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Case Study – UCLH

University College London Hospitals NHS Foundation Trust (UCLH) had already brought in remote and hybrid working for office-based staff and were keen to offer flexibility to other areas as well, giving ward-based staff more control over their working patterns. Here’s how we supported them to successfully pilot self-rostering for 152 staff across four wards.


UCLH is a large teaching hospital, part of the Shelford Group, which has over 10,000 staff working across 10 London sites. The leadership team is keen to create a work environment in which staff feel valued, encouraged and supported, and as part of this, has sought to explore how to improve work-life balance.

The challenge

Like many organisations, UCLH implemented remote and hybrid working for office-based staff during and after the pandemic. However, there are unique operational constraints in some patient-facing and clinical areas, mainly wards and teams delivering 24-hour services. Hybrid working was not a viable flexible working option for ward staff and the leadership team felt it was important to find other ways to offer flexibility for these teams. This was reinforced by a survey in 2021, which revealed that 51% of staff felt they had a good balance between work and home life, and just 48% felt that UCLH was committed to helping them balance these two elements.

Following this feedback, UCLH launched a new flexible working policy in 2022, which offered a more proactive approach to flexible working. This included the implementation of a new electronic rostering system, which in turn opened up opportunities to explore innovative approaches for ward-based staff.

However, the team felt they needed to bolster local resources with dedicated external expertise to drive the project forward, including the support of someone with experience in delivery. A member of UCLH worked with Timewise on a previous project at another NHS Trust and approached us to provide support for the self-rostering project.

The solution

Our team worked with UCLH to pilot a self-rostering approach, which allows staff to select their preferred shift arrangements and days off. These requests build a draft roster, which is then reviewed and adjusted (if necessary) by the ward manager / senior nurse. On completion the roster is 1st level approved by the ward manager followed by a 2nd level approval by the matron. It gives staff more input and control into the shifts they work, and makes the rostering process easier, and quicker, for the ward managers.

We agreed to pilot this approach with four wards of varying sizes, which were spread across two sites, and represented different clinical divisions and ward size. Approximately 152 staff were involved.

The process

Working closely with the UCLH team, an integrated project team was created. We began with a research phase that looked at existing workforce data, and explored how the staff on the four wards were currently using the system. We then brought representatives from each ward together to work with us to design the pilot, setting out the principles and etiquette that would allow self-rostering to run smoothly.

We also sought to engage directly with the ward managers and matrons from each ward, knowing that they would be responsible for managing the new roster on a day-to-day basis, and for fielding questions about how to use it. And we created a range of resources for the UCLH intranet, which set out the parameters of the project, explained how to use the roster and answered common questions.

Having sought to get everyone on board, we then ran the pilot across the four wards for three months. Feedback was gathered through ward visits and surveys, and fed into a formal evaluation of the pilot, which could be used to steer a potential wider rollout.

Learnings and outcomes

We identified potential challenges before we began the pilot, such as the technology limitations, and the ‘first-come-first-served’ nature of the system being potentially contentious. However, the roster team provided the necessary training to ensure the rostering technology could be used effectively. The project team presented and communicated clearly the ‘etiquette’ involved in this new approach to rostering – encouraging staff to consider the impact of the shifts they were selecting on the wider team, by drawing on the Trust values. This helped mitigate these potential problems, none of which turned out to be issues during the pilot itself.

We did encounter some implementation challenges as the pilot developed. For example, although self-rostering should be used to book shifts or days off, some staff began using their allocations as a way to book time off work, instead of going through the annual leave process. Similarly, while each shift needed a senior nurse to select the nurse in charge shift some staff were not booking into these shifts. This impacted the overall shape of the roster and so the issues were addressed, and both of these were quickly overcome through conversations at a local level.

In terms of outcomes, we sought to evaluate how many staff were using the new roster approach to input their preferred shifts, and how many were approved. By the end of the pilot:

  • 60% of staff were using self-rostering – we know anecdotally that in some hospitals, the uptake for self-rostering is as low as 20%, so this is an excellent outcome.
  • Approval rates were at 86% – which demonstrates that staff understood the new approach and were able to use it successfully. This rate increased during the pilot, indicating that any misunderstandings about how to use the new system were dealt with swiftly and effectively.

Critically, this new way of rostering was used by all staff groups, though slightly less by the unregistered staff. Positively, the ward managers reported they saved time, due to a large proportion of the roster already being populated before they got involved and had fewer swap shift requests after roster publication.

The UCLH team provided a detailed evaluation of the pilot, and are considering their next steps, including a future rollout across the organisation. The four wards that were involved would all like to continue with self-rostering.

Advice for other organisations

Claire Stranack, HR Business Partner at UCLH, has this advice for anyone considering a similar project:

  • Make sure you get representatives from all wards involved in the process from the very beginning. Not only will it help them feel ownership of the project, but it will also help you identify potential problems and solutions before they arise.
  • Engagement with ward managers is key. They are the ones who have to say yes or no to the initial roster, and see the process through, so it’s important to have them as champions, and give them all the information they need to reassure staff, act as fairly as possible, and answer any questions.
  • Use as many different methods of communication as possible to make sure everyone involved understands what is happening and why. You need to reach people where they are, and cover all bases. We were really surprised, for example, by the high turnout at virtual briefing sessions.
  • Check in regularly during the pilot itself – this will help you pick up any issues early, so you have time to adapt your plans to match.

Inge Cordner, Lead Nurse for Nursing & Midwifery Workforce, has some additional suggestions from the frontline:

  • Pay attention to laying the foundation and be as detailed as possible. Make the objective clear, and ensure to communicate the purpose, the process, timelines and measures from the beginning. Be aware that no two areas are the same, so though you adhere to the principles of self-rostering, allow room for flexibility and adjustments throughout the process.
  • For self-rostering to work well, buy-in from the ward managers is central. It is important as Project Leads to be available to answer questions outside of project meetings, attend ward team meetings as necessary, and be physically available for the pilot areas. Know the roster dates and creation periods so you can reach out at critical times and respond and advise in a timely manner. I found that this showed that we were also fully invested and committed to the self-rostering initiative working.
  • Have a dedicated member of the rostering team as part of the project team and attending project meetings throughout. This helps with awareness of system capabilities, timely resolving of system issues or staff access and data extraction when analysing uptake etc.
  • Staff and their well-being remain a priority in providing patient care. Self-rostering provides a means for staff to have more control over scheduling and shows that the Trust is committed to supporting their work-life balance. It improves morale, nurtures team cooperation and generates a great team spirit!

The client’s view

Timewise brought a huge amount of experience and resources and supported us at every stage of the process. They acted as a critical friend, supporting and facilitating design and engagement sessions, and driving the project forward at a pace we could not have achieved alone. There is no way we could have delivered this pilot within this timescale without Timewise’s involvement.

Claire Stranack, Human Resources Business Partner at UCLH

Often working in the NHS we have so many competing priorities that you can often be pulled in many directions. Someone outside of that space, supporting with external expertise, as provided by Timewise, meant we were able to hit the ground running whilst being able to build our own organisational knowledge at the same time. The project was well managed and enabled us to use our time efficiently. Thank you, Amy!

Inge Cordner, Lead Nurse for Nursing & Midwifery Workforce, UCLH

Published June 2024

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