Why team-based rostering?
Timewise developed the team-based approach to counteract a
number of downsides in the current roster process. The first is that flexible
working arrangements are rationed to make the shift system work. This creates a
two-tier system with ‘special’ arrangements for a few, and flexibility
discouraged for everyone else.
More than in any other profession Timewise has worked in,
childcare tops the ‘hierarchy of needs’. Nurses with other reasons to want
flexibility are expected to be available in whatever pattern is left. The
result is a sense of unfairness and resentment.
In the team-based approach we
developed, all the needs of all nurses on the ward are considered. Producing
a fair rota is a collective responsibility, requiring cooperation across the
Measuring the impact
post surveys of participants showed that the proportion of nurses who:
- felt their work-life preferences were being met
went up from 39% to 51%
highly on amount of input they
have into rosters went up from 14% to 26%.
- felt they had a strong sense of collective
responsibility improved from 16% to 36%.
The costs of implementing this approach (training time, and
the increased time to put the roster together) need to be set against these
Overall, we are cautiously positive about the results of
this pilot. Our key conclusions are:
- The approach has three main benefits: better
meeting nurses’ work-life preferences; increasing nurses’ input into rosters;
and improving collective responsibility.
- Distributing responsibility among a lead team
also improves the quality of the conversations about work-life balance.
- There are costs attached – upfront training time
and an increased time for a team to put the roster together (compared to the
time of a single roster-creator).
- Ward managers play the key role in making the
approach work. Implementation is much smoother where ward managers are willing
to step back and delegate responsibility.
- Lead team members need to be chosen carefully,
to ensure they have the right skills.
The report makes three key policy recommendations for the
- For NHS Trusts to scale up the team-based approach as part of shared governance initiatives. NHS professionals can request the Timewise ‘how-to’ guide that resulted from the pilot, by emailing firstname.lastname@example.org.
- For policy makers such as NHS E/I to provide better definition of what flexible working means in a rostered environment, and better guidance on how to build work-life balance for all nurses into the roster.
- For NHS Trusts to develop better training and guidance on e-rostering for work-life balance.
Published September 2019
Download full research report