Case studies
At Zircadian we understand the issues trusts face in deploying their hospital doctors compliantly and cost-effectively. We can ease this process for you.
North Bristol NHS Trust (2)
Workforce planning by Zircadian leads to successful business case for additional staff
Background
In September 2008, the Plastic Surgery Department at North Bristol NHS Trust asked Zircadian for advice on their SpR rota, and for assistance with workforce planning in this group.
The Challenge
The SpR rota had recently converted from a traditional on-call rota to a hybrid shift system, due to compliance problems with the New Deal requirement for five hours uninterrupted rest at night. This had further reduced the daytime availability of the SpRs for service and training, because rather than simply having half a day off duty after each on-call, the SpRs are now away from daytime service for a whole week when working a week of nights. There were already severe problems covering clinical sessions as required by the service, and these problems were anticipated to become even worse with the introduction of the WTD and its limit of 48 hours a week in August 2009.
The department had established service requirements for the SpR group by counting the number of sessions (clinics and operating lists) that a middle grade doctor was required for, on each weekday morning and each weekday afternoon. SpR grade doctors or equivalents are the only staff group that can provide the level of speciality expertise necessary, and it was accepted by the trust that neither the plastic surgery SHO group nor any other staff group would be able to do SpR-level work in this tertiary speciality.
The problem then lay in covering the numbers of sessions required for service delivery into numbers of SpRs to be employed on the rota, taking into account annual leave, study leave and bank holiday absences in the SpR group. The matter was further complicated by contributions to daytime service requirements by 1.6 WTE non-training grade doctors, who worked on particular weekdays only.
The Solution
Zircadian assisted the trust's medical staffing department in calculating average WTE absence through planned leave for each day, and then used Zircadian's e-Rota software to model various rotas with increasing numbers of doctors. This resulted in a clear business case for adding another three doctors to the existing group of 10 doctors with immediate effect, and in the recommendation to employ a 14th doctor, if possible in a daytime contract only, for WTD compliance in August 2009. The paper included an analysis of the financial impact in all options (the cost of the additional posts can be partially offset by pay-banding savings, if the rota group consists of 13 or more doctors).
The Benefits
The business case was convincing, and was swiftly accepted by trust management. Finance was agreed for the additional posts, and the department is now recruiting. The department is looking forward to having its clinical sessions covered appropriately as soon as the additional doctors start work, and there is now a WTD compliance plan in place that will obviate the need for any more work on this rota and WTD compliance in 2009.
Zircadian's expertise in consultancy work and their MRM software helped us to prove middle grade workforce requirements in our plastic surgery department to our managers. Zircadian wrote an excellent business case for us that made the discussion with our managers a lot easier. This paper was successful in getting agreement from our trust to fund three additional SpR posts immediately, and another post as from August 2009 for WTD compliance.
Mr Sherif Wilson, Consultant Plastic Surgeon, Frenchay Hospital, North Bristol NHS Trust