Lord Carter believes up to £2bn in savings could be delivered across the NHS by improving workflow and containing workforce costs. This can be achieved by “promoting the use of e-rostering systems and the adoption of best practice roster policy”. (Review of Operational Productivity in NHS Providers- Interim Report). An e-rostering system is a complex web based application that automates the shifts of hundreds of employees across multiple locations, with rosters being created and published in minutes.
Over the last ten years, exponential growth in technology has allowed developers to create highly advanced and incredibly fast web applications; the ability to “drag and drop” an object is now common place for example. Unfortunately, the majority of NHS organisations still use Internet Explorer 8 (IE8) as their main web browser, and I have recently seen the need for applications to run on IE6. The issue with these browsers is they are slow, do not support the advanced features that modern browsers support and they pose a security risk. IE8 was created in 2009 and, as of this year, Microsoft no longer provides technical support or security updates for this browser. IE6 has been around since 2001 and has frequently been referred to as one of the “worst tech products of all time”. It is infamous for its complete lack of security and big websites, such as YouTube, do not support it any more.
With this lack of internet security, how has the NHS survived so long without a major breach? Sensibly, the NHS IT infrastructure operates within a closed environment under the protection of the N3 Gateway. However, by failing to upgrade the internal operating systems, it can be difficult to promote the use of applications, such as e-rostering systems, to reduce costs. To give you an idea of this, asking for an e-rostering application to run on IE6 is like asking for a mobile app that will work on a Nokia phone from 2001. For most technology providers, developing applications to run on these outdated browsers is simply too complicated and too costly.
Clarity already supplies workforce management technology to NHS trusts which allows them to manage bank and agency staffing more cost effectively. Thus, we understand the challenges faced when deploying applications to production environments across all internet browsers, old and new.
For us, developing an e-rostering system is the perfect addition to our product offering for the NHS. To give you some insight as to how this system would automatically roster a trust unit, it would need to take into account variables such as:
- The rules laid down by the European Working Time Directive (EWTD) that govern the working hours and rest periods for staff
- Trust policy rules
- Staff annual leave
- Staff contracted hours
- Shift patterns
- Part time workers
- Time off in lieu (TOIL)
- Seasonal holiday periods = increased demand for annual leave requests
- Bank holidays, with enhanced pay, could attract higher demand from staff to work
- New employees
- Emergencies will happen that require staff to be redeployed
- Bank shifts
- Patient safety will always require a specific skill mix to be present at all times
E-rostering systems allow the staff that normally create the roster to be freed up and provide clinical care rather than spending hours creating a paper based roster. E-rostering systems should be auditable to aid governance both clinically and financially and be able to take into account all staff requests to keep the roster fair.
To pursue such large cost savings using complex technology requires the NHS to invest in their IT infrastructure in order to host the complex technology.