Case studies

Background

East Lancashire NHS Trust needed to redesign their junior doctors’ rotas to achieve Working Time Directive 2009 compliance (WTD) by August 2008, a year early as required by the North West Strategic Health Authority.

 

The Challenge

The trust employs 453 junior doctors on 41 different rotas. In January 2008 it identified that 32 of these rotas did not comply with the WTD. Given the tight deadline set by the SHA, and the scale of the task, the trust felt that it required Zircadian’s assistance to find the right solution.

 

The Solution

Zircadian organised meetings with trust managers, consultants and junior doctors from all departments to confirm existing working arrangements. From this the ‘gap’ to WTD compliance was clarified and new, compliant rotas developed that addressed concerns regarding education and training, service delivery and patient safety.

 

In many cases, simple re-design of rotas into more doctor-friendly versions was enough. On some understaffed rotas additional doctors were required if the service and training was to continue unaffected. 14 additional posts (3% clinical staff) were needed at an anticipated annual cost of £750,000. However, as all 41 rotas had been examined for appropriate pay-banding, savings amounting to £450,000 were also identified. A further £127,000 of potential savings were identified in posts where higher than expected band payments had been argued as essential in attracting applicants (histopathology trainees).

 

The Benefits

• project completed in 3 months, on time and under budget
• comprehensive and accurate understanding of the junior doctor workload based on audit of existing rotas
• ‘inclusive’ approach to new rota design resulting in more sustainable solutions
• transparent business case for recruitment of additional doctors based on needs of service and training
• clear project plan to achieve 100% WTD compliance by August 2008
• significant time saving for medical staffing department