09th June 2015 Written by Dr Jenny Harrop – Medical Workforce Specialist

Image: 7 day service.Jeremy Hunt advocates ‘smart’ rostering to limit agency spend – vital step on the road to affording 7 day services.

David Cameron kicked off his unanticipated majority government with a not so unanticipated announcement on the NHS – as expected there are no major reconfiguration but an acknowledgment that services are not equal in quality and safety every day of the week and that the NHS should rectify this by 2017. Whilst we are also told that ‘7 day services’ doesn’t necessarily mean 7 day working for all; it would be naïve to suggest that a 7 day vision can be achieved without patient facing folk regularly spending more of their evenings, weekends, and possibly overnight, at work.

Current terms and conditions for clinical staff pay a premium for unsociable work. Unions representing Nursing staff have stated that removal of this premium would be resisted by their members whilst doctors contractual arrangements for the future still remain in limbo since negotiations between NHS employers and those representing doctors broke down in the summer of 2014.

Add to the mix of uncertainty over contractual costs a major workforce shortfall in available substantive clinical staff both in the UK and Europe plus a lengthy and complex immigration process to navigate should an organisation want to look more globally for appropriate full time staff. Is it any wonder, then, that temporary staffing budgets have doubled compared to expected, reaching £1.8bn in the last 12 months (BBC News). It is currently far more profitable and suitable for work life balance for clinicians to work via agencies and on short term contracts than it is to take a full time post.

What can organisations do to reduce the need for costly additional staff whilst addressing the challenge of 7 day services?

Changes to contracts and a cash injection are required but these will be a long time coming (including the £8bn promised in 2020). Jeremy Hunt, Health Secretary advocates the use of rostering techniques and technology available to mitigate for the need of expensive agency staff. Providers must grasp the concept that how they operationally manage and deploy clinical staff should not be a supplementary activity conducted by staff in back offices but should be a fundamental operational function linked to performance and cost avoidance and given a spot high up on the performance and quality agenda.

In reality this means addressing the entire workforce model; having the right administrative staff in place and clinical ownership throughout the process. Doctors and nurses should stop feeling at the mercy of their rota or off duty and take control of the process in conjunction with HR functions that see to the necessary regulatory and legal compliance of working patterns. E-tools should be used to mitigate for human error and communicate the operational workforce plan across the organisation in real time so that everyone knows who else is in and what they are doing. Consultant job plans should be optimised with regards capacity against a true understanding of local demand instead of doing only what we did last year plus 4% more for inflation. It won’t happen overnight but then neither will 7 day services – we have to start somewhere or else wait for money and changes in contracts and peoples will to work seemingly unsociable hours that just might not ever come. I would say that those organisations that have started down this road are at least one step ahead.

To find out how Skills for Health can help support you and your organisation is developing a 7 day service delivery; please contact your Regional Director to arrange a meeting. Our e-rostering and compliance reporting tools teamed with our Workforce Planning strategies and highly experienced consultants can help realise this type of delivery effectively and efficiently.