Ask Rose Hagreen if technology has made much of a difference in her being able to make sure the wards of her hospital always have enough staff, and the answer comes back pretty strong:
We were told to reduce our agency spend costs, and after implementing this technology our workforce has been able to improve its work/life balance planning with a user-friendly, accessible tool to view and plan their work patterns; there’s been an increase in the visibility of unfilled shift positions for Trust temporary workforce to review and book shifts appropriate for their skills; we have seen a confirmed reduction in expenditure due to an increased Bank fill rate that’s reducing the number of shifts we need agency help to fill - and we’ve even been able to move two full-time staff off this kind of low-level admin work on to other duties .
Even better, she and her management colleagues at the NHS institution in question, Calderdale and Huddersfield Foundation NHS Trust, can provide actual numeric proof of just that level of improvement: for the full financial year following the implementation of the technology we’re going to talk about in a second, temporary staffing spend went down by 13.5%, or just under £300,000… and once you know that English Trusts spent an estimated £1.46bn on agency nursing help in 2017 alone, then you’ll see why this is an impressive result.
It’s also a win that may have much more than local significance - as Calderdale is also aspiring to be a NHS England Global Digital Exemplar site, so improvements it identifies through smart use of tech will also be potentially replicated in other parts of the NHS, too. Time to stop being mysterious, then, and to be explicit about what Hagreen and her team have been using. It’s e-rostering, which some may believe to be a ubiquitous technology within the NHS now, but which surprisingly enough only 59% of the UK clinical workforce is currently deployed via such a tool.
It is also possible, of course - as in Calderdale’s case - that staff groups beyond nursing, such as doctors, allied health professionals, pharmacy and radiological specialists and other team members could also start better scheduling their time this way.
Hagreen, whose formal job title is Head of eRostering Nursing & Midwifery Services at the Trust, told diginomica/government that her organisation employs around 6,000 staff who deliver care from the Trust's two main hospitals sites, Calderdale Royal Hospital and Huddersfield Royal Infirmary, as well as in the community, health centres and in patient homes.
The Trust’s vision is that together, we deliver outstanding, compassionate care to the communities we serve by providing the right care, at the right time, at the right place.
A context of change
At the beginning of the 2018/19 financial year, she says, the Trust was under “intense scrutiny” from the national Foundation Trust regulator, NHS Improvement, and tasked with reducing agency nurse usage.
That luckily coincided, she states, with work going on already to improve use of staff resources in the Trust, which cared for over 120,000 in-patients and 460,000 out-patients in 2016/17 alone:
Over the previous nine months, we had already embarked on a substantial programme of work to improve the utilisation of our nursing staff and which had prioritised a focus on effective use of staffing resource available within our wards and departments.
This project centred on use of software from Calderdale’s primary e-Rostering partner, Allocate, she says, which then shifted on to a 2018 ‘Bank App’ Department of Health and Social Care-supported pilot to explore how things like mobile app-delivered staff scheduling could help the NHS cut costs.
We were one of 12 Trusts successful in securing a position as part of the pilot and saw this as a key component in facilitating the requirement set by NHS Improvement to reduce [our temporary] agency usage.
The specific app that Calderdale decided to use, as another Trust we looked at last month, Blackpool, was something called ‘Allocate Me’. In Calderdale’s case, this replaces an existing employee online Web-based tool staff were already using to book things like their annual leave, training days, shift swaps with colleagues, review of their pay and to add requests for future shifts patterns and the like.
The difference, though, is that an app is much easier for staff to use, enthuses Hagreen - and it also can offer more functionality, like staff shift swaps, which she says is a huge benefit in terms of overall flexibility and control. This new, digital way of working was carefully introduced to the workforce by a special internal comms campaign, she adds, that included engagement and encouragement to drive downloads and use - and as a result,
Staff can now manage all aspects of their work/life balance at a time or place of their choosing from their phone, which is a feature increasingly important to the next generation of the workforce.
That comms campaign seems to have been very effective, as use of this way of booking their shifts is now used by nearly 3,000 staff, mainly Nursing, Midwifery, Additional Clinical, & Operating Departmental Practitioners (ODPs), with maybe 5-10% of that number, she estimates, being non-nursing (admin and clerical).
In terms of functionality, another big win for the Trust is that the app can allow team members to easily view and directly book into any outstanding unfilled shifts within the Trust. They can also see shifts an agency worker may have been booked in but opt to work the shift in their stead - something Hagreen says increases shift fill rates for her in-house temporary workforce but also cuts her need to book agency nurses even further.
The real USP here is that this is an app available in the app store that you any member of the workforce can download onto their phone or tablet. This allows them access to it independently without any need for our support on the eRostering Team.
We will now continue to grow our in-house Registered Nursing temporary workforce and increase shift fill, further reducing Agency costs. We’d also like to roll it out to our wider medical workforce, with all non-consultants rostered and fully utilising this form of software in six months’ time.”