City Research & Enterprise Review 2011: Time is money - software to save the NHS millions
Research shows that electronic rostering could make inroads into the £150 million a year lost by the National Health Service (NHS) through workforce inefficiencies. Two Cass academics may have the solution.
Academics at City's Cass Business School have developed software that could be the Holy Grail in drawing up staff rotas for hospitals. The state-of-the-art electronic rostering (e-rostering) programme devised by Celia Glass, Professor of Operational Research, and Dr Roger Knight, Research Fellow, has the potential to save the health sector millions of pounds by improving use of resources, reducing reliance on costly agency staff and minimising the risk of fines for breaching legal requirements such as the European Working Time Directive (WTD).
NHS trusts with efficient e-rostering systems could each save around £500,000 a year, according to a study (E-Rostering and Workforce Management: How Healthcare Trusts Can Take £150M Out of Their Post- Election Cost Savings Targets, 2010. Available from: pac-online) by the market research and strategic consultants Pierre Audoin for SMART, a company that specialises in complex staff rostering. Yet 54 per cent of NHS trusts do not have such systems in place, the study found. NHS Direct and the Centre for Better Managed Health and Social Care at City University London have highlighted several ways in which Professor Glass and Dr Knight's software would make a positive contribution. These include more appropriate use of resources (saving time and money and improving patient care); more sensitivity to business and patient needs; enhanced staff morale; improved decision-making and better industrial relations.
Professor Glass and Dr Knight have created a tool that allows rosters for nurses and junior doctors to be drawn up in just a few minutes. To test it they took four widely publicised benchmark problems involving different numbers of nurses and shifts over different time spans and produced optimal rosters with the minimum number of undesirable shifts per employee. The software ensures shifts are fairly distributed and accommodates individual off-duty requests without the time-consuming "tinkering" associated with many existing e-rostering systems.
"The first thing about all this is that we can do it at all, scheduling efficiently without the need for agency staff, which is a very difficult problem. Additionally, the programme takes account of flexible contracts and holiday requirements,"
says Professor Glass, who draws on 30 years of experience in mathematical optimisation techniques and applications. Dr Knight has 25 years of experience in workforce management.
Professor Glass adds:
"The second thing is being able to accommodate personal preferences and human factors such as work design to ensure maximum fairness. It even goes down to the number of weekends worked so it's fair. Junior doctors are not usually even asked what work they want and there's a lot of interest at that level."
Dean Fathers, Director of the Centre for Better Managed Health and Social Care, says the system would help the NHS to save resources and to avoid hefty fines for non-compliance with regulations such as the WTD. Health sector employers are particularly vulnerable to litigation, given the long hours worked and the stressful conditions faced by many medical staff. Helen Young, Executive Clinical Director and Chief Nurse at NHS Direct, agrees that inefficient rostering systems - manual or electronic - can result in financial penalties and clinical safety issues, leaving the organisation and its executive team vulnerable to criticism and, ultimately, prosecution.
In a four-month trial of the software in the Accident and Emergency department at the Horton General Hospital in Oxfordshire, the e-rosters were able to accommodate almost all holiday requests and complied with the New Deal (a 1991 package of measures to improve the conditions for doctors in training, including - since August 2003 - a 56-hour limit on the working week), WTD and Health and Safety Executive guidelines. In the trial, the software - which so far remains unnamed - distributed fairly the number of hours worked, days on leave, weekends off and bank holidays. The number of consecutive night duties and consecutive days was noticeably reduced. Additionally, nobody worked a late shift followed by an early shift.
For more information on the software, contact Professor Celia Glass at