The shifts that collapsed at six on Friday and stayed empty until Monday.
A locum desk was losing shifts not to a shortage of clinicians but to the chase between availability and booking. A support desk with out-of-hours cover closed the gap.
Sector: Healthcare staffing. Market: United Kingdom. Services used: Locum recruiting, Out-of-hours desk.
A locum desk was losing shifts not to a shortage of clinicians but to the chase between availability and booking. A support desk with out-of-hours cover closed the gap.
The situation
A UK locum desk was consistently failing to fill a share of its shifts, and had assumed the cause was clinician supply. Reviewing the pattern suggested otherwise: most unfilled shifts were ones that had been booked and then fell through, usually late on a Friday or over a weekend, at which point nothing happened until the following working day.
What we did
We took the support layer rather than the clinician relationships. Systematic availability chasing across the existing bank so the desk knew who was genuinely free rather than who had said so a fortnight earlier. Candidate identification in the grades, specialities and geographies that were consistently short. Compliance co-ordination alongside our compliance desk so registration and mandatory training did not lapse mid-booking. And evening, weekend and bank holiday cover for the rebooking work specifically.
What the research found
Four findings that changed the decision.
Unfilled shifts were mostly re-fill failures, not fill failures
The original booking usually succeeded. What failed was replacing it when it fell through outside working hours.
Availability data decayed within about two weeks
Clinician availability gathered more than a fortnight earlier was unreliable often enough to break bookings, which meant the desk was working from a stale picture most of the time.
Rural and out-of-area shifts needed identification, not chasing
For a minority of shifts the local bank genuinely could not cover it, and the answer was fresh candidate identification rather than more contact attempts.
Compliance and availability were failing independently
A clinician who was free and a clinician who was compliant were being tracked in different places, so a booking could clear one test and fail the other at the last moment.
The outcome
Fill rates improved once the Friday-evening and weekend rebooking work was actually being done at the time it arose rather than on Monday. Availability was refreshed on a cycle short enough to stay reliable. Compliance and availability were reconciled in one view. The agency's own consultants kept every clinician and client relationship — the desk sat behind them and was invisible to both.
The point of it
A fill-rate problem is frequently a timing problem wearing a supply-problem costume. The shifts were fillable; nobody was working at the hour they became unfilled.
A note on confidentiality. Clients are never named without written consent, and we do not publish project values, candidate records or commercially sensitive figures. These accounts describe real engagement patterns with identifying detail removed. Where a specific number is not stated here, it is not a number we have published — please do not infer one.
How this engagement was structured
The commercial and methodological shape of the project, for readers assessing whether a similar approach would suit their own situation.
| Service | Locum recruiting support |
|---|---|
| Scope | Sourcing, registration verification and availability qualification behind a clinical desk through a winter demand peak. |
| Commercial model | Fixed project fee in pounds, agreed against a written scope before work began. No commission and no percentage of salary. |
| Data ownership | Every record produced transferred to the client permanently at the close of the project. |
| Lawful basis | Legitimate interest under UK GDPR and the Data Protection Act 2018, documented for the project with an agreed retention period. |
Method
What we actually did
The decisions that determined whether this project produced something usable.
Registration checked at source
Every clinician verified against the relevant public register before reaching a consultant, with the check dated on the record.
Availability confirmed against the actual rota
Not general availability — the specific shift pattern, which is where bookings most often collapse.
Rate agreed in principle
Before the candidate reached the consultant, removing the most common late-stage failure point.
Compliance run in parallel
So a willing, qualified clinician was not blocked from starting by outstanding paperwork.
What this engagement demonstrates
Fill rate is a research problem before it is a sales problem. Adding consultants to a desk that cannot qualify candidates fast enough does not raise fill rate.
A note on how we present client work
Client identities and commercially sensitive details are withheld unless we hold explicit written permission to name them. Where figures are quoted they come from the engagement itself. Where an example is constructed to illustrate a method rather than describe a specific client, we label it as illustrative rather than presenting it as a case study. We would rather publish a less impressive page than an unverifiable one.
Questions we are asked about this work
Can we speak to a reference client?
In many cases yes, subject to the client’s agreement. Some engagements are confidential and will stay that way — which is itself a reasonable indication of how we would treat yours.
Would this approach work for our situation?
That is exactly what a scoping call establishes. Thirty minutes is usually enough to tell you whether the method transfers to your market and what the right scope and fee would be — including telling you if it does not transfer.
How much would a comparable project cost?
It is quoted as a fixed fee against a written scope, driven by market breadth, seniority and the depth of validation required. Because scope drives the fee, a meaningful figure needs a short conversation about what you actually need.
Recognise the problem?
Most of these engagements began with a client describing a symptom. Thirty minutes on a call is usually enough to work out what is actually causing it.