NHS Safe Staffing – 6 Key Findings

nhs-Safe Staffing

In our last blog we discussed the increased pressures facing the NHS and how organisations such as NICE, are offering their guidance on achieving safe staffing in the NHS through technology and toolkits. Kronos hosted a series of ‘safe staffing’ workshops with NHS trust managers which offered some valuable insight into the challenges facing NHS trusts today. Of course each trust has quality patient care top of mind, but when it comes to achieving this, there are a number of operational issues they must overcome.

From the three workshops we hosted, the top operational challenges facing trusts at the moment are:

 

  1. Planning efficient rosters and robust ‘sign off’ of those rosters

After much discussion, it was evident that many of the trusts are still battling to successfully embed eRostering into the culture of the trusts. The effective implementation of any technology relies on senior management and CEOs. It requires their understanding and evangelising of the benefits of the solution to the whole team. Furthermore, making is clear how the solution will be used and enforce the processes rigidly.

A recent report from the Royal College of Nursing (RCN) revealed that 72% of staff reported that staff shortages occur frequently. A further 66% have also considered leaving the health service because of increased workloads and the stresses of the job. This makes it clear that action must be taken to keep the workers on the side of the NHS. When these workers feel stressed and overworked it can negatively impact the work they do and patient care they provide. Senior NHS management must therefore recognise the importance of technology in supporting safe staffing initiatives.

 

  1. Inefficient data collection

Inefficient data collection regarding the actual attendance of staffing is a serious issue for three reasons. The first is that the lack of real-time data capture of activity, means ward managers have an administrative overhead caused by retrospectively entering the data. The second is how manual data entry results in the data being more likely to be inaccurate. Lastly, the lack of real-time visibility from this data collection method means important staffing decisions are delayed, ultimately resulting in the quality of care being compromised.

These issues can be resolved if trusts implement time and attendance (T&A) solutions to record, using real-time data capture, the presence and availability of the nursing team.

 

  1. Alignment of the digital data held within trusts

Staff are currently using a range of different technologies in their day-to-day roles. They would like to see how all these technologies and devices could strategically ‘talk’ to one another where possible. This would improve the quality of data gathered because it could be cross referenced with the different measurements being made. It was good to see that, following concerns raised by NHS employees about staffing levels on more than 2,500 occasions in the last year, a government spokesperson said that a national framework for the “reporting of adverse events” will be rolled out. It’s crucial that we begin to see more consistency across trusts in terms of technology and reporting, in order to keep the service aligned and quality of care monitored effectively.

 

  1. High level visibility of actual staffing on shift by shift basis

The operational management of safe staffing was a heavily discussed area in our panels. The process for many trusts would entail a ‘breakfast staffing’ meeting at Matron-level each morning to go through the plan for the whole day.

The general consensus was that scenarios could still change throughout the day, and therefore, the morning meetings can be lengthy and costly in terms of time and efficient use of senior staffing. Systems such as Kronos OptiLink and T&A provide management of staff with the holistic visibility into the staffing on their wards and across the whole trust, freeing up time usually spent on morning planning meetings.

 

  1. Compliance and validity of acuity recording within trusts

It was found to be quite challenging to measure how effective the decision-making is of the nurse logging the acuity recordings. Without an investment of staff resource to either do the recording corporately or to scrutinise the data, there is no real way of measuring this.

Kronos OptiLink makes the capturing of acuity data simple and efficient, using tablet devices. Having acuity data on the tablet devices also helps with handovers between nurses, giving them the ability to review and discuss the recorded conditions of the patients easily.

 

  1. Commissioning

Trusts were keen on the idea of being able to consider detail at a commissioner level and how impactful this could be on future contracts being awarded to a trust and equally, investment in services. They saw the value in being able to articulate the service need more figuratively and identify trends, as well as how this could have a positive outcome.

