Increased efficiency through better rostering of staff – (how Countess of Chester is contributing to planned NHS savings of £5 billion).

The Countess of Chester Hospital NHS Foundation Trust comprises a district General Hospital in Chester and a smaller facility at Ellesmere Port.

It has a staff of almost 4,000 and provides a range of medical services to patients in Western Cheshire, Ellesmere Port, Neston and North Wales. The Trust has an excellent reputation for providing high quality care and is nationally accredited at the highest level in many areas, in particular those relating to clinical outcomes and patient safety. It was rated as ‘good’ by the Care Quality Commission following inspection in 2016.

The effective use of staff is a critical component of the Trust’s ability to serve patients and remain within evermore challenging financial constraints. Collinson Grant was asked to support the implementation of the Trust’s programme to be The Model Hospital, advocated in Lord Carter’s review of efficiency.  Our work centred on working alongside the newly formed E Roster team to:

• test rostering practice and processes, and help to create a new rostering policy and practice document
• design benchmarks for Care Hours Per Patient Day throughout the Trust and help to develop a new ‘Countess Acuity Tool’
• support the review of flexible working and shift patterns; and analyse bank and agency hours
• help to create the Benefits Realisation Plan, which describes cost reduction targets and objectives for improving services
• support the development of The Model Hospital plan, which incorporates a HealthRoster system.

The work revealed some striking opportunities to reduce overall staff costs by using nursing and Medical Locum staff supplied by agencies more efficiently; by organising shift patterns and flexible working requests better; and by managing absence and sickness levels more effectively. The potential savings from these initiatives were in the range of up to 15% – 40% in each cost category.

The Trust now has a roster policy and practice document that is fit for purpose. It is using the new ‘Countess Acuity Tool’, which calculates care hours per patient day and matches staff numbers to patient requirements via SafeCare.  Standard shift patterns and formal flexible working requests will help to reduce bank and agency expenditure, which in turn will significantly reduce costs.

A Benefits Realisation Plan provides a clear set of objectives and targets that the Trust will use to measure cost reduction and improvements in quality of care as the new rostering process and HealthRoster are introduced. The rostering survey has given the Trust a set of data it can use to monitor and review improvements to rostering practice.