County Durham and Darlington
Summary
County Durham and Darlington NHS Foundation Trust has saved more than £750,000 on avoidable staffing costs, created a fairer system for allocating shifts, cut back on administration and put more staff on the wards with RLDatix Optima.
The challenges
County Durham and Darlington NHS Foundation Trust provides secondary hospital care from three main sites in North England; all to a population of around 1.2 million from the region. It currently has around 4,700 whole time equivalent staff and 1,200 beds. It is also a best practice example of a hospital Trust embarking on modernisation to identify and reduce waste, reduce exposure to risk and deliver best quality patient care while working within budget.
Addressing the rostering
County Durham and Darlington NHS Foundation Trust implemented RLDatix’s Optima to manage core nursing staff across more than 70 nursing teams. Managers can now review rosters weeks in advance and make informed decisions on future staffing requirements, with the added bonus of removing all reliance on agency staff. Following the implementation, the Trust saved over £750,000 on nursing costs in one financial year.
“Optima does what it says on the box. One ward had a significant overspend before Optima was implemented. Now we are coming in on budget.”
Ged Whitfield, Practice Development Matron
The road to efficient
In recognition of the significance of this solution, the Trust’s procurement panel undertook a thorough investigation of four e-Rostering suppliers. The Trust was looking for a system that would provide visibility of movement of staff across wards, enable the Trust to model future staffing scenarios; provide managers with the visibility to allocate shifts according to patient requirements rather than ad hoc staff requests, as well as the transparency to understand how rostering decisions impact upon budgets. Out of the four suppliers, it deemed RLDatix e-Rostering solution, Optima, as the only tool that could meet all these requirements, while providing best value for money.
“…nursing staff across more than 70 nursing teams. Managers can now review rosters weeks in advance with the added bonus of removing all reliance on staff.”
Meeting Goals
Initially, Optima was installed across medical and surgical directorates and then rolled out to the main operating theatres, maternity wards and emergency departments. The solution processes 1,500 substantive timesheets and more than 1,900 bank shifts per month for Payroll. Following the implementation of the e-rostering solution, County Durham and Darlington NHS Foundation Trust has significantly improved control over nursing rosters and addressed issues with overspend. Initially, Optima was installed across medical and surgical directorates and then rolled out to the main operating theatres, maternity wards and emergency departments. The solution processes 1,500 substantive timesheets and more than 1,900 bank shifts per month for Payroll. Following the implementation of the e rostering solution, County Durham and Darlington NHS Foundation Trust has significantly improved control over nursing rosters and addressed issues with overspend. The hospital measured the financial savings by choosing a sample of wards and then removing all the major impacts from the equation such as staffing changes, increasing or decreasing the numbers of beds on the wards and so on. It compared the data from one year before and one year after implementing Optima and found that it had already made savings of £329,000. With this in mind, it projected savings of more than £750,000 across the then live wards.
On the wards
With e-Rostering, ward managers can manage staff workload and rosters more efficiently. Now rostering policies are standardised, it is easier to see which staff are available. Based on this realtime information, matrons and senior nurses can make informed decisions on the movement of staff, ensuring the right skills mix of staff are on the wards at the right times and maximising care. Rosters are now produced according to clear rules set by the management, which allows for a fairer system and more equitable distribution of shifts. Ward managers, matrons and senior nurses have access to a range of instant reports that show sickness absence, unavailability and fairness indicators. Annual leave and study days can now be closely managed so that they are allocated consistently across the year, and breaks have also been standardised. This has gained a whole time equivalent (WTE) of 37.5 hours a week, in just one ward. Across the whole Trust, the increased availability of nursing staff is equivalent to 643 hours per week.
“Having the Agenda for Change rules inbuilt and direct interfacing with ESR has significantly improved payroll accuracy and likewise a reduction in queries.”
Managing agency staff more efficiently
The temporary staffing module manages all aspects of the Trust’s temporary staffing requirements. This makes things very transparent – for example, ward managers can see which staff members from the nurse Bank have been assigned to their ward, the nurses’ training and experience. Optima also empowers ward managers to book bank staff themselves, circumventing the need to submit paperwork in advance. This means that as soon as a manager identifies a requirement for additional staff with a particular skills set, he or she can immediately request that gap be filled with an appropriate employee; thereby reducing the time spent on paperwork and sourcing a replacement.
“Optima also empowers ward managers to book bank staff themselves, circumventing the need to submit paperwork in advance.”
Ian Stiff, Payroll Manager, County Durham and Darlington NHS Foundation Trust
Furthermore, the temporary staffing module ensures staff are European Working Time Directive (EWTD) compliant, so ward managers can see who is working over 37.5 hours per week and if anyone is exceeding the 48 hours limit.
Simplifying payroll processes
Integrating Optima with ESR has been a great success. Entering the data from the 1,500 or so timesheets was a time consuming exercise. Data can now be retrieved from the wards and uploaded to ESR in a fraction of the time. Providing time sheets are correct, payroll is now 100% accurate and the number of queries has reduced significantly. It also benefited patient care; by taking the complexity out of payroll, senior nurses can free-up more time to spend on the wards. In addition, by giving the Trust real-time information on staff absences, managers can ensure wards are adequately staffed and shifts are allocated according to staff availability – which again is crucial to providing the best patient care possible.
“We will continue to improve and expand the use of Optima across existing and new departments. For example, were introducing a new skills strategy in the near future and we believe Optima will be a key solution to help manage staff competencies and training across the Trust.”
Glenys Curry, Associate Director of Nursing, County Durham and Darlington NHS Foundation Trust
Plans for the future
County Durham and Darlington NHS Foundation Trust plans to extend Optima further across the central management and planning operations, by rolling out RLDatix’s web based central performance dashboard, Roster Central, right across the Trust. Roster Central has key performance indicators that show the off-duty up to eight weeks in advance, so problem areas can be identified and rectified well in advance. Roster Central will be used to further monitor and manage annual leave ensuring even distribution throughout the year. Safe and even distribution of leave is paramount to maintain good quality care whilst also preventing unnecessary backfill costs. The ‘lean benefits’ of using Optima are currently being explored; saving managers time by optimising the processes and reducing administration, for example having real time access to monitor and report sickness has key benefits to reducing ward mangers time spent gathering this information thereby enabling them to spend as much as possible with patients. In addition, being able to create academic and skills profiles has provided the Trust with an academic profile of the nurses it employs and will be used to show academic gaps as nursing moves toward a graduate profession.
In summary, the Trust is continuing its modernisation programme and anticipates sustained benefits and savings from implementing e-Rostering throughout the organisation.
“RLDatix and CDD have worked in partnership over the last three years to develop the solution for mutual benefit. The Trust has taken an active role in both regional and national user groups for Optima, feeding back to RLDatix vital user information that is required to make ongoing improvements for the collective benefit of NHS Trusts”