For more information on Kronos for healthcare solutions visit www.kronos.co.uk/healthcare

 

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NHS – The Operational Challenges of Safe Staffing

NHS Safe StaffingAs an election year looms, the pressure on the NHS continues to build. The future of the service continues to be a heavily debated topic and a clear battle ground for the main parties. The issue of privatisation remains prominent with many public thinkers expressing doubts over whether the service will soon cease to be free. Whilst others suggest taking the pressure off hospitals and GP clinics by spreading patient treatment across pharmacies instead.

Undoubtedly, the biggest concern for all must be the quality of patient care. The NHS care watchdog recently warned of a risk to patient care due to a shortage of doctors and nurses. Then its annual report assessing NHS and social care services, the Care Quality Commission (CQC) said recently that while much care is excellent, “the variation in the quality and safety of care in England is too wide and is unacceptable”.

Against this backdrop, organisations are continuing to offer their guidance to NHS leaders in order to improve patient care. For example, recently the National Institute for Health and Care Excellence (NICE) endorsed a decision support toolkit to be used alongside its guideline on safe staffing for nursing in acute hospitals.

It’s clear that as the service continues to face financial challenges, technology will play a key part in supporting staff in their roles.

Kronos recently hosted a series of NHS workshops following the initial guidelines published by NICE. These were attended by a broad spectrum of healthcare professionals from NHS trusts across the UK. The aim of these workshops was to help NHS trust managers meet safe staffing obligations, control labours costs and improve patient care. Through the discussions at these workshops, a number of consistent challenges were highlighted.

One of these issues were the Unify reports. These report templates are a government requirement for trusts to report their staffing levels. But there appears to be inconsistencies and a disparity in the way trusts are reporting safe staffing. These inconsistencies arise from Trusts recording the supernumerary/supervisory status of nurses as clinical hours or not. In addition, there are some discrepancies with how the wards are recording the hours in terms of long or short days.

The unify report simply asks for hours on day and hours on night shifts. With enough detail lacking in these logs, it could negatively impact some trusts, especially if they are logging reports differently. The hope is that soon enough, there will be thorough guidance provided on reporting expectations.

But, how is the staffing data impacting upon patients right now?

The consensus here seems to be that patients are not using the data or they cannot understand the data. Staffing numbers are not currently being quoted in complaints, for example. Trusts believe that patients are either not interested in the numbers, or are not aware of the relevance. This will change though, and it will be interesting to measure the impact upon service requirements for those having patient choice for surgery, etc. There was a clear consensus from our panels that whilst data is not used during normal clinical visits, it could be used in future complaints or legal cases. Therefore, in the future it is imperative that trusts will need to have access to accurate records. And those that fail to manage this process will find themselves under immense scrutiny from public sector leaders and the public.

Keep an eye out for our next blog, where we’ll discuss the operational challenges facing trusts today.

How good is your vision?

Better VisibilityWhether you agree or disagree with the age old adage of “You can’t manage what you can’t measure”, the fact remains that having better visibility sure makes life easier.

Take driving for instance. If we didn’t have side windows, and relied only on the windscreen, at some stage we would inevitably get side-swiped by something we didn’t see or anticipate. The same goes for business too. We stand a much greater chance of meeting our business objectives if we are able to anticipate, visualise and react to the changing needs of our internal and external customers.

One of the most rewarding things about my role is meeting our customers and learning how our solutions are making a positive impact to their organisations. On almost every occasion, at some stage during our discussions, the customers will cite “greater visibility” as being one of the key benefits of their Kronos workforce management solution.

A brief story…..

On a recent visit to one of our UK hospitality customers I asked their operations manager what benefits Kronos is delivering. It was fantastic to hear him say the solution was delivering a 6% to 8% saving on labour costs as a result of improved labour demand forecasting and scheduling. However, he went on to say that the true benefit to him personally is the ‘visibility’ the solution delivers. Having detailed labour data at his fingertips means he can now have meaningful conversations with each of his general managers. He is able to discuss and review the impact that programmes and activities, such as staff training or additional labour budget allocations, are truly having on their sales performance.

