Why does the NHS not use e-rostering?

 Deborah Tarrant provides her views on why e-rostering has not yet taken off and why it should be an issue on HR directors’ agendas.

 
HPMA President Deborah Tarrant recently joined colleagues for a Health Service Journal roundtable to explore how better rostering could reduce the NHS’s swelling temporary staffing bill. It followed on from HSJ’s Clinical Workforce Investigation, which called on organisations to rapidly embrace and adopt e-rostering solutions as a means of better workforce planning.
 
In an article based on the roundtable which appeared in the HSJ on 8 June entitled ‘Is the NHS ready to roster?’, Deborah couldn’t help but recall a meeting she’d had in the early 2000s. The subject: rapidly implementing an e-rostering system across London. It was a recollection which underscored just how slow progress has been on such systems. Arguments about the benefits are well known, and have recently been given prominence by the Carter review.
 
The idea of better managing which staff are required when, and linking such management to patient need, is a clearly attractive one. In the current context, the related potential to reduce dependence on temporary staff is also highly appealing.
 
So just why has the NHS failed to consistently implement and capitalise on e-rostering?
 
“For me, it always comes down to leadership and people management,” said Ms Tarrant.
“Without that, it doesn’t matter what solutions you have, there’s no follow through, there’s no embedding, there’s no sharing. I think you have to have those structures and systems and performance management.”
 
In thinking back to the e-rostering pilot at her trust in the early 2000s, she explained there was one area in which the system had worked well and two where it didn’t. “And why was that? Because the trust didn’t say this is really important, this will make the difference. It wasn’t followed through with the investment, the systems, the support to people, and they went back to using paper.”
 
Deborah felt, used properly, e-rostering could be a means for supporting such flexibility. “If we talk about junior doctors, how difficult do we make their lives? They don’t get sight of the rota. But if we talk about a rostering system where people can be electronically notified by text, that gives them huge flexibility, that they could text back a change in something, that the system picked it up, made sure that the rota was right because of the acuity that real time was on the ward.
 
“And the modern generation, that’s what they’re used to doing. They’re used to getting on their smartphone and texting something and arranging it.”
 
Flexibility was a theme returned to multiple times during the debate, in large part because it was felt the lack of it in permanent posts explained the swelling temporary staffing workforce.
 
The lack of leadership is absolutely key to the problem, Deborah believes. “Part of the reason [that in the NHS] we start an initiative once and then come back to it, and then come back to it again – and it could be any initiative – is because it seems to me in the NHS that money drives actions. So when there’s a crisis, when there’s a problem, all the solutions are thrown up again. And then the system changes, the system gets confused by all the structural change, we never can follow through, then there’s a different policy or a different practice.
 
“So it was a crisis, we threw a tool at it, it didn’t quite work because we didn’t give the
human factor, we didn’t get people to engage and understand it and see how it could be good for them, and we didn’t have the leadership to follow it through.”
 
To read the article in full, please visit www.hsj.co.uk