We’re now at a particularly exciting point in our FlexAbility in Nursing project, a piece of action research into how flexible working could bring about the change the profession needs.
Having explored the issues with the existing system, and subsequently identified team-based rostering as the preferred approach, we’re now part-way through the pilot stage. Our team have been working with over 100 staff across three wards at Birmingham Women & Children’s Hospital to build their first rosters.
Team-based rostering has already been shown to work in a number of similar sectors, such as social care, but the need to have a fully staffed ward at all times required a bespoke approach for nursing.
We have therefore designed a new way of creating each roster, using a ‘lead team’ on each ward, each of whom represents a group of colleagues. The lead team members are responsible for liaising with their colleagues to populate a draft roster, based on individual preferences and requirements, and then collaborating with them further to negotiate an agreed version.
Our aim was that the new system would create much higher engagement from individual team members, and that has proved to be the case. Personal communication about work-life needs and preferences is more adaptable than the previous system of requests being input into a ‘system’ each month.
The feedback we’ve received so far is that individual nurses feel empowered by their ability to get involved, and are taking more responsibility for managing any changes. For example, one ward manager told us:
“I got a text this week saying ‘I need to change my shift, but don’t worry, I’ve already done it.’ Before, this request would have come through to me to sort out; instead, the nurse has worked with her team to find a solution. That’s a great result.”
The pilot has also indicated that the nursing staff see team-based rostering as a fairer system which gives everyone a chance to have some flexibility in their schedules, rather than just those on formal flexible working arrangements (FWAs) which are often only granted to those with childcare responsibilities.
For example, one junior sister explained that, under the previous system, she ended up taking on a disproportionate amount of unpopular shifts, because she didn’t have any specific caring responsibilities or a FWA.
The new system has created an understanding that everyone has to take their fair share of the less popular shifts, and that other responsibilities and preferences (such as being a Brownie leader, taking care of one’s own health, or attending a weekly class) are equally valid.
A third major benefit of the new system is that people have grasped how complicated it is to put a nursing roster together. As a result of working as a team to find the best solution, the nurses now appreciate the effort required to account for all the skills mixes and working requests, and are more prepared to be flexible themselves.
However, as we expected, the pilot has also highlighted some challenges which we need to address as we move forward to the next stage. These include:
In most cases, the lead team members didn’t have any previous experience in leading 1:1 conversations, and were unsure about how to discuss work-life balance and working preferences. Some felt they just needed to write down the shifts people wanted rather than having a dialogue. Others weren’t sure how to handle talking to their colleagues about their personal circumstances.
As a result, we’ve been spending individual time with lead team members who need support to develop these skills, and role playing conversations they can have as they negotiate their next roster.
There were real differences in the length of time that lead team members took to create the draft roster, ranging from 30 minutes to three hours.
This time will reduce as the nurses become more proficient at using the roster technology, but for the future pilots, we plan to incorporate additional training on the most efficient way to create a roster, prior to the first ones being built.
For some groups, such as clinical support workers, who work in small teams which don’t tend to overlap, it was difficult for lead team members to get face to face time with their colleagues to discuss their preferences.
For the purposes of the first pilot, this was tackled using technology such as WhatsApp, and by fitting in meetings just before or just after their shifts. However, we will talk to the team about alternative ways to manage this issue before the next stage.
Some of the participants took a while to understand the collective nature of team-based rostering – that is, it isn’t just about what you want, but about working as a team for the best overall outcome.
We’ve tackled this by making sure we restate the principles throughout the process, and working particularly closely with individuals who are more resistant to change.
The pilot runs until June, and will cover the creation of four rosters for our three wards. We