Workforce Intelligence
Temporary cover has a way of becoming permanent without anyone deciding.
Agency and overtime spend is approved shift by shift, reported monthly in total, and reviewed annually. Between those three cadences a unit can move from occasional cover to structural dependency without a single decision being made.
Works from rostering and payroll extracts your organization already produces.
The problem
Nobody chose to run that ward on agency. It happened one shift at a time.
Premium pay decisions are made under pressure, individually, by people doing the right thing in the moment. A shift is short, cover is authorised, the ward is safe. Repeat that a few hundred times and an organization has a structural staffing dependency that nobody designed and no single person can see.
The reporting does not help. Premium spend is aggregated to a monthly total and a variance against budget, which is the format most likely to conceal concentration. A number that is 12% over budget could be spread evenly or could be three wards on two shift patterns — and only one of those is fixable.
Turnover has the same shape. It is reported as an annual rate, which is far too slow. By the time an annual figure shows a problem on a unit, the people who could have told you why have left, and replacing them costs multiples of what retaining them would have.
- Premium pay is reported as a monthly total and a budget variance, with no concentration analysis
- Nobody can say which wards and shift patterns account for most of the spend
- Turnover is an annual number, which is far slower than the decisions it should inform
- Vacancy, sickness and premium spend are tracked separately and analysed together only in a crisis
- Temporary cover on some units has been continuous for months and is treated as normal
- Establishment reviews happen annually and are outdated within a quarter
Capabilities
What Vizier surfaces in workforce data
Vizier evaluates staffing patterns continuously and raises where cost and risk are concentrating — while the pattern is still a pattern rather than an established cost base.
Premium pay concentration
Which units, staff groups and shift patterns account for agency and overtime spend, rather than a total and a variance.
Temporary becoming structural
Where cover has been continuous long enough to be a dependency rather than a response, which is usually the point substantive recruitment becomes the cheaper option.
Turnover signal, earlier
Where leaving is accelerating on a specific unit or staff group, surfaced against the unit's own history rather than an annual organizational rate.
Vacancy and cover interaction
How vacancy, sickness and premium cover move together, which is where the actual cost driver usually lives.
Skill mix drift
Where the mix delivered has moved away from the mix planned, and what that has cost.
Quantified exposure
What a staffing pattern is costing annualized, so a recruitment business case can be argued with a number rather than an anecdote.
What a finding looks like
The organizational agency figure had been over budget for two quarters, and the response had been an organization-wide control on authorisation — which slows everything down and fixes nothing.
The actual problem is two wards, one shift pattern, and twenty-two continuous weeks. That is a recruitment business case with a number attached, not a spending control.
Two wards on one shift pattern account for over half of agency spend.
- Two of nineteen wards account for 54% of registered nursing agency spend.
- Both concentrate on night shifts; day-shift cover on the same wards is close to establishment.
- Night cover on these wards has been continuous for 22 consecutive weeks.
- Substantive vacancy on the two wards has been stable, so this is a filled-by-agency pattern rather than a growing gap.
Compare the annualized premium cost of the two night rosters against the cost of substantive recruitment to the same establishment.
The reporting gap
Why workforce reporting finds this late
Workforce data is generally well captured. The difficulty is that the reporting cadence and the aggregation level are both wrong for the decisions they are meant to support.
- Monthly totals and budget variance conceal concentration by design.
- Annual turnover rates are far slower than the retention decisions they should inform.
- Rostering, payroll and HR data sit in separate systems and separate reports.
- Shift-level authorisation means no single decision ever looks significant.
- Establishment reviews are periodic, so drift between them is invisible.
What this replaces
This replaces the annual establishment review, and the spending control that follows it
The usual organizational response to premium pay pressure is a control: tighter authorisation, a spending freeze, an escalation threshold. Controls are blunt because they are applied everywhere, and they impose cost on the 85% of the organization that was not the problem.
The alternative — finding where the spend actually concentrates and fixing that — requires cutting rostering and payroll data by unit, staff group, shift pattern and duration, repeatedly. That is analyst work nobody has capacity for, which is why the control gets chosen instead.
Vizier does that analysis continuously, so the response can be targeted at the two wards rather than the nineteen.
