Savings programme 2024-25 – supplementary staffing integrated impact assessment

A reduction in agency and overtime use across Partnership services.

There has been no public involvement in the proposal.

1 March 2024

Name Job Title Date of IIA training
Jacqui Macrae Chief Nurse  
Hazel Stewart Programme Manager Feb 2020
Jane Brown Senior Care Home Manager  
Siobhan Murtagh HR representative  
Karen McErlean HR representative  
Robert Smith Disability services manager  
Billie Flynn Deputy Chief Nurse  
Evidence Available – detail source Comments: what does the evidence tell you with regard to different groups who may be affected and to the environmental impacts of your proposal
Data on populations in need All data for this proposal has been taken from CEC management accounting systems relating to service budgets and budget codes Most agency spend is within residential care services such as care homes for older people and people with a learning disability. Most overtime spend is within the homecare and reablement service. There is minimal use of agency within the NHS with most of the supplementary staffing spend being used on the staff bank.
Data on service uptake/access Staffing establishments and vacancies across services
Data on socio-economic disadvantage e.g. low income, low wealth, material deprivation, area deprivation. NRS: Projected population of Scotland (2020-based) Joint strategic needs assessment – Edinburgh
Data on equality outcomes Equality act 2010 – guidance

Fairer duty Scotland: Guidance for public bodies

Research/literature evidence n/a
Public/patient/client experience information n/a Anecdotally we know that service users prefer consistency so using agency staff can be disruptive to the service user and the services permanent staff
Evidence of inclusive engagement of people who use the service and involvement findings Not at this stage
Evidence of unmet need Vacancy lists across services and staffing establishments
Good practice guidelines Safe staffing programme

Health and care (Staffing) (Scotland) Act 2019

The Health and care (Staffing) (Scotland) Act 2019 will come into effect from 1 April 2024 and will support health and social care providers to staff safely and effectively.
Carbon emissions generated/reduced data
Environmental data
Risk from cumulative impacts
Other (please specify)
Additional evidence required
Equality, Health and Wellbeing and Human Rights  Affected populations

By reducing reliance on agency staff, better health and wellbeing in our permanent workforce through having a consistent and familiar workforce.

More consistency for service users due to less agency staff providing care.

Supporting staff’s health and wellbeing by encouraging reasonable adjustments to get people back and improving absence management processes.

Increased focus on good housekeeping for managers, giving more job awareness and satisfaction.

Greater awareness of budget management improving management skills.

Improved rostering skills within management teams, increasing knowledge and experience.

Greater opportunity work across service areas/roles to increase experience and skills by greater internal flow and movement.

NHS Lothian is moving towards zero agency, increasing opportunities for staff to join the staff bank and work in other areas, gaining extra experience and skills.

Better support for staff wellbeing by greater awareness and oversight to meet working time regulations (internally this can be better managed)

NHS staff cannot work for agencies within their own Board or connected Boards which lessens the appeal of agency working. 

All patients and service users of Partnership services

Service users with learning disabilities in residential care settings.

Patients in HBCCC

Patients of community district nurse teams.

Families of service users




If staff are unable to work for agency within their own location or connecting board could have a negative impact on their health and wellbeing or financial situation.

Potential negative impact on some agency staff through reduced use of agencies overall.

Potential impact on some roles through revised staffing models, could impact negatively on staff health and wellbeing.

Reduced flexibility in rotas and rosters has pushed people into working for agencies for flexible work options so by changing rotas and rosters to be more flexible, could impact on people with protected characteristics.

Some of the terminology used in job adverts and descriptions can put people off working for us particularly if they mention complex and challenging behaviour.

Internal redeployment opportunities can offer a range of experiences for staff (for example staff transferring from older people’s services to learning disabilities) but can destabilise the service they are transferring from. This could be mitigated by actively pursuing positive redeployment opportunities instead of staff redeploying in adverse circumstances.

If recruitment processes are not completed in a timely manner and services are unable to use supplementary staffing, it can put additional pressure on existing workforce.

If we can’t attract staff who work with us from agencies to transfer permanently this could have a negative impact on service users who have come to rely on them

Negative impact on permanent staff when working alongside agency workers who are earning more for doing the same role and can entice permanent staff to join agency for greater flexibility and pay.

The recruitment process is resource intensive for managers and may be contributing to the excessive use of supplementary staffing.

