Nursing and Midwifery Workload and Workforce Planning
Nursing & Midwifery Workload and Workforce
Planning
Planning and Managing Staff Resources
Quality Education for a healthier Scotland
Nursing and Midwifery Workload and Workforce Planning
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
• Rostering affects:
– patient care
– Budgets
– Staff morale/ wellbeing
• Rostering requires skills in:
– planning
– knowledge of expected
workload activity
– knowledge of patient care
– collaboration
– communication
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Nursing and Midwifery Workload and Workforce Planning
Methods
• self rostering
• computerised rostering (e-roster)
• rotational roster
• manual off duty
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Nursing and Midwifery Workload and Workforce Planning
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
Quality Education for a healthier Scotland
Nursing and Midwifery Workload and Workforce Planning
Rostering Protocols
Rostering should 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
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Nursing and Midwifery Workload and Workforce Planning
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
Quality Education for a healthier Scotland
Nursing and Midwifery Workload and Workforce Planning
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
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Nursing and Midwifery Workload and Workforce Planning
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!
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Nursing and Midwifery Workload and Workforce Planning
Framework For Building An
Effective Roster
1. Matching demand with an appropriate supply of
nurses
2. Allocating a unit’s budgeted WTE
3. Determining and allocating a suitable mix of
competency and experience
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Nursing and Midwifery Workload and Workforce Planning
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
•
•
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Nursing and Midwifery Workload and Workforce Planning
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
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Nursing and Midwifery Workload and Workforce Planning
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
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