As the NHS gets to grips with the digital revolution, e-rostering proves an effective agent

Liz Lees

E-rostering can bring about significant savings, effective resourcing and better care for patients. Liz Lees, former director of nursing at East and North Hertfordshire NHS Trust, explains how.

The increasingly complex demand being placed on the NHS calls for workforce deployment innovation to improve care and productivity.

From my time at East and North Hertfordshire NHS Trust, this is something I have personal experience of tackling, and I recently shared this with a healthcare workforce expert group I am a member of, known as the Workforce Deployment Expert Group.

The group, as the name suggests, brought together workforce experts from academia, the NHS and Allocate Software to discuss the impact of e-rostering technology on workforce deployment and planning across the NHS.

The conversations naturally focused on the key workforce issues the NHS is currently facing: staff retention, patient care and cost efficiency.

Our discussions and collective knowledge have been used to inform and shape the production of the latest workforce optimisation technology report, Realising the paperless revolution: how rostering in the NHS went digital.

One of the key findings from is that workforce optimisation technology supports effective staff deployment. Through the use of risk-based profiling alongside patient demand, staff can deliver better targeted care.

As such, it was only right that East and North Hertfordshire Trust was an exemplar within the report as a source of encouragement and challenge to other trusts. For example, the trust’s use of e-rostering software to establish an enhanced nursing care team – to prioritise the care of patients and ensure the right staffing mix is available for its patients – has seen it transform care for patients and reduce agency spend on enhanced care duties by more than half.

The most impressive thing about the team is that while there has been an increase in demand for enhanced care, it has reduced temporary staff spending and even decreased the cost of enhanced care. This has been done by flexibly deploying the team to meet the needs of the patients throughout the day to provide high-quality safe care to some of our most vulnerable patients.

In quarter one of 2016/17, our temporary staff spend was £225,322, but in quarter one of 2017/18 it was £83,463 – a reduction of £141,859 for the quarter.

My three main learnings from our use of e-rostering to focus on patients’ needs have been the tangible cost savings that came from the reduction in agency staff, an improved ability for the trust to plan its resourcing needs, and, most importantly, better clinical care and patient experience.

As well as the case studies, to make the report a helpful document for NHS trusts, we have developed key recommendations, which I hope workforce leaders take on board:

  1. Operational workforce and rostering process data should be shared within and across trusts, alongside clinical performance, activity and finance data. This should be centrally facilitated, through systems like the NHS improvement model hospital dashboard. This local use of national data will enable meaningful comparisons and drive improvement.
  2. Trust boards should assess themselves against the workforce optimisation opportunity map to determine any areas where they currently are not leveraging technology, but other trusts have successfully deployed.
  3. Human resources directors working closely with nursing and medical directors should continue to digitise key aspects of workforce planning.
  4. Trust boards should develop a robust roster policy that has clearly defined roles and responsibilities for managing rosters from board to frontline staff and will help ensure a dynamic, demand-based approach to rostering.
  5. Those responsible for the workforce need to embrace workforce optimisation, in the context of the Five Year Forward View, by having systems that are able to support working across health and social care, through sustainability and tra nsformation partnerships, integrated care systems and accountable care organisations. Thus, ensuring the workforce is more flexible to the needs of the population it serves, through better identification of who to deploy.

It has been great to see and share workforce innovation taking place across the NHS that is resulting in improved patient care and staff efficiency. I’m excited by what the future holds as we continue to realise further potential from workforce optimisation technology.

Liz Lees is former director of nursing of East and North Hertfordshire NHS Trust. Follow the trust on Twitter @enherts

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