10 Common Challenges for Workforce Management in the NHS

nhsLast week Kronos hosted its annual conference for the EMEA region – Kronos Live EMEA. The event is naturally one of the highlights of Kronos’ year. Spending time with customers and prospects talking about their workforce management challenges and requirements is invaluable and vital to ensuring that, as a business, we continue to meet the needs of our users.

Ahead of the main conference I also had the pleasure of hosting an intimate dinner for workforce management professionals within the healthcare sector. The discussion was led by LSE professor Dr. Tony Hockley, who recently authored the report – NHS Staffing: Not Just a Number.

It’s clear that NHS Trusts across the UK are all at different stages of technology implementation and – to some extent – their experiences and user demands are unique. However, there are also many commonalities which exist, regardless of a Trusts location, size or the type of care it offers to patients.

Here are my 10 observations – in no particular order – which the NHS faces when approaching workforce management.

  1. Nurses and administrative staff should be proud to be workforce management trailblazers. Some might feel that nurses have been ‘picked on’, as they comprise the majority of health professionals who are currently utilising workforce management or eRostering technology. I think the opposite. Nurses and admin staff are leading the way and inevitably other health professionals (medical and other services, etc.) will follow.
  2. Transparency through technology is essential. The NHS relies on the good nature and professionalism of its employees. But too often this can then be open to mismanagement or abuse. Technology can help to remove guess work and provide evidence around hours worked, shift patterns and workforce anomalies.
  3. Accuracy, accuracy, accuracy! Transparency is only of value if the data is precise and – crucially – provided in real time.
  4. Ratios of staff to patients are important, and collectively we have to get it right and respond positively to proposed government targets. But patient care will never be an exact science. Across all forms of care there are anomalies, inconsistencies and exceptions.
  5. We all want a simpler life… I am always astounded to hear stories from across the NHS about how many shift patterns exist across a Trust. Whilst it’s vital to offer employees the flexibility to fit work around other commitments, greater standardisation and simplicity of shift options means greater efficiency. In one instance a Trust consolidated an unwieldy 68 shift options to just six.
  6. Workforce management solutions are still in their infancy in the NHS. We can certainly learn from private sector industries, such as retail and manufacturing, which are now well established and in their third or fourth iterations of technology deployment. But it is wrong to try and compare like for like. The NHS is different from the private, sector and we have to recognise that.
  7. We all need help to become better managers. One consistent challenge which does exist across private and public sector is that continuous development and training is essential. Nurses shouldn’t be expected to become team managers without investment in management training and learning. The best technology in the world can’t help if managers aren’t confident, empowered and up-skilled to make managerial decisions based on the insight IT solutions provide.
  8. Build a justification case for implementation. In tough economic times, all tech decision makers are under pressure to show the value of their investments and ROI. As technology vendors, it’s our responsibility to help our customers do this.
  9. Change management is the key to success. The NHS is driven by people and behavior. No tech implementation or change to processes and practices will succeed without the buy-in of staff.
  10. Finally, it’s all about the patients. In a climate driven by cost saving, efficiency and cuts, we must never lose sight of the fact that we are all here to serve the best needs of the patient.



Reliable systems will help the NHS fight fraud

NHS Fraud

The NHS has suffered a great deal of scrutiny recently – as the service tries to battle with public sector cuts and increasing demand from patients, it must now respond to the latest blow: the cost of fraud in the NHS. A BBC Panorama programme which aired last month revealed that NHS fraud and error is ‘costing the UK £7 billion a year’. The last thing the service needs is to lose money to fraud and error when the pressure to save and cut costs has never been higher.

Given that the biggest areas of fraud are found to be payroll and procurement budgets, we must focus on these processes to determine where the faults can be fixed. Payroll fraud can happen in a number of ways: some examples include employees claiming overtime for hours not worked, false expense reimbursement claims and lastly, unauthorised changes to an organisation’s payroll systems (such as an employee adding ghost employees to the payroll who either do not exist or do not work for the organisation).

A report from the National Fraud Authority echoes this and states that payroll fraud costs the public sector £335 million a year. In reality, the figure is probably even higher– not all payroll fraud is accounted for because it can go unnoticed with unreliable systems in place. Fortunately, this doesn’t have to be the case.

