Nursing & Midwifery Workload and Workforce Planning

1. Nursing & Midwifery Workload and Workforce Planning Planning and Managing Staff Resources

2. Rostering affects: • patient care • Budgets • Staff morale/ wellbeing • Rostering requires skills in: • planning • knowledge of expected workload activity • knowledge of patient care • collaboration • communication A roster for nursing and midwifery staff is a plan showing on and off duty periods for staff within a defined area such as a ward or community locality. The plan should reflect the peaks and troughs of expected workload, ensuring staff are available at the times they are required

3. Methods • self rostering • computerised rostering (e-roster) • rotational roster • manual off duty

4. Principles of Rostering Whatever method is used however, the following principles should apply: the rota should be available to staff at least four weeks in advance and modified to take into account unexpected events methods of rostering and shift patterns should be reviewed regularly the rota should be kept as a legal document as it shows who was working when rota and shift patterns should reflect European Work Time Directives which should be incorporated into hospital policies

5. Rostering Protocols Rosteringshould be supported by clear protocols to guide decision-making. Such protocols should include rules about: minimum and maximum skill levels minimum and maximum staffing numbers procedures to be followed in the event of unplanned absences procedures for the use of bank and agency staff maintenance records audit requirements length of shifts nature of individual’s shift patterns

6. Why Modernise our Rostering Practices? • Social Change: • society demands greater efficiency • increased patient choice in the health care system • public more informed • Political and Professional Change: • recent policy documents • Workforce change: • staff want greater flexibility and ‘work/life balance’ is becoming more important • improved working conditions • greater involvement in decisions which affect them

7. Why Modernise our Rostering Practices? (2) • Technological Change: • IT gives opportunity to modernise • Organisational Change: • SCNs, SCMs & TLs to become more strategic • drive for greater empowerment of workforce • need to proceed on a partnership basis

8. Building an Effective Roster The principles of accountability in rostering according to the Office for Health Management (2003) are: • patient and service needs come first • involve staff as much as possible • consider staff competence • be fair and flexible • agreeing for one person sets a precedent • think twice • communicate verbally and in writing • then communicate again!

9. Framework For Building An Effective Roster • Matching demand with an appropriate supply of nurses • Allocating a unit’s budgeted WTE • Determining and allocating a suitable mix of competency and experience

10. Building An Effective Roster • To roster an appropriate number of staff you will need to be aware of: • WTE establishment for your ward / department • predicted absence allowance (22.5%) Indicative breakdown: • 14.5% annual leave • 4% sickness • 1% maternity leave • 2% study leave • 1% other annual leave • the numbers and skill mix of staff required to meet workload ‘peaks and troughs’ throughout the day and / or across the week • local protocols / guidance

11. Planned Time Out and Absenteeism • difficult to estimate accurately • nationally agreed minimum predicted absence allowance of 22.5% built into in patient staffing budget • unplanned absences through employee sickness disrupt service provision and increases costs of providing services • patterns may indicate that there are aspects of the working environment that require management attention • HR employment policies

12. Use of Agency and Bank Staff The Nationally Co-ordinated Nurse Bank Arrangement: Report and Action Plan (SEHD, 2005c): • analysed the pattern of usage of bank nurses • NHS boards should set targets on an annual basis to reduce the proportion of complementary staff utilised from agency as a percentage of the total nurse staff deployment • ensure policies and procedures are in place A Good Practice Guide in the Use of Supplementary Staffing (Scottish Government, 2007c): • highlights the organisational policies and responsibilities of those who manage the nurse/midwife staffing resource • provides rationale and means of assessing the ward, care setting or organisational position