Recent media coverage highlights genuine concern from the BMA and other NHS representative bodies about the impact of threatened and actual cuts in NHS staffing levels.

Although the government has promised to guarantee NHS spending growth in real terms, there is no escaping the ongoing pressures to deliver more efficiency savings while meeting patient demand and quality outcomes.

This in turn is creating demand for new ways of working, new innovations and a sharper focus on the best ways to reduce costs and maximise efficiency across all operations. It is only by doing this that the quality of services, the delivery of the highest levels of patient care and jobs will be protected, but where does a trust start?

Healthcare e-rostering does improve workforce effectiveness

E-rostering in healthcare has been widely recognised, both internationally and within the health service as a way to help utilise staff in the most effective and efficient way.

However, this approach, which is supported by NHS Employers, has more typically been used for managing nursing staff where it is proven to deliver multiple savings and benefits on a trust-wide scale.

Within nursing, effective e-rostering systems have helped trusts replace paper-based systems and achieve a more efficient and accurate way of managing staff and their time. By stripping back the administrative processes and utilising substantive staff more effectively, trusts have been able to save on average 1.5% of nursing staff costs and up to 1.2 whole time equivalent per ward per annum, while ensuring that the highest possible levels of care are consistently delivered. 

However, e-rostering is less well developed among medical teams; even though the consequences of ineffective management of this group can have just as major an impact on operations.

Current processes are still largely manual and independently managed, meaning that there is little or no link between dependent rotas across other staff groups and a lack of real time operational information on the medical workforce at speciality level. Often resulting in ineffective decision-making regarding staff deployment, and insufficient information to proactively highlight issues and determine preventative actions before they have occurred.

Understanding the challenges of managing medical staff

Effectively and efficiently managing the time of medical staff is a highly complex process. With unique work-pattern drivers such as consultant schedules, interlinked rotas, work rotations and on-calls all contributing to the task. This coupled with increased and increasing complexity of medical workforce management due to initiatives, such as European Working Time Directive and New Deal, only complicates the process.

A new approach with medical e-rostering

It is clear then that effective workforce planning of this group is paramount to continuing to deliver high quality care in a cost effective manner; which makes for an even more compelling case for e-rostering. And what is apparent is that in order to successfully manage the complexities of the rotas and accommodate the exceptional working patterns and requirements of this group, an entirely new approach with a unique tool set is required.

Realising the benefits through e-rostering

An e-rostering system specifically for medical staff opens up enormous opportunities to more effectively manage the schedules of junior doctors, and the work patterns of consultants and locums, while operating within the required constraints. It also enables trusts to effectively manage and monitor sickness absence, minimise the use of agency staff through more effective utilisation of salaried staff, quickly adjust staff rotas when consultants’ schedules change, and keep accurate audit trails to maintain the highest levels of clinical governance.

In addition, e-rostering requires less time to administer than traditional paper-based systems and can lead to a saving of one-quarter of a medical staffing coordinator, per specialty, per year. In trusts where consultants are managing junior doctor rotas, e-rostering has led to the freeing up of at least half a programmed activity.

Allocate Software has been working with Trusts to implement its e-rostering solution,Healthroster, across multiple staffing groups. For medical staffing groups, the solution provides trusts with accurate data which enables them to help maintain optimal banding levels and monitor performance against initiatives such as New Deal and EWTD. The system’s “real time rules engine” manages this process by identifying in advance any potential rule breakages resulting from, for example, staff requests and proposed shift swaps.

By using Healthroster, interdependent rotas can be linked, and managers can proactively manage the rota, reallocating staff based on demand and priority. For the first time a Trust is able to have a single view of its entire workforce and how they interrelate, helping managers to allocate and deploy all required staff to deliver a collective capability, such as an operating theatre, and ensure that optimum levels of correctly skilled staff are available to deliver a service at all times.

This new, more efficient and simplified method of managing medical staff rotas can deliver real financial savings. In addition, increased visibility of the rota means that managers can make better decisions based on their staffing requirements and staff availability to ensure that patients’ needs are met in the best possible way.

Working with Barking, Havering and Redbridge University Hospitals Trust

Healthroster helped Barking, Havering and Redbridge University Hospitals Trust achieve its target of becoming compliant with the European Working Time Directive by August 2009 (protecting it from the significant financial breaching penalty). The requirement has been successfully managed ever since.

The technology has also increased the transparency of rotas, which has helped the Trust to monitor and track annual leave more effectively and ensure more equitable management of staff.

Gill Perry, deputy director of human resources, says that implementation of Healthroster is proving to be a great success, with benefits already being realised across the trust.

“As well as efficiency savings in producing and maintaining doctors’ rotas, there is now a level of visibility to the rota that wasn’t previously available,” she says. “This has enabled management to make objective staffing decisions, refocusing the delivery of services to meet patient needs.”