Many parts of the NHS still rely on “weak data” to run their payroll and workforce management systems, rather than leveraging real-time data to show staff availability and validate that rosters are being worked as planned.Yet, the latter is important not only for accurate shift allocation, but even more so for patient safety. For example, a recent report from the London School of Economics and Policy Analysis Centre shows that even an inaccuracy of 0.09% in the NHS payroll equates the cost of the employment of up to 2,000 additional nurses!

In order to eliminate payroll fraud, NHS leaders and staff need to embrace the latest Time and Attendance (T&A) systems and integrate them with payroll. The London School of Economics and Policy Analysis Centre report supports this by voicing potential savings of £71.5million from the use of T&A systems in the NHS.

For this vision to become a reality, the image of industrial-style “clocking-in” systems must be scrapped. Modern self-service biometrics terminals allow staff to quickly, easily and securely record their activity, thereby ensuring accurate payroll and preventing fraud occurring. The Royal College of Nursing (RCN) issued guidance earlier this year, describing good quality data as “the cornerstone of effective staff planning and review”. Now, when the topic of fraud arises, NHS leaders must remember that good quality data and reliable systems will be the answer for prevention.

Public Sector Sickness Absence in the Spotlight (again)

Thinking about my heritage I thought it would be interesting to review an article in the Scottish online magazine, The Courier, about stress being the main cause of sickness absence in Angus Council. The cost of direct absence for the council stands at £4m for FY11/FY12 – an increase of 5% on the previous year and stress-related reasons were given for absence in almost a quarter of claims which was also up from the previous year. In another article in the same magazine Fife Council workers averaged a day per month off for absence that’s an average of 11.8 working days per employee in 2011-12 and earlier this year it was revealed that Fife council paid £10 million in sick pay in only nine months during 2011. These figures are extraordinarily high, twice the private sector average and should be a concern to all tax-payers who, after all fund the public sector.

Employee absence has a huge impact on any organisation. It affects staff morale, disrupts the work of others, and reduces the quality of work output. Whether the absence is planned, incidental, or extended, it carries costs, risks and reduces productivity. To control the impact of absenteeism, organisations need to be able to see trends and need to manage absence policies so they can minimise compliance risk. They also need to identify workers with attendance issues and address them in real time so they can improve workforce productivity.

Implementing an automated solution for absence management brings an immediate reduction in the cost of absence and improved productivity that would easily support the deployment of the solution. An easily achievable reduction in the annual cost of absence of 2% would mean Angus Council would reduce their absence bill by £80K and Fife can easily save £200K in sickness pay! Whatever steps these and other organisations are already taking to address the causes of absence – “you can’t manage what you don’t measure” and without an automated workforce management solution to help support their absence policies, they are missing an opportunity to make cost savings, improve productivity and stop wasting taxpayers’ money.


Efficient Government Needs a Lean Workforce

Workers Protesting Over Proposed Job Cuts

Some things in life are predictable but too often it’s not good. Take for instance my morning commute of only a few miles. It still consists of road works, traffic jams and the odd shout at the radio to tell Nick Ferrari to “shut up and let the other person speak!”  These days, added to that mix is the despondency that comes from hearing of further job cuts, especially in the Public Sector.

Last week the Government was telling public sector workers to expect to take pay cuts in order to keep their jobs. Yes, we know that many private sector companies have been doing this for years to stay afloat yet it still comes as a shock to the public sectors.

If I were one of those people facing a potential pay cut I would want to know that my organisation had done everything possible to maximise productivity. If I was asked to take a 15% pay cut when our productivity rates were so low and our absence is typically 30% or more higher than the private sector I would not be happy!

Every organisation, public or private should be applying ‘Lean Labour’ principles to their workforce in order to maximise productivity and efficiency. Organisations must get smarter about how they use their most valuable resource – their employees.

Lean Labour is simply the process of measuring work activity, aligning it to business demand and automating manual processes.  By measuring activity you are able to identify wasted time and effort. Aligning to demand means that the workforce is there when business demands it and automating processes means more time can be spent on value added activities. All of this results in greater productivity.

Amongst our clients is one of the largest Fire and Rescue services. They are a great example of how ‘Lean Labour’ principles can benefit the public sector. The service needed to improve productivity and appliance availability. After implementing their Kronos system, to administer annualised duty rosters and optimise their work schedules to meet demand, that Fire and Rescue service were able to greatly increase productivity and appliance availability. Saving money and lives – how good is that!

If the CIPD’s absence statistics and other metrics quoted daily in the press are anything to go by, higher productivity is what we need in the public sector. Download the latest CIPD Absence Report.