Radical approach to staff rosters for businesses using shift work

THE roll out of a radical new approach to calculating the working hours of staff at East Midlands Ambulance Service NHS Trust (EMAS) could revolutionise staffing for emergency services and businesses using rotating shifts.

EMAS is the largest rural ambulance service in the country, operating 38 ambulance stations in an area of over 2700 square miles, serving almost 3 million people.

It has introduced a revolutionary system that will bring the working week down to the Governmentís 37.5 hours target.

Now emergency service bosses, and heads of human resources departments, are watching EMAS with interest.

Ambulance staff were working an average of between 39 and 42-hours per week, but results of an investigation into the efficiency and effectiveness of the shift patterns meant a radical rethink was needed.

The compulsory introduction of a 37.5 hours working week provided EMAS with the opportunity to identify and establish the core staffing resource necessary to maintain and improve patient service levels, factoring in regular shift breaks and the need to reduce reliance on overtime and relief staff.

Manchester based Working Time Solutions Limited, (WTS), was given the task of reforming the working hours system. It carried out a review of the potential for, and benefits of, demand-led working time in the organisation and provided EMAS with a new perspective for its given scheduling situation and objectives for reform.

The new system needed to be more flexible than the traditional approach to working out rotas ñ giving staff acceptable time off and flexibility, but ultimately improving service provision.

Paul St Clair, Assistant Director (Operational Support) at EMAS, is delighted with the approach, which will be fully rolled out by the end of April.

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

ìWe 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.

ìWe 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.

ìWTS has provided a tool that allows us to match demand to resources, allowing us to move with Agenda for Change.î

He added: ìThe feedback from members of staff on the self rostering has been very positive. Once they understood the concept they were willing to give it a go, and are pleased with the initial results.

ìIn 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.

ìThere are a lot of benefits all round with this system.î

Maurice Haslam, UNISON representative at EMAS, added: ìThe 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.

ìThere is also much more flexibility within the system to swap shifts and holiday time.

ìOf 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.î

From December 2004, EMAS was required to implement new ways of working under the Governmentís 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: ìEach station was required to be on stand-by 24 hours a day, seven days a week, but had different, local operational demand profiles.

ìThere was dissatisfaction with the centrally-produced rosters, being inflexible and unable to simultaneously meet the needs of staff, the organisation and the ever-changing demand profiles.

ìStaff 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.

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

ìInsufficient 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.

ìConversely however, at certain times, an overstaffing issue was also identified.î

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, in line with A4C terms and conditions

Improve capacity at key times of the day to improve performance target delivery

Accommodate, and effectively utilise, 300 additional staff within the new rosters

Staff to influence the final design of the roster pattern, in line with resource requirements

Promote more flexibility around staffís working time commitments

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 ëtradeí 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.

For more information about the system visit www.workingtime-solutions.com or phone WTS on 0161 929 3333.