Outcomes modelling: risk, lives, locum spend
How Nexin models the headline numbers: 19% Total Clinical Risk reduction, ~£53.8m of avoidable NHS doctor locum spend, ~1,800 avoidable deaths per year: and how a deployed Outcomes Pack measures actuals at trust level.
Modelled, not measured: what the headline numbers mean
The headline numbers Nexin discusses publicly are modelled estimates based on the 232-doctor survey, the Innovation Focus appendix, and NHS England published locum spend data. They describe what could happen at scale. Actual outcomes are measured per trust by the Outcomes Pack against the baseline established in the first four weeks of deployment.
The three headline numbers
- ~19% reduction in Total Clinical Risk for a typical Directorate after Nexin Allocation, derived from the survey-modelled risk-by-staffing-state distribution and the post-optimisation distribution observed in proof-of-concept.
- ~£53.8m / year in avoidable NHS doctor locum spend if Nexin reduces locum bookings by 10%, against the NHS England published baseline of £539m / year (NHS Digital).
- ~1,800 avoidable deaths per year if Nexin reduces excess-mortality risk by ~20% against Hogan’s 2012 estimate of ~9,000 understaffing-attributable deaths per year.
The macro pull
- Streeting’s 30% short-term agency-spend reduction target (announced Nov 2024).
- The government’s longer-term ambition to eliminate agency use altogether by Parliament-end.
- ~£1bn already saved in 2024-25 against the £3bn 2023-24 baseline.
These targets are binding pressures on every Trust CFO. Nexin’s contribution is direct: fewer gaps, fewer locum shifts, fewer overruns.
How a deployment proves it
Every Nexin contract carries a written outcomes commitment. We:
- Establish a baseline in the first four weeks, Service Quality distribution, locum spend per Directorate, service cancellations.
- Generate a quarterly Outcomes Pack, pre/post Service Quality, locum spend baseline vs. realised, cancellations baseline vs. realised, clinical-staff satisfaction.
- Report against the contracted commitment. Where the commitment is missed, the Outcomes Pack proposes a remediation plan.
Last reviewed: 2026-05-06