Improving efficiency and the patient experience

With more patients to see than ever before, the ability to deploy staff as quickly and effectively as possible can make a large difference to patient waiting times. Here, Skills for Health look at effective e-rostering

From the reality of the digital patient to Jeremy Hunt’s aim of a paperless NHS by next year, the entire health sector is being strongly encouraged to shift to more digital working practices to save money and improve services. This cross-sector change in approach and practice was given further momentum by the Carter Review when it was published last February.

The review detailed that all trusts should have key digital information systems fully integrated by October 2018. Another of its key recommendations was the implementation of e-rostering, widely considered a solid means of ensuring staff are deployed in the most productive way. Effective e-rostering has a positive effect across organisations, helping to improve the experience for patients as well as staff.
Planning ahead breeds confidence
 E-rostering systems, such as Skills for Health’s Realtime Rostering, provide a cost-effective, accurate solution to the many staff scheduling challenges that organisations currently face. Organisations are able to plan ahead to make sure they have the right mix of skills and competencies that they need, where they need them. This reduces short-notice cancellations of appointments or procedures due to an absence of appropriately-skilled staff.

It can also help reduce dependency on costly last-minute agency staff to cover any skills gaps, as such unplanned absences can instead be covered from within the existing staff capacity.

Switching to an e-rostering system has in some cases helped organisations to reduce their reliance on agency provision. Current Realtime Rostering users report that roster planning now takes them 75 per cent less time since adopting the system, and that they have reduced locum spend by 10 per cent to 20 per cent.

Developed by healthcare industry experts, Realtime Rostering consolidates information around staff deployment, shift preferences, sick leave, holidays and other staff movements - all in one place. For managers, getting the roster right is more than important - it’s critical. Bryan Kessie, head of Technical Development at Skills for Health, says that managers have had their hands tied with a paper system which cannot cope with last minute changes.

He explains: “Systems within modern hospitals demand integrated work patterns between different staff groups. Hospital theatres or multidisciplinary clinics depend on a range of staff across different professions, different grades and different locations all coming together in one place at one time to provide patient care – this needs to be co-ordinated and able to cope with changes to staff, times and location.

“Integrated care across complex hospital systems can no longer be done on spreadsheets or stickers on a wallchart, where one [wrong] click can remove data, or staff leaning against a wallchart take away a key clinic.”

E-rostering solutions are better at giving ‘realtime’ data to staff, and can be integrated with existing hospital systems to make them easy to use and provide all the data at staff fingertips. Staff can access their rota information from anywhere, at any time, giving them the ability to request changes and have the changes agreed within one simple system. 

By ensuring adequate cover is secured well in advance, the technology also helps ensure staff morale and the overall demands of the Working Time Directive are maintained across all staff groups, even during busy times.

Benefits across the board
Being able to plan further ahead and make the best use of current staff has an even greater impact over the winter, at hospitals’ busiest time. When winter demand is at its highest, any gap in staff rotas can leave staff struggling to pick up the slack. Realtime Rostering allows organisations to plan rotas up to a year in advance, with the flexibility to make changes in real time to deal with unexpected absences or shift swaps. 

At a time when the need for efficiency savings to be made has been so widely emphasised, not only in hospitals across the NHS but for a wide range of organisations, e-rostering is also seen as an effective means of ensuring good people management practices are in place, and that staff are deployed in the most productive way.

There are decreased cancelled clinics and procedures, and there is improved communication. This gives patients and service providers the security that they can trust that any appointment will take place. Importantly, the monitoring of hours ensures staff are working within their limits providing better care.

Jessie continues: “There are also improvements for the organisation that staff are being used in the most efficient and safe way. Easier and faster production of compliant safe rotas by staff means more time can be devoted to patient care not administrative rostering tasks.”
Best practice
Nick Pitman, a consultant at Crosshouse Hospital in Kilmarnock, uses Realtime Rostering’s module created specifically for doctors, the Doctors’ Rostering System (DRS). Nick explains the impact of the DRS software on his job as rota lead, and how the time which he has saved on rota population, sickness and leave has been cut.

Rota population – the hours spent allocating juniors to teams and rotations, and allocating them to slots on the rota - is incredibly time-consuming, and Nick often had to work on rotas in his own time at home, especially when accommodating sickness requirements - finding cover for unplanned absences - and approving and recording of leave to be taken. Now, thanks to the DRS, he has been able to dramatically reduce the time spent drawing up, populating and shuffling massive Excel spreadsheets.

Nick says: “While the system has a number of advantages over the old, Excel-based, system, if we look at actual work reduction I see two key benefits. The main impact on my workload has been rota population, which has greatly reduced the amount of work I need to put in at changeover time.

“E-rostering has reduced errors and allowed better cross checking of cover between teams. It has also made it easier to react to last minute staffing changes and publish the rota in a timely manner. There is also a significant benefit from the dynamic updating of the rota in realtime and the ability to use the changes log to troubleshoot when needed.”

The software has also meant sickness time is more straightforward to cover, as it is easier to see where staff might be released from to cover gaps, and the handling of annual leave has been ‘revolutionised’.

Nick adds: “Requests are more easily submitted by the juniors, more easily checked for clashes on the rota, and more easily updated. This has had a massive impact on the time our rota admin team member has needed to spend administrating the rota. I understand that this has changed from being a full-time job for her to something that she can now manage part-time in parallel with working as a medical secretary in the Cardiology team.”

Workforce planning for staff and service delivery
Staff in healthcare organisations are a valuable resource that needs to be managed effectively and efficiently. Effective workforce planning relies on accurate data, in order to be able to plan appropriately to meet future demand. Realtime Rostering offers a rich source of staff data that can be used to improve workforce planning.

At an operational level, individuals responsible for creating staff rosters can pinpoint the information they need easily - and they can do it from anywhere, at any time. Realtime Rostering makes it easy to see who is supposed to be working where and when, and who is working currently. It can be integrated within whole spectrum of the organisation’s existing systems, including HR, finance, time and attendance systems.

For staff, improvements will be seen for those working in a stressful environment, by giving more clarity and transparency on what they and their team are doing, when and with who. Holistically, less stress among the staff will offer benefits throughout the organisation.

As well as improving staff experience, e-rostering has a knock-on effect on patients too. Being able to plan further ahead for the necessary skill mix, could reduce cancellations due to last-minute absences or lack of skills. Patients’ mental wellbeing is served by the certainty of an appointment and bringing the benefits of being treated by the right person, with the right skills, at the right time, leading to overall improved trust in the system.

Overall, Realtime Rostering offers organisations an integrated effective rostering solution that puts vital staff information at the heart of the organisation, increasing operational productivity, staff efficiency and improving patient care. It is hoped that the increased use of such digital working practices will streamline procedures and centralise data, creating a more efficient, forward-thinking NHS that is better equipped to deal with the demands of the future.

For more information about Realtime Rostering, and how it can support your organisation, visit

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