Without a thorough and centrally managed approach to temporary staffing, the Health Board was incurring unsustainable levels of agency spend. Individual departments were booking locums directly, via both on and off-framework agencies, with little knowledge or understanding of the costs.
The Health Board needed much firmer procedures and control, along with detailed management information reports to help them understand what they were spending and why across each department.
There was also a need to implement a Direct Engagement model to realise valuable additional VAT savings and efficiencies.