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

 

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.

 

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

 

Are You Ready For The 4G workplace?

multi-generational-workplace-300x199The recent UKCES (UK Commission for Employment and Skills) report ‘The Future of Work’ takes a look at the workplace of the future and whether the emerging multi-generational workplace will be a good or a bad thing for employers and employees and the CIPD’s study of nearly 3000 employees and over 900 employers points strongly to the latter. It also highlights the fact that few employers are actually planning for this phenomenon.

  •          31% of employers say that they react to issues relating to the ageing population as they arise rather than having a strategy in place.
  •          34% of employers say their organisation does nothing to ensure it has access to enough skilled and diverse people of all ages.
  •          22% of employers say their organisation has no provisions in place to ensure employees of all ages develop and keep their skills up to date.
  •          46% of employers said that line managers are not trained in managing teams of different generations and that their organisation has no plans to change this.

Almost a third of employees saw no challenges whatsoever in working with colleagues from different generations, with employers and employees in agreement that knowledge sharing and greater innovation are by far the leading benefit which is very reassuring to know but, as can be seen from the statistics above, if employers aren’t ready to meet the differing needs of all their employees the benefits of the 4G workplace may not be gained.

With this huge increase in 4 Generation (4G) workers, the workplace of the future has to be more flexible about where, when and the number of hours people will be working. So how are employers going to manage this greater need for flexibility and ensure that workloads are spread appropriately according to skills and capabilities? One thing seems clear to me – without the workforce management technology in place to support this flexibility – employers will struggle.

CIPD Report

UKCES Report

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

Five Alternative Ways To Reduce Staff Turnover – And Save Money

VacancyMany of you will be aware of the headlines this week about the recent rise in staff turnover. It would seem that businesses are now paying the price for the long period of time that employees, fearful of losing their jobs, have put up with wage restraints, lack of bonuses and some pretty tough management decisions that have been made during the economic downturn.

According to research it costs on average around £30,000 to replace a member of your staff that leaves. This figure includes the cost of employing a new member of staff and lost productivity whilst bringing your new employee up to speed in their role. That’s a big expenditure and if turnover suddenly accelerates, your organisation can find itself  in a very tight corner operationally and financially. So your organisation needs to make sure it retain’s key talent and keeps employees motivated and productive. And remember that retaining great employees isn’t always about hiking pay.

Here are 5 alternative ways that can help keep staff engaged, motivated and productive:

  • Create connections through self-service

As more people perform day-to-day activities such as shopping, reading the news, paying bills, and socialising with friends online, they want the same flexibility and instant access to up-to-date information on the job. For example, why would an employee prefer to wait days for the busy HR department to process a handwritten leave request, when he or she can submit it online in seconds using self-service? As more employees leverage self-service technology in their personal lives, they are increasingly willing to adopt it in the workplace too.

  • Let employees participate in the scheduling process

Scheduling automation also helps organisations find last-minute replacements so they can meet demand. When an employee calls in sick, some scheduling systems can automatically recommend replacement workers, prioritising them by wage, seniority, skills, or other company-defined criteria. Some scheduling systems can even notify qualified replacements via email, text, or a manager call list to speed the process and further minimise impact on production and fellow employees.

  • Empower employees to take ownership of performance

Workforce management systems can help your organisation gain control over processes such as compensation cycles and performance reviews by automatically letting managers know when preliminary budgets and employee evaluations are due. Automated alerts help organisations keep their compensation planning and performance review processes on schedule, so employees receive feedback and rewards in a timely manner

  • Foster career development and professional growth

Workforce management systems can also help organisations track employee certifications and licenses — automatically notifying managers when those critical qualifications are about to expire — to minimise compliance risk and maximise workforce safety.

  • Increase employee engagement — and the bottom line

Workforce management technology can help organisations increase employee engagement. By providing employee self-service applications and automating processes such as time and attendance tracking, scheduling, human resources, and labour analytics, organisations can empower employees to take a more active role in HR and scheduling activities, take advantage of training and professional development opportunities, and get the continuous feedback on performance required to motivate and encourage innovation. For organisations looking to control costs and increase productivity, increasing employee engagement through the effective use of workforce management technology may be the answer.

Find out more and download the full white paper ‘Employee Engagement as a Competitive Differentiator’

Defining Stress in the Workplace

imagesCAUWCGLJBritain has the highest rate of people with mental health issues in the developed world claiming disability or out of work benefits a recent report has revealed. Georgia Graham, writing for the Daily Telegraph claims that British workers are among the most stressed in the world and employees unable to work because of mental health issues are costing the UK economy over £70 billion a year. The main cause of work-related mental health issues, according to the report, was unemployment and the inability to find work. This seems slightly at odds with the commonly held belief that overwork and the long hours culture in the UK is the main cause of stress and stress–related absence.

Burn-out of workers who are swamped by their workload is, of course, a problem as pointed out in the article by the BBC earlier this week about Welsh Ambulance Services. The article highlights the fact that almost three times as many staff are being signed off for stress as for a common cold or flu due to what employees feel is an excessive workload. However, I believe that employers should also be aware of the danger of under-employment of staff in the workplace which can also raise stress levels. Employees who feel undervalued and who are underemployed often fear the loss of their jobs and can feel stressed and anxious over a long period of time – increasing the risk of mental health problems.

Managers who are responsible for managing the workload of their team need to ensure they are able to spread workloads equitably and fairly and ensure employees are not compromising their mental health. Deploying the right people, with the right skills to cover the workload is vital. Whether it is an ambulance team trying to save lives and meet their targets, a retailer who needs to make sure there’s enough coverage to meet the demands of customers at any given time, or a manufacturer or distribution organisation that needs to ensure skilled workers are available to ensure production and delivery targets are met; having the right tools to plan and deploy staff to business demands and track and monitor, attendance, productivity and compliance will help managers support their staff and meet those organisational objectives.

Download the Forgotten Workforce Report

Download CIPD Absence Report 2013