When building a business case for a workforce management solution you need to focus on the tangible benefits, which in the main will be around cost reduction. However, once the solution is live it’s the intangible benefits that start to materialise and make a positive impact on the business and the individuals.

In the case of this particular customer their business is growing significantly, and so is their labour budget. But having visibility into key labour metrics is allowing them to maximise their return on labour budget and build an even stronger business. www.kronos.co.uk

Neil Pickering, Twitter: @ZamberP

 

Is Technophobia Preventing Your Business From Reaching Its Full Potential?

technophobiaDefinition of Technophobia from Wikipedia: ‘Technophobia is the fear or dislike of advanced technology or complex devices, especially computers. Although there are numerous interpretations of technophobia, they seem to become more complex as technology continues to evolve. The term is generally used in the sense of an irrational fear, but others contend fears are justified.’

Now, some of you will be sitting and nodding in agreement – ‘Yes, technology is a mystery to me and I don’t need it anyway! Whilst others are probably thinking ‘What on earth is the problem? Technology is fantastic! Where would we be without it? Bring it on!’  But, generally, people tend to sit somewhere between these two extremes… ‘I will use it at work because I have to or, I love it, can’t get enough of it, what is the next gadget I can get’

At work technology is commonplace – it could be an email solution, a solution for presenting financial information or documentation, or even a manufacturing process solution. At home you could be using your computer, phone or iPad for online shopping or banking. But if your organisation is resistant to technology – it could be wasting time, money and lagging behind more agile competitors.

Manual processes that, when automated, can improve productivity, ensure compliance and reduce labour costs could be something that your technophobic organisation may be avoiding, fearing it will be too complex and costly to implement; yet it could have the single most positive impact on your organisation’s bottom line and bring real competitive advantage. After all, when the right people are in the right place at the right time and productivity is being tracked and measured, the visibility and control it gives can only lead to better business decisions and improve profitability allowing you to free up capital to support other areas of your business strategy.

If you don’t wish to invest capital in a solution that will help you manage your people more effectively, you should consider a SaaS solution. Software as a Service enables organisations to invest in technology on a per employee per month basis – you use only what you need, you will achieve significant business benefits without upfront capital outlay and without waiting on your over-stretched IT resource to set up any required infrastructure as it is managed and hosted by the supplier. It will give you a technological advantage and agility that will allow you to compete with larger organisations by streamlining your workforce management operations. If, like many, you are concerned that your organisation is suffering from a little technophobia take a look at this useful guide: ‘Unlocking Your Workforce Potential’.

Zero Hours Contracts – Are We One Step Closer To A Truly Agile Workforce?

imagesCAHIW1UVI believe it can only be  good for UK business that zero hours contracts are being taken seriously and that the pressure on the Government to provide guidelines for employees and employers is growing. The CIPD report following a public consultation has concluded that change is required to ensure the flexibility that can be offered by zero hour contracts benefits both employers and employees.

Flexible working contracts have become increasingly important for many businesses; allowing them to become more agile and competitive and improving employee engagement by giving employees the total flexibility they may need to balance complex home and working lives. At the risk of sounding repetitive, I believe a major issue that needs to be addressed by many organisations is that of making zero hours and other flexible contract employees easier for managers to manage. The way to do this easily is by using workforce management technology that can automate some of the processes needed to track employee attendance and schedule employees according to both business requirements and employee preferences.

Below are the four main recommendations made by the CIPD:

  • The use of exclusivity clauses in zero hours contracts preventing workers from working for another employer should be banned, with a narrow exemption for employers that can demonstrate a compelling business reason, for example, confidentiality or the protection of trade secrets.
  • CIPD recommends that staff on zero hours contracts should, after a minimum period of 12 months service with an employer, have the legal right to request a minimum number of hours per week.  Employers would have to respond positively to the request unless they had a business reason for turning it down.
  • The CIPD believes all workers should be legally entitled to a written copy of their terms and conditions not later than two months in employment (currently under the Employment Rights Act 1996 only employees are entitled to this). This would help provide greater clarity on behalf of both parties on the issue of employment status and the associated employment rights.
  • The CIPD would support the creation of a code of practice setting out for employers and zero hours workers some key principles and guidance on the responsible management of these types of working arrangements.