Environment and Sustainability including climate change emissions and impacts  Affected populations

If relying less on agency workers, we may reduce travel as people tend to be employed in or near their local area.

All patients and service users of Partnership services

Service users with learning disabilities in residential care settings.

Patients in HBCCC

Patients of community district nurse teams.

Families of service users




May increase travel across the city if staff are asked to cover shifts in buildings that are not their usual place of work

Economic Affected populations

Reducing the use of agency staff will be more cost effective for the Partnership.

Potential employment opportunities for staff through the creation of a centralised supplementary staffing function.

More effective use of existing workforce through better ratios, shift patterns and rotas.

Potential to offer greater flexibility in rosters and rotas supporting better recruitment and retention.

Additional specialist resources have been targeted at reducing supplementary staffing spend from experienced teams.

Greater oversight of recruitment and recruitment processes through newly created recruitment panels.

Targeted recruitment campaigns for hard to fill roles, raising awareness and allowing potential applicants the opportunity to speak to staff working in the service.

A reduced reliance on business support to process all agency forms and invoices so better economic viability for the organisation.

Reducing reliance on agency will reduce the number of agency staff on parity terms and conditions and will reduce the amount spent on retainer fees.

Although the CCP contract will end at the end of the month, CCP have agreed to inform us of when they are running recruitment events and will allow the Partnership to participate.

There is potential for Health and Social Care to join with NHS events to have a Partnership presence.

Look to revisit the volunteer network, previously this was used to give people experience of working in areas they may not have worked in before.

Sponsorship is fairly common in the NHS and works well widening the pool of potential new recruits. Although there is a cost to the organisation, it is fairly cost effective. This could be used wider across health and social care.

All patients and service users of Partnership services

Service users with learning disabilities in residential care settings.

Patients in HBCCC

Patients of community district nurse teams.

Families of service users




Agency providers could be negatively impacted economically through reduced use, and this could destabilise their organisation.

If services cannot use supplementary staffing options, they may need to reduce service provision or ultimately close beds/place based care support.

A reduction in services and the inability to staff services appropriately will impact on top line costs, ultimately making the service less financially viable.

There is a risk that by reducing supplementary staffing, the Partnership turns off one of the routes that attracts people into applying for employment in our services.

Agency workers that have worked for the Partnership in a temporary role have experienced the organisation and had exposure to roles they may not have experienced before, raising awareness. By reducing agency use, the Partnership may reduce the potential employee pool available.

Service areas recruit in isolation with no central oversight, a more collaborative approach to recruitment should be considered.

The unintended consequences of losing resources over previous years are being directly felt in relation to recruitment (withdrawal of centralised HR teams to support recruitment)

More sponsorship is being requested by there is a lack of awareness by managers to understand what this entails and what is required. Managers need to understand their responsibilities to staff who are sponsored including any costs to the organisation.

NHS recruitment processes are challenging and lengthy and can take a long time to get people into posts, further requiring supplementary staffing to bridge the gap.

Workforce panels now in place – good for oversight but adds time to recruitment process (KPIs in place for the time to complete end to end recruitment processes)

Due to the length of time taken in the recruitment process within the NHS, there is experience of new recruits moving on to other areas / departments before the initial recruitment process has completed.

More consideration should be given to attracting students into roles across the organisation.

Recruitment events have been ongoing but the contract is due to end with CCP at the end of March. No more recruitment events planned but a lessons learned will be conducted to assess the value of these events and identify areas of good practice to take forward as an organisation.



A communications plan will be developed along with an implementation plan if the proposal is approved. All communications to staff will be developed in collaboration with communications colleagues and would meet all accessibility requirements.

If yes, it is likely that a Strategic Environmental Assessment (SEA) will be required and the impacts identified in the IIA should be included in this.


If further evidence is required, please note how it will be gathered. If appropriate, mark this report as interim and submit updated final report once further evidence has been gathered.

Specific actions (as a result of the IIA which may include financial implications, mitigating actions and risks of cumulative impacts) Who will take them forward (name and job title Deadline for progressing Review date
To understand if an IIA report is required or if an IIA statement would be suffice. Hazel Stewart 5 March 2024 July 2024

The implementation plan will develop KPIs to monitor progress and to assess the impact the changes have on specific groups

Mike Massaro-Mallinson's signature

Name: Mike Massaro-Mallinson

Date: 8 March 2024