Effective sustainable answers to retention and recruitment challenges – The case for Open Collaborative Staff Bank

Male nurse pushing stretcher gurney bed in hospital corridor with doctors & senior female patient


The HIN works with a number of innovators which could potentially support the health and social care sector. Here we hear from one of the companies we have worked closely with. We would like to introduce Dr. Ahmed Shahrabani, doctor by trade and co-founder of Locum’s Nest – a holistic workforce solution connecting healthcare professionals to temporary work in healthcare organisations.

My Co-Founder, Dr Nicholas Andreou, and I worked together as first year doctors at St Helier Hospital in Sutton, South London, where we experienced first-hand the inefficiencies and problems that poor staffing created for us, our colleagues and, more importantly, our patients. We stood back from front-line medicine in 2016 and started Locum’s Nest, which has already saved the NHS £80 million by seamlessly filling vacant shifts, avoiding added admin and agency fees.

Our vision is to increase transparency, collaboration and improve care, through our intuitive mobile and web multi-product platform used by healthcare professionals and NHS management teams. Our mission was clear from the get-go: to remove barriers to workforce mobility across the NHS, which has led us to pioneer the formation of digital collaborative workforce banks across the country, enabling cross-covering of shifts across an ever-growing number of NHS Trusts.

With an existing significant workforce deficit, it is increasingly important in the context of the current pandemic to have the right workforce with the right skills in place to help deliver the best quality care to patients and maintain the service. As witnessed during the last six months, it is clear that technology has a vital role to play in this area.

However, owing to the way healthcare professionals are deployed – which can feel outdated and not aligned with levels of demand and patient needs – there are many factors which need to be addressed in order to help retain and recruit NHS staff.

Collaborative Staff Banks: Making the best use of our workforce with clever technology

We firmly believe in flexible and collaborative working and are continuously working on creative ways to support NHS organisations to work in a more transparent manner and increase engagement of their workforce.

After merging the Royal Surrey and Ashford & St Peter’s NHS FT contingent pool of workers in 2016, the two Trusts doubled their effective workforce of doctors overnight. The resulting workforce climate was exactly what we wanted to create, enabling absolute NHS workforce mobility and improving patient continuity of care.

This grassroot project, enabling clinicians to cross-cover vacant shifts is now known as The Digital Collaborative Bank (DCB) and has expanded to eight acute NHS Trusts, namely: Hampshire Hospitals NHS Foundation Trust, Salisbury NHS Foundation Trust, Dorset County Hospital NHS Foundation Trust, North Middlesex University Hospital NHS Trust, Gloucestershire Hospitals NHS Foundation Trust and Poole Hospital NHS Foundation Trust.

The DCB, spanning across 150 miles, now counts over 5,000 clinicians across all grades and specialties, covering thousands of shifts each month, positively contributing to continuity of patient care and saving millions on agency costs.

There’s never been a better time to end silo working and embrace collaboration

By working openly and collaboratively, the group’s fill rate (amount of vacant shifts covered by clinicians) was consistently 5-10 per cent higher than the average Trust working independently, reaching a record-breaking 91 per cent shift fill rate across all eight Trusts at the height of the pandemic.

Despite these positive results, the NHS as a whole has not yet agreed to operate cohesively as one employer. Instead, hospitals up and down the country unfortunately continue to compete and work in silos. Over the decades this has often proved counter-productive, with organisations blocking available clinicians from offering their services to other organisations by ring-fencing their contingent workforce.

After years of working with Trusts’ leaders, conducting academic research, plus collating data and testimonials from leaders in technology, workforce and clinical services within the NHS, we produced our Workforce Report exploring the consequences of ring-fencing our contingent workforce vs breaking down freedom-of-movement barriers. This report makes a strong ethical, financial and practical case for an open bank approach as a key strategy in tackling our health service’s workforce challenges across four key aspects:

  • staff morale;
  • patient care;
  • financials; and
  • governance.

To support healthcare organisations even further, the team has created an entire library of content with plenty of resources dedicated to the creation of collaborative staff bank.