During my time as an NHS rostering lead, the task of staffing rotas safely and sustainably could feel like a continuous game of jenga. By carefully moving one piece, you could unwittingly destabilise the rest. Toppling the whole tower was rare, but you never felt more than a few moves away from it.
When it comes to workforce planning across the NHS, operational and clinical teams are tasked with managing fast-evolving service demand and an equally steep rise in staff shortages. NHS teams are working tirelessly to tackle these staffing gaps and meet care needs, while simultaneously trying to reduce spend on external agencies.
However, both my colleagues across the health service and I were working alongside a crucial ‘blindspot’. In many organisations, rostering systems are disconnected from service plans. This means that workforce teams often have to draw up rotas and deploy staff without oversight of each department’s service demand (the information which details the volume of specific activities that must be delivered on any given day).
Without this information, it’s difficult and time-consuming to reliably deploy the right number of qualified staff to deliver against these targets. The result? Rotas can easily become out of sync with actual staffing requirements, leaving activities such as clinics, theatres or wards at risk of overstaffing on certain days and understaffing on others, impacting patients and service users.
Not only does this ‘blindspot’ reduce the efficiency of service delivery and make it harder for clinical teams to tackle the growing care backlog, it piles more pressure on clinicians, damaging retention and worsening staff shortages. The good news? This isn’t an insurmountable problem to solve. And fixing it would unleash huge benefits for the whole system.
During my work in the NHS and since, particularly in my role supporting NHS organisations at Patchwork Health, I have become determined to help fix this dilemma and enable a more effective “service-based” approach to rostering. Below, I’ll explore the issue and why it’s so important to tackle it.
How updated systems could eliminate staffing blindspots
Workforce teams have to work with the tools they’re given. The outdated, inefficient rostering systems on which they frequently have to rely inhibit effective data sharing when it comes to service plans, making it extremely difficult for them to effectively access the insights they need.
In many healthcare settings, vital information around service plans remains stuck in siloes, making it virtually impossible for teams to effectively coordinate. Time-intensive, manual cross-referencing is required to pull this information together and organise rotas in line with service planning. This is time that pressured NHS workforce teams can ill afford to spend.
Unlocking a truly “service-based” approach to rostering
At its root, the answer to this challenge seems simple. By making service plans readily accessible at the point of rostering staff, we can provide rostering teams with the visibility they need to easily and efficiently deploy clinicians in line with demand.
Building digital workforce systems that can ‘talk’ to other platforms and safely share information can enable us to integrate multiple streams of information easily. This means that workforce teams can have instant, simultaneous access to these different sets of data within the same digital system, without having to manually switch between separate systems or copy and transfer information back and forth.
As a result, the information detailed in service plans can be easily lifted and used to directly inform rota planning. Staff schedules can be more reliably built to reflect the reality of the demand being faced by specific departments across any given week. As a result, each service can be consistently staffed with the right number of qualified clinicians to deliver the care that has been proposed, or anticipated.
Taking pressure off clinical colleagues
For clinicians, this means that fewer shifts are likely to end up understaffed, putting less pressure on their workloads and freeing up capacity for them to spend with patients. This can significantly impact staff retention. The most recent NHS Staff Survey revealed that only one-third of clinicians feel that there are enough staff at their organisation for them to be able to do their job effectively.
Meanwhile, by reducing the number of staffing gaps that workforce teams have to try and fill last-minute, unlocking service-based rostering can help to reduce overreliance on external agencies and lower workforce spend in accordance with targets set by NHS England.
Look closely, and the staffing blindspot leaving NHS services in a bind is clear to see. But crucially, we have the tools to resolve it. By developing better digital workforce systems that can assimilate information from service plans into rostering tools, we can hand workforce teams the visibility to successfully coordinate rotas with service demand – driving more sustainable workforce planning, reducing agency reliance, and boosting staff retention.
By Daniel Chilcott, Medical Rostering Specialist and Client Enablement Director at Patchwork Health