The full consultation can be downloaded here: http://www.cipd.co.uk/publicpolicy/consultation-responses/zero-hours-contracts.aspx

The full report, ‘Zero hours contracts: Myths and reality’ is available to download here: http://www.cipd.co.uk/hr-resources/research/zero-hours-contracts-myth-reality.aspx

Monitoring Absence At Work Does Not Increase It

AbsenceThere has been a lot of coverage recently about getting sick people back to work. It is a big issue for most businesses – and the Government takes the loss of productivity caused by absence, particularly long-term absence, very seriously. Around 960,000 workers in Britain were on sick leave for more than a month each year between October 2010 and September 2013. To address this issue The Department for Work and Pensions (DWP) are launching a scheme where workers will be referred for health assessments if they are sick for more than four weeks in an effort to address the issue. It is planned that the assessments will be carried out by occupational specialists who will draw up a plan and timetable to get the patient back to work quickly. The DWP believes the scheme will save employers £70 million a year and cut the time people spend off work by 20% to 40%.

While this is good news for employers – I know from many years of discussing HR and workforce management with a wide variety of businesses that many employers really don’t know the extent of sickness absence in their organisation. Of course if it is a long term absence someone is usually missed, but believe it or not, occasionally that’s not the case and employees  are paid long after they have left the company or even this earth!  Short term, unscheduled absence is, however, frequently missed or not captured and costs employers dear in lost productivity, overtime payments and employee engagement.

When I speak to employers about tracking their absence it always surprises me that they often think real-time capture of attendance raises unscheduled absence rates.  But if they think about it – what it actually reveals is that they were unaware how bad it was in the first place!

If you don’t know to what extent absence is affecting your business and managers aren’t able to spot absence trends amongst their employees, it makes it almost impossible for them to take steps to reduce it – after all you can’t manage what you don’t measure. So next time you notice one of your employees is not at their post – ask yourself this – if you knew the true cost of employee absence to your organisation – what would you do differently?

Here’s the popular list of the Top 10 Tips to Reduce Absence

Real increases in pay will only be delivered through increases in productivity

The recent CIPD Megatrends Report ‘Have we seen the end of the pay rise?’ concludes that businesses must be agile and aware of changing trends that may affect their business and be ready to respond to them and make them work in their favour in order to maintain an advantage over the competition.

The findings showed that since January 2009 average weekly earnings (without bonuses) have fallen by 8%. And the recession also saw a fall in labour productivity (the amount of value added/created per hour worked). Less productivity has meant less money available for wages. And it is not only the UK that is affected – many employees across Europe saw their pay frozen or cut during the recession.

Here’s how one manufacturing company has found a way to help improve productivity and control labour costs.

Based in Birmingham, Hozelock employs up to 600 people at its 28,000m² site. Hozelock manufactures and assembles equipment for garden watering, spraying and aquatics for the UK and international markets. The company identified the labour-intensive assembly area as the key area to focus. By introducing job costing software that works together with their manufacturing workforce management solution they gained visibility into how their operations perform against productivity goals and benchmarks.  Alan Murphy, Manufacturing Manager at Hozelock explains: “We introduced (Kronos) Activities part way through the season and immediately started to see that productivity had already improved about 2% over the previous year on our assembly lines. The closer scrutiny on performance at a local level, rather than globally, increased levels of focus on output and performance.

TWS20.600.productivity

Read the CIPD Megatrends Report ‘Have we seen the end of the pay rise?’

Read  Workforce Management – The final piece in the Hozelock jigsaw to become a world class manufacturer