Hertfordshire Partnership NHS Foundation Trust - e-rostering to reduce agency spend


01 / 11 / 2012

High Impact Change 1: Increase understanding of the issue

The trust understood that their staff were their most important resource and that they needed better information to help them reduce sickness absence and bring down their use of expensive agency staff.

What we did:

They began with a pilot project to bring in e-rostering for a couple of wards where they believed it would have the greatest impact.

High Impact Change 2: Manage the process and take control

The system was rolled out ward by ward, each time taking on board the lessons they had learnt along the way.

What we did:

They created a project plan which started with acute wards and rolled out the system in one hospital before moving on to the next. They introduced electronic timesheets so that nurses and ward manager weren’t spending hours every month calculating staff hours and this also meant the payroll was more accurate. A bank module was also introduced so that managers could see their total resource – bank staff, agency staff and establishment. As part of implementing the bank module they moved all staff onto monthly pay, which reduced the time spent on payroll. Each ward area was given savings targets and given the tools, via e-rostering to achieve them.

High Impact Change 4: Work collaboratively and demonstrate leadership

The trust chief executive was pivotal to the success of the project and nursing leadership was key to its implementation. Keeping the board informed was also crucial.

What we did:

With changes of personnel at board level the project team kept them informed and constantly refreshed that information as the trust made savings, seeking their input on new challenges. The chief executive was very supportive and one of the project leads for implementing the bank module used to be a member of clinical staff, which helped to ensure clinical concerns were addressed.

High Impact Change 5: Engage with staff

Nursing and operational staff engagement was needed and the project team also knew that staff side engagement would be important.

What we did:

The project leads did a lot of engagement with clinical staff, taking on board concerns and their response to the new system. They worked closely with staff such as newly qualified nurses, who embraced the new technology, and shared information about good outcomes and experiences for patients. Putting substantive staff onto the bank system saved the trust money and also had a positive impact on patient care.

New wards and hospitals coming onto the system could see the benefits from those areas that were further forward and the project team worked hard to communicate these. They also set up a policy for partnership working with staff side from a perspective of staff allocation and ensuring fair shift allocation, while also ensuring the sustainability of the organisation.

Results and next steps:

The trust saved £750,000 over three years, and increased the amount of information available to help manage their staffing resources. The project has meant they are able to use their substantive staff better, reducing risk and improving consistency, with positive outcomes in patient care and experience.

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