Exhibition appearance for radical approach to staff rosters in the Emergency Services

Date: Wednesday 19 April 2006

Working time and scheduling experts from Working Time Solutions Ltd will reveal the technology that is helping to revolutionise East Midlands Ambulance Service NHS Trust at this year’s AMBEX Conference & Exhibition.

Working Time Solutions (WTS) has developed a radical new approach to calculating the working hours of emergency service staff at East Midlands Ambulance Service (EMAS).

Now the work WTS has done with EMAS looks set to revolutionise the staffing method of emergency services across Britain.

Its experts will be at the show in Harrogate from Wednesday June 28 to Friday June 30 (Hall A, Stand 19a) with critical advice and solutions to improve efficiency and service provision by improving staff planning.

The Manchester-based company has helped EMAS slash overtime, and brought the working week in line with the Agenda for Change 37.5 hours target.

EMAS is the largest provincial ambulance service in the country, and bosses faced a major challenge of reform. Ambulance staff had been working an average of between 39 and 42-hours per week, but an investigation into its emergency service workload demand revealed the centrally-produced shift patterns to be inflexible and inefficient, unable to simultaneously meet the needs of staff, the organisation and the ever-changing demand profiles.

WTS was given the task of reforming its working hours system and carried out a review of the potential for, and benefits of, demand-led rostering in the organisation. It provided EMAS a new perspective for its scheduling situation and objectives for reform.

The new system needed to be more flexible than the traditional approach of roster planning, giving staff definate shift breaks while working, and reducing the reliance on overtime and relief staff. Staff also required acceptable levels of time off and flexibility, but ultimately the new rosters needed to improve service provision.

Paul St Clair, Assistant Director (Operational Support) at EMAS, is delighted with the approach, which will be fully rolled out to its paramedic service by the end of April. The system will be rolled out to other parts of the organisation once this first phase is complete.

He said: “We are aware that other ambulance services are very interested in what we are doing because it is such a pioneering move.

“We recognised the fact that demand on services had changed and shifted over the years, and a complete rethink was needed to ensure we continued to provide the best possible service.

“We introduced the system in December last year and the benefits are just starting to show. It will be another month before we can see the full effect of the investment, but we are very pleased with it so far.

“WTS has provided a tool that allows us to match demand to resources, allowing us to move with Agenda for Change.”

He added: “The system has enabled us to move to self-managed rosters and feedback from members of staff using this facility has been very positive. Once they understood the concept they were willing to give it a go, and are pleased with the initial results.

“In simple terms, the system gives them a set number of contracted hours and finds solutions to managing that time to fit around them and their leisure time requirements.

“There are a lot of benefits all round with this system.”

Maurice Haslam, UNISON representative at EMAS, added: “The advantage of the system is that you can plan time off on an annual basis, so you know well in advance when your longer breaks are going to be.

“There is also much more flexibility to swap shifts and holiday time.

“Of course such a large change is going to meet with some teething problems, but I can see the advantages to the system, which is far less rigid than the traditional method of rostering.”

From December 2004, EMAS was required to implement new ways of working under the Government’s national Agenda for Change (A4C) programme, and redesign employee roles to increase the focus on patient need and service delivery.

It began an investigation into its emergency service workload demand, to identify trends and evaluate the efficiency of its current shift patterns, and create a reduced working week of 37.5 hours for employees, with regular, unpaid, meal breaks within shifts.

Kevin White from WTS explained: “Each station was required to be on stand-by 24 hours a day, seven days a week, but had different, local operational demand profiles.

“Staff were under-utilised during slack periods, but periods of high activity meant that meal breaks were often missed, or, service levels declined at these times, and, due to the nature of emergency calls, staff often experienced an unequal work-life balance.

“Daily, weekly and seasonal variations in demand occurred, but the rostered labour supply remained largely unchanged in comparison.

“Insufficient cover was especially a problem on Friday and Saturday nights, and Sunday afternoons and evenings. Staff sickness, holidays, training or other reasons for absence, meant that overall, the lack of employee capacity was increasing labour costs in terms of overtime and relief staff, as well as having a detrimental effect on patient service levels.

“Conversely however, at certain times, an overstaffing issue was also identified.”

EMAS faced a major challenge of reform to satisfy staff, patient and organisational expectations, and it required a rostering tool and method dynamic enough to be able to allocate staff based on predicted demand and make provision for unexpected variations and staff requests.

Requirements of the new system were:

• To reorganise all A&E rosters to match current demand profiles
• To ensure staff work rosters based on 37.5 hrs per week, were in line with A4C terms and conditions
• To improve capacity at key times of the day to improve performance target delivery
• To accommodate, and effectively utilise, 300 additional staff within the new rosters
• To enable staff to influence the final design of the roster pattern, in line with resource requirements
• To promote more flexibility around staff’s working time commitments
• To encourage a team-based approach and accountability for roster planning and delivery

An important element of the reform process for EMAS was the need to improve staff satisfaction and motivation.

Essential consultation with trade union officials introduced the system to staff, and has given them more flexibility in their working hours.

They also have less shifts to work per year, and self-managed rosters have been introduced at a local level.

Paramedic team leaders now manage shift patterns and the allocation and monitoring of shifts, per station.

Team members have flexibility regarding which shifts they work, and colleagues can also ‘trade’ between three and five shifts with each other, and work these hours either in advance or arrears to achieve additional time off, such as for a holiday.

Staff have been given the option to retain a managed rota, and a number of stations have taken this option. However, their rosters still correspond with the demand patterns and meet the A4C target of 37.5 hours per week, and in consequence, EMAS has been able to operate with both systems, complementing each other to deliver a more dynamic cover level.

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