With the help of a training and staff appraisal system, Nottingham City Hospital trust has overhauled the way its staffing in theatre is arranged. Traditionally, the nurses would only work for the surgeons and the operating department practitioners for the anaesthetists. Each had different responsibilities and was on different rates of pay and conditions.
'It was just a nightmare, ' says Sue Hawkins, acting personnel officer. 'The clinical director said it had to stop. ' The hospital managed to negotiate a common rota for both sets of staff, a single pay spine and performance-related pay.
They also set out levels of competency expected at the new grades, with training available to meet the new requirements.
Staff were given appraisals and set personal development plans.