The digital upstart targeting the NHS’s £6bn flexible staffing market

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Leaders: Altrix has proven that automation in the NHS works (GettyImages)

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App-based nursing agency Altrix saves money, streamlines patient care and grows nurses’ pay

Keeping National Health Service (NHS) wards and units properly staffed and able to deal with a growing, aging and increasingly sick population is a seemingly intractable problem.

More than a decade of austerity and the exodus of nurses due to retirement, burnout and Brexit means there are now around 43,000 full-time equivalent (FTE) vacancies, more than 10 per cent of the NHS’s 353,000 permanent nurses and midwives.

Trusts rely on a flexible workforce made up of agency and bank staff to fill the gaps. Some 230,000 – 60 per cent – of currently employed NHS nurses work extra shifts, providing 2.7m hours/week.

Even with this, we estimate there are 1.7m hours a week that need to be staffed, around half of which remain unfilled at the time of the shift. This has profound implications for patient care.

This has become very big business – the NHS spends £6bn a year on agency and bank workers, with around £1.2bn being spent on agency nurses. Of this £1.2bn, between £250m and £350m goes to agencies in fees every year. Locum agencies cost global healthcare providers $46bn a year.

The market is highly fragmented, with 1,400 nursing agencies in the UK, of which 450 are on the approved NHS frameworks, meaning they provide properly vetted staff at a lower cost. The balance comprises off-framework agencies with no guarantee of vetting quality.

The NHS has been using agency staff for the past 50 years.

Since flexible workers are usually needed on short notice, online advertising, social networks and job boards can fail to deliver results within the required timeframes. Most agencies maintain a database of available candidates and, when presented with a job requirement, the agency contacts several to find one who is both suitable and available. Costs remain high because one recruitment consultant can only plug one shift at a time.

Because traditional nursing agencies remain tied to this cumbersome and costly recruitment model, we now have a dichotomy within the industry: the NHS is trying to cut costs, and recruitment agencies have expensive overheads in people and compliance.

There is a massive opening for technology to improve efficiencies, keep costs down and improve the worker experience.

Altrix has four major goals:

• Automating flexible workforce recruitment and placement for the NHS

• Considerably reducing agency costs (we estimate potential savings of between £50m and £100m per annum for the NHS)

• Improving hourly rates for healthcare professionals

• Creating a marketplace with pricing transparency

As a digital-first start up, we have built an Uber-like system to meet these challenges, which has resulted in 98 per cent of our bookings being booked via our app, eliminating the need for a large team of recruitment consultants. Our team is primarily focused on maintaining compliance standards that safeguard patient care and on creating positive relationships with healthcare professionals to ensure that only fully qualified and vetted staff make it onto wards.

We aim to automate 90 per cent of compliance administration and 100 per cent of bookings for agency workers while improving workforce utilisation and quality. Once healthcare professionals are fully compliant and meet all the required standards, they can then self-book shifts via the app.

This puts the power back into the hands of the healthcare professional to choose when they want to work, and improves utilisation as we can send out, within the app, all the available shifts to choose from. We’ve cut out the part where a recruitment consultant has to confirm shifts.

Altrix is perfectly positioned to take advantage of the opportunities presented by increased use of technology within the NHS. We also have the option to expand into parallel and vertical industries that also require regulated staff.

Unlike traditional agencies, which remain people-intensive and very often have limited, or only local reach, we are scalable and can quickly expand to meet demand.

Five years from its launch, Altrix fills roughly a million hours from our existing customers a year. This leaves 8m more nursing and midwifery hours available from these customers alone which we are not filling but have access to. Across the NHS’s 219 NHS Trusts in England, three Trusts in Wales and seven health boards, we estimate there to be nearly 40m nursing and midwifery hours filled by agencies per year. The scope for growth is vast.

Altrix currently partners with around 60 NHS Trusts in England and Wales, and about 40 per cent of their communicated demand remains available to Altrix to fulfil at the time the shift starts. Fulfilment of this demand is constrained by how quickly Altrix can grow its workforce. We have nearly 1,600 fully compliant members available to work across England and Wales and we aim to have 7,600 members on our books by 2026, equal to the current market leaders. Some 26 per cent of our workers undertake at least three shifts per week.

Altrix has proved automation in the healthcare professionals space works. We have scaled, saved the NHS money and paid our staff fairly and quickly. This market is ripe for consolidation and further innovation, and we want to lead that process.

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If you are an NHS Trust looking for innovative providers of RMN, specialty and RGN nurses then please get in touch atjames@altrix.co.uk.