- Blanket premium-pay controls applied across units that were never the problem
- Annual establishment reviews that are stale within a quarter
- Analyst work joining rostering, payroll and HR extracts to answer one question
- Recruitment business cases argued from anecdote because the numbers took too long to assemble
- Discovering a retention problem from an annual turnover figure
Who this is for
One staffing pattern. Three teams who each see part of it.
COO / Operations
Where is staffing cost concentrating, and is it a gap or a habit?
- Throughput and patient flow constraints identified by location and service line
- Performance variability between sites made visible rather than averaged away
- Operational deterioration flagged while it is still a trend, not a crisis
CFO / Finance
What is premium cover costing annualized, and would recruitment be cheaper?
- Revenue leakage surfaced with the exposure quantified
- Reimbursement and payer performance movement, early
- Financial impact ranked so the biggest number gets attention first
Analytics / Data
How do we join rostering, payroll and HR without rebuilding it every time?
- Consistent definitions so two leaders asking the same question get the same answer
- Self-service investigation that does not generate another ticket queue
- Governance, access control and audit logging that survive review
Getting your data in
Start from rostering and payroll extracts.
Workforce data is usually already extracted for payroll and reporting, which means the starting point exists before any integration work.
- A rostering or temporary staffing export covering shifts, units and staff groups.
- Payroll data for premium and overtime cost.
- HR extracts for establishment, vacancy and leaver data where available.
01
Upload
CSV, Excel, or an export you already produce. Drop it in and Vizier reads it. This is where most organizations start, and it is enough to see real findings against your own numbers.
02
Scheduled
A recurring feed over secure transfer, on whatever cadence your team already runs. No one re-uploads anything by hand, and nothing about your source systems has to change.
03
Connected
Direct read-only connectivity to your EHR or source systems via FHIR R4, HL7 v2, or vendor APIs. Vizier reads; it never writes back.
Connect your EHR when you’re ready. See supported systems.
Security and governance
The page your CIO will ask for
Security questions get answered before a demo, not after procurement stalls.
HIPAA compliant
PHI handled under HIPAA Security Rule safeguards.
BAA included
Executed within one business day, on every plan.
Encrypted throughout
AES-256 at rest, TLS 1.3 in transit.
Read-only access
Vizier reads from source systems. It never writes back.
Role-based access control
Scoped permissions with SSO available.
Audit logging
Every query logged with account, timestamp and result size.
Tenant isolation
Your data is segregated from every other customer's.
SOC 2 Type II audit underway
Not yet certified. Report available under NDA on completion.
FAQ
Questions buyers ask
Does this need individual staff data?
For cost and pattern analysis, no — unit, staff group, shift pattern and cost are sufficient, and that is where the large findings are. Turnover analysis at unit level works on aggregate leaver counts. Where a use case genuinely needs individual-level data, that gets scoped with your HR and information governance teams first, and we would generally rather start with a phase that avoids it.
Can it tell us why people are leaving?
It can tell you where leaving is accelerating, which units and staff groups it concentrates in, and what correlates with it in the operational data — premium cover intensity, shift patterns, vacancy duration. It cannot tell you what people would say in an exit interview, and any product claiming otherwise from rostering data is overreaching. The value is knowing where to ask.
We are in the NHS. Does this work with ESR?
Yes. ESR extracts plus rostering data cover the substantive picture, and bank and agency reporting covers temporary staffing. The framing on the NHS pages is built around the measures used there — agency spend against cap, bank fill rates, vacancy and turnover by staff group — rather than translated from US terminology.
How does this connect to patient outcomes?
Where the data supports it, staffing patterns can be examined alongside operational and quality measures on the same units — which is often where the strongest argument for substantive recruitment comes from. We would be careful about causal claims here; the honest position is that these things can be looked at together, and that looking at them together is more than most organizations currently do.
Will this tell us our required establishment?
No, and that is deliberate. Establishment setting involves professional judgement, acuity tools and regulatory expectations that are not ours to override. What Vizier does is show what is actually being delivered against what was planned, where the gap concentrates, and what it costs — which is the evidence base for that decision rather than a substitute for it.
Related reading
See where your premium pay actually concentrates.
Bring six months of rostering data. Thirty minutes, and you will know whether you have a gap or a habit.
Start with the data you already have. Connect your EHR when you’re ready.