The background
Herefordshire & Worcestershire Health and Care NHS Trust (HWHCT) provide a broad range of services including mental health, community healthcare, and learning disability support across a diverse and geographically widespread region.
As a key NHS provider in the West Midlands, the Trust plays a vital role in supporting both urgent and long-term care needs for local populations.
Like many NHS organisations, HWHCT faced in increasing workforce pressures - particularly in managing medical locum staffing. The Trust was heavily reliant on agency-supplied doctors to fill rota gaps across multiple specialties. However, this reliance came with a growing set of challenges.
- Escalating Agency Spend: The lack of a unified approach to locum staffing led to uncontrolled costs. Many engagements were made off-framework or at unstandardised rates, with additional VAT inefficiencies further inflating expenditure.
- Variable Fill Rates: Departments experienced inconsistent staffing coverage, which created planning - especially within high-demand specialties.
- Compliance and Risk Management: Limited oversight of agency worker credentials and on-boarding created compliance risks and potential exposure to regulatory scrutiny.
- Fragmented Supply Chain Without a centralised system or agreed supplier framework, the process of managing agencies was administratively burdensome and offered minimal transparency or strategic control.
Recognising that the existing staffing model was unsuitable, HWHCT sought to implement a modernised, trust-wide solution that would increase visibility, enhance efficiency, and reduce costs - while safeguarding clinical service delivery.
To achieve this, the Trust partnered with Agile Workforce to transform its temporary staffing approach, aiming to move from reactive, high-cost agency use to a streamlined, compliance, and cost effective medical locum strategy.
The solution
Neutral Vend Model with Full Direct Engagement. Agile Workforce implemented a Trust-wide Neutral Vendor model aligned with NHS frameworks (HTE and West Midlands Cluster rate cards), supported by a full Direct Engagement strategy.
1. Stakeholder Engagement: Agile worked closely with clinical directors, finance, HR and procurement teams to ensure alignment and support.
2. Agency Onboarding: All incumbent and framework-approved agencies were onboarded under the new PSL to maintain supply continuity and encourage competition.
3. Education & Change Management: Internal teams and agencies received training on the new processes, benefits of Direct Engagement, and updated compliance workflows.
4. Monitoring & Governance: Agile delivered monthly governance reports tracking fill rates, cost savings, compliance, and time-to-fill metrics.
Results - first 6 months
- Direct Engagement uptake - 100% uptake across all agency-supplied medical locums.
- Cost savings - Delivered £190,000+ in total savings through the DE model.
- Average fill rate - Maintained a 100% average fill rate.
- Compliance monitoring - Fully embedded monthly compliance reporting in line with governance standards.
- Supplier coverage - All HTE and Cluster rate card agencies successfully onboarded and active.
- Flight Path to West Midlands Cluster Rates - Achieved 78.9% rate compliance by month 5. £97,565.63 monthly savings.