Health November 8, 2018
Transforming a medical workforce at Sherwood NHS Trust

By Daniel Male - Accountable Care Journal

For several years Sherwood Forest Hospitals NHS Foundation Trust has wanted to improve the visibility of the medical workforce issues, specifically to understand productivity, agency spending and annual leave management in greater detail.

In order to achieve this, the Trust knew they needed to implement a standardised job planning process linked to workforce activity. As Dr Andy Haynes, Executive Medical Director, explains: "We were working from paper-based systems which were not co-ordinated."

They started by implementing a paper-based method, but recognised the best way to implement a change would be through a digital solution. Therefore, Dr Haynes with other Trust workforce leaders developed a business case for Allocate Software eJobPlan and ActivityManager, which was approved by the Trust Board.

Dr Haynes says: "eJobPlan was a huge enabler in the effective roll- out of standardised, fair and visible job plans for our consultants."

Job planning has been effectively embedded across the medical workforce, with 98 per cent of consultants signing off job plans linked to annual activity.

The creation of these job plans connected to workforce activity data has successfully increased visibility within the trust. As Dale Travis, Divisional Manager of General Medicine, explains: "The software has given us a daily view of every doctor in work at a service, ward and divisional level while providing much more accessible data and intelligent reporting.

"For example, heads of service are able to see junior doctors’ activity through one rota, even if they move across services.

"As well as identifying where doctors are in the hospital, we can see which doctors are not in but are available if needed and those unavailable due to study leave."

To ensure this transformation in transparency is sustainable and facilitates continuous improvement, the Trust has established a board-to-ward review process including the development of:

  • A one-page summary for Dr Haynes to review productivity and annual leave

  • An independent panel to review team job plans

  • An annual clinical process and activity evaluation

  • A fortnightly financial review of agency and substantive staff costs

The trust is also rolling out voluntary monthly meetings with the consultants, to improve engagement, share ownership and ensure activity is being delivered to plan.

Dr Haynes says: "Through ActivityManager and monthly reports we can track delivery of job plans and annual leave. We can interrogate anything that looks unusual and take appropriate action where necessary."

This has led to the trust being able to better plan their services around the patient, while making workforce savings. The data also enables service leaders to open up different dialogues with the workforce that they have not been able to have before.

Therefore, the trust was able to identify other service opportunities. For example, they introduced hot week working, reduced the use of agency staff to cover unexpected demand, reduced waiting list initiatives and increased theatre productivity.

Through service redesign the trust has seen a reduction in agency spending from 30 per cent (of the total workforce spend) in May 2017, to 17.1 per cent in May 2018.

Dr Haynes concludes: "Allocate Software’s solutions have given us visibility of medical workforce issues in a way that wasn’t possible with a paper-based system. The granular data allowed us to redesign services and deploy our workforce to better meet the needs of our patients. In turn, this improved efficiency and played a key role in allowing us to achieve a £6 million saving on agency spend."

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