Rostering for Workforce Wellbeing: Flexible, Fair, and Fit for the Future
Summary
The Newcastle upon Tyne Hospitals NHS Foundation Trust introduced team-based rostering through its e-Rostering Team and Nursing and Midwifery Safe Staffing Team to improve workforce wellbeing, flexibility, and fairness across 24-hour clinical services. Initially piloted across two wards, the approach enabled nurses to self-roster within agreed safety parameters, increasing autonomy and transparency while maintaining safe staffing oversight.
The initiative addressed long-standing challenges around work–life balance, fatigue, and perceptions of unfairness in shift allocation. Positive staff feedback, measurable improvements in wellbeing, and reduced sickness absence supported expansion of the model. The approach is now live across 17 departments, including critical care, with phased rollout continuing across inpatient services and day units.
The Challenge
The e-Rostering Team and Nursing and Midwifery Safe Staffing Team recognised an opportunity to introduce a more flexible and collaborative approach to workforce planning across 24-hour clinical services. Traditional rostering approaches were associated with challenges around work–life balance, fatigue, and perceptions of unfairness in shift allocation, impacting staff wellbeing and overall workforce experience.
The challenge was to design a model that enabled nurses to self-roster within safe and clearly defined parameters, including requirements for weekends, nights, skill mix, and safe staffing levels, while maintaining appropriate managerial oversight to ensure patient safety and operational compliance.
A further challenge was ensuring meaningful co-production with frontline staff and ward leaders, alongside alignment with fatigue expert guidance, to ensure the model was safe, acceptable, and sustainable. Concerns around fairness, workload distribution, and maintaining consistency across teams required careful management through structured engagement, governance, and clear escalation routes.
Ongoing evaluation and feedback were central to the programme, ensuring the model could be refined based on frontline experience and developed into a scalable approach suitable for wider adoption across increasingly complex inpatient services.
The Solution
A phased, co-produced approach was used to introduce team-based rostering across pilot wards, involving frontline nurses, ward leaders, the e-Rostering Team, and the Nursing and Midwifery Safe Staffing Team. Staff were actively involved in shaping the model to ensure it reflected the realities of 24-hour clinical services while supporting fairness, flexibility, and workforce wellbeing.
The model enabled nurses to self-roster within clearly defined safety parameters, including agreed rules around weekends, nights, skill mix, annual leave, and safe staffing requirements. This balanced greater staff autonomy with appropriate managerial oversight to maintain patient safety and operational resilience.
The programme was developed alongside fatigue expert guidance and supported by structured evaluation, feedback mechanisms, and ongoing review to monitor impact and refine the approach based on frontline experience. Clear escalation routes and governance processes were established to support fairness, consistency, and safe implementation across participating areas.
By combining digital rostering capability with co-production and shared ownership, the initiative helped create a more transparent and supportive rostering culture within 24-hour care environments.
Results & Next Steps
The introduction of team-based rostering delivered significant improvements in staff wellbeing, flexibility, and workforce experience across participating wards. Survey results demonstrated marked improvements across key measures: rostering satisfaction increased from 46% to 71%, perceived fairness from 48% to 73%, and perceived support for work–life balance from 52% to 83%. Reported wellbeing benefits increased from 39% to 70%, with staff highlighting improved recovery time between shifts and greater ability to plan personal commitments.
Qualitative feedback indicated a cultural shift from manager-led rostering towards greater shared ownership of staffing, strengthening team cohesion and trust. Managers also reported up to a 50% reduction in time spent producing rosters, releasing capacity for leadership, supervision, and quality improvement activity.
Operational outcomes included reduced sickness absence in pilot areas compared with wider organisational trends, alongside improved staff engagement indicators and lower reported intention to leave. Incident reporting also reduced in areas where the model was live.
Following successful evaluation, the model has now been scaled across 17 departments, including critical care, with further rollout underway across day units and inpatient services. Learning from the programme continues to inform wider workforce transformation work around self-rostering, shared governance, and sustainable staffing models, while published peer-reviewed evidence and external interest have strengthened confidence in the approach as a scalable model for NHS organisations exploring more flexible workforce practices in 24-hour care settings.
