North Cumbria Integrated Care NHS Foundation Trust (NCIC) was nationally recognised in autumn 2024, for the development and operation of a workforce sharing initiative that saw its health care support workers (HCSWs) working across both the Trust and adult care homes within the locality. Sian Evans-Carpenter, workforce planning and projects lead at North Cumbria Integrated Care NHS Foundation Trust explains
The aim of the innovative pilot scheme was to solve several challenges within the health economy with a coordinated approach to deploying workforce and the judicious use of rostering technology.
These challenges:
- NCIC’s need to recruit a large number of substantive FTE HCSWs while simultaneously increasing its Bank workforce.
- Several local authorities in the region (since consolidated into one unitary authority – Cumberland Council) were struggling to recruit adult care home staff in many localities. This left the authority with a choice: either leave some funded care home beds ‘closed’ or rely on expensive agency workers to increase capacity.
- These two challenges impacted NCIC’s ability to safely discharge medically optimised patients from one of its acute hospitals. This, in turn, contributed to long delays for patients in A&E, alongside long waits to move patients to appropriate wards.
The catalyst and opportunity for change
In 2023 NCIC launched a recruitment drive to fill a large number of FTE vacancies among its health care support worker roles and increase its Bank workforce. Its ‘New to Care’ campaign was successful in not only filling 300 FTE vacancies over the course of three events, but also resulted in substantial increases in NCIC’s bank workforce of HCSWs.
Following the recruitment drive, the Trust decided to pilot a scheme which saw it share its HCSWs with the local authority to understand whether this would enable more care home beds to become available.
The method
While sharing staff across NHS settings was nothing new, there were key barriers when it came to NHS organisations and adult social care sharing staff. The innovative new working agreement meant the trust effectively became an employment business to facilitate the HCSWs working within council-commissioned care homes. Under the scheme, the HCSWs remain NCIC employees and continue to be paid by the Trust for the shifts they work on behalf of the care homes.
The Trust now cross charges Cumberland Council, plus a minimal uplift on the monthly total, to cover the extra work costs that this work stream generates
At the outset of the project the council did not have the resources to operate a contact centre for booking shifts, so the trust’s e-rostering team built a virtual ward for each care home and trained council managers on how to use the trust’s RLDatix Optima rostering system to advertise their shifts. This combination of innovative thinking and the strategic use of technology has brought a significant number of benefits.
The results
The initiative has helped to boost both adult care home bed capacity, provided better value for money, improved patient flow through the trust and enabled more efficient discharge of medically optimised patients from one of the trust’s acute hospitals.
So far five care homes have joined the programme to make use of NCIC’s HCSW bank since May 2023. Each institution has either reduced or completely eliminated its use of agency HCSW staff. This essential service has contributed to the success of the intermediate care service which has saved over 5,000 hospital bed days.
Between January 2024 and September 2024, NCIC’s bank staff picked up 2,630 hours of work in local care homes. The initiative has also opened the door to improved career development opportunities for the Trust’s existing healthcare assistants and HCSWs, with many taking on a second contract of employment with Cumberland Council as a direct result of the initiative.
Of those HCSWs recruited via the ‘New to Care’ campaign, 72% remain in employment at the trust, many of which have proceeded to gain permanent employment or nursing apprentices Meanwhile, all care homes that have opened additional care beds have been able to keep this additional bed capacity open and staffed.
Feedback from council managers, HCSWs, patients and residents has been extremely positive. The HCSWs themselves have reported the way in which they value the chance to widen their experience in other environments while also being able to access shifts at the trust.
Reflecting on the scope of the work carried out, NCIC e-Roster and e-Community lead, Emily Littleton, said: ‘The legalities of this piece of work were extremely complex and took 12 months to conclude. It’s worth noting that the Council was also undergoing a period of change itself at this time, by unifying from four smaller district councils.
‘However, the impact of the workforce sharing scheme has had on our staff and patients has been overwhelmingly positive. Staff are developing their skills, improving their understanding of their roles and the impact they have as they see the patients’ journey across the system.
‘Patients are also comforted as they now see a friendly face in the staff they see, thanks to the fact that they are often looked after by the same staff in the hospital.’
RLDatix managing director for UK and Irelan Arti Fiaz said: ‘The need for organisations to deploy their workforce most effectively during periods of resource constraint to maximise care outcomes has seen a range of innovative projects across the country. It has been an enormous privilege for us to be able to play a key role in providing the technological underpinning for NCIC’s forward-thinking workforce sharing initiative.’
