CCS website Further questions and comments after today • Please email CCS with any further comments or feedback: peoplepillarcomms@crowncommercial.gov.uk 14 • Complete an RFI to provide more detailed feedback to help inform the strategy: http://ccs-agreements.cabinetoffice.gov.uk/procurement-pipeline/health-sector-resourcing 14 22

30. Additional information Additional information on the HSR procurement, such as presentations, updates on timelines and the RFI for suppliers to complete, is available at: http://ccs-agreements.cabinetoffice.gov.uk/procurement-pipeline/health-sector-resourcing 14 A copy of this webinar presentation will be shared via the above webpage Thank you for joining today 23