29th April 2014

Earlier this month the HSJ published a synopsis of the findings of a government instructed taskforce assessing the impact of the European Working Time on clinical availability and training of UK medical Workforce.

Image: Review your workforce rotas!Commissioned by the Government and carried out by the Royal College of Surgeons, the review found what many of us in the health service have known since 2008; that the restrictions of working time go beyond a simple reduction in hours to 48 by introducing breaks into continuity of care and rest required due to delivery of unscheduled unexpected emergency care (especially in clinical areas where working to a shift pattern would be of detriment to learning and professional development).

Whilst acknowledging that a reduction in overall working hours for clinical staff was indeed a good thing, the taskforce then made a number of recommendations in a bid to guide employers on how to mitigate for the undesired effects of the Health & Safety legislation.

  • Review and share best practice in workforce rota design
  • Identification of specific education and service elements in working arrangements
  • Consideration for the wider use of the Opt Out arrangements where safe to do so

So, what does this mean for local employers?

None of these recommendations are ground breaking but it is suggested that "where necessary, trusts may need to reorganise their teams and services to deliver their own local solutions". The rest of the recommendations require action from wider NHS bodies such as Health Education England (in the form of contract negotiations) and NHS employers, with regard to consideration around rest requirements outside of the European Directive.

Therefore, there is no imminent end in sight to the restrictions of working time. A new contract for doctors in training cannot alone solve the complexity of medical workforce management. Simple work pattern revision will also not solve the problem but long term INTELLIGENT DESIGN AND DEPLOYMENT of the workforce can have a significant impact that will directly affect the patient experience.

Moreover, this examination has highlighted the need for intelligent workforce management for all clinical staff (coupled with a centralised control of workforce deployment) if organisations are to have an efficiency impact on service delivery, education and on cancelled activity.

The workforce currently do all they can to mitigate for illness or unexpected absence but, as an organisation, operationally more can be done to have a 'back up plan' running in constant parallel with the expected delivery of service.

All of this functionality exists within Realtime Rostering, the Clinician driven e-rostering tool developed with Skills for Health by those best placed to know how to mitigate for the complexities of delivering a safe and efficient service within the confines of working time regulations and other contractual requirements.

All of the above are not easy issues to solve but using a specifically designed tool such as Realtime Rostering can significantly reduce errors in deployment, cancelled activity and missed learning opportunities. Surely a 'must' for all organisations?