Working for the NHS – England’s largest employer – can be hectic at the best of times. But allocating and organising shifts for thousands of employees in a stressful environment, while maintaining safe staffing levels and ensuring they provide the best patient care, is a monumental undertaking for any organisation.
For North Tees and Hartlepool NHS Foundation Trust, this colossal task was further compounded by its archaic workforce planning processes, which were used on a case-by-case basis to manually deploy staff to any ward or area that needed them, often with no regard for their individual experience or specialism.
Jamie Waters, the trust’s e-rostering manager, says this tactic resulted in staff feeling unhappy working in unfamiliar specialities and culminated in sharp drops in retention. “Some staff felt a sense of injustice if they were sent to a new ward multiple times,” Waters says. “They thought it was personal, and it meant they felt no sense of stability, which was breeding an unhealthy culture.”
He adds that ward managers were also facing a backlash – they not only faced the challenge of finding enough staff to cater for increasingly complex patient needs, but also the stress caused by staff being constantly moved around meant sickness and absence rates were skyrocketing.
In early 2016, Waters and his team were tasked with overhauling the trust’s workforce planning approach to make sure it was responsive to the staffing needs of different areas of the hospitals, while still making the most of each worker’s specialist experience. As part of this, new specialist software from rostering system provider Allocate was put in place, meaning managers could see in real time which wards were in need of additional staff and could get an overall picture of trust-wide workforce requirements as they happened, rather than isolated areas.
Following a 12-week training and implementation process later in 2016, Waters said the revamped approach has helped the trust transform from a “siloed” culture, where ward managers were protective over the few staff they had on shift, to an open and sharing one where employees feel comfortable being deployed to different areas of the hospital and feel their skills are being utilised effectively.
As well as making better use of available staff, the trust has also pooled its recruitment efforts in a bid to streamline the hiring process for roles across the organisation.
“Now we have a much more organisational approach to deploying staff, instead of a ward-by-ward approach,” Waters says. “Managers can see what is going on beyond their ward, which has given them a deeper level of understanding of what’s going on in the trust and the pressures each team is under for that shift.”
Both morale and retention have seen a boost, with shift allocation across the trust much more based on each individual’s unique skillset and experience, meaning staff are aware of where and when they will be deployed, and are more engaged with the process.
Streamlining recruitment has also been an immense improvement, adds Waters. “We used to recruit new staff on a case-by-case basis, which involved a lot of duplication of work and wasted time,” he says. “But with our talent pool and assessments now shared across departments, we’re able to fill vacancies a lot more consistently.”
And the changes have led to the trust boasting one of the lowest agency bills in the entire NHS – in 2018-19, it spent just £1.3m on temporary staff, compared to £4.8m in 2016-17.