Value relationships and effectiveness – pilot study in health

Purpose - The research aim is to identify and evaluate “value” and “effectiveness” in the system of temporary staffing in one NHS Trust. Temporary staffing, known as Bank and Agency (B & A) staffing, is an increasing proportion of NHS expenditure (Bank staff are already contracted with the Trust and work extra shifts, while Agency staff are independently employed through the agency, costing more per shift). The system is reviewed in terms of quality, delivery and cost in relation to customers. The study assesses if unnecessary complexity, and poor standards significantly impact on effective performance. Design/methodology/approach - A diagnostic action research field based approach is taken with qualitative and quantitative analysis of the current system. This includes, cross‐functional mapping, stakeholder value analysis and historical data collection. The theoretical perspective includes system theory, stakeholder theory and value. Findings - Research results indicate that the requirement for temporary staffing is predictable (previously thought to be unpredictable). Consequently, agency staffing can more readily be replaced with bank nurses. This could improve the outcomes of quality in service, delivery and reduce Trust expenditure. Research limitations/implications - Research results could be idiosyncratic and contextual therefore a comparative study is underway to determine validity. Indications are NHS expenditure on temporary staffing, particularly agency nurses, could be reduced while increasing effectiveness of the service. Originality/value - This research analyses working practice and value relationships within the temporary staffing system. A potential future state system is developed, that indicates improved value, quality, delivery, a win for patients, wards and Welsh NHS secondary care Trust, having wider NHS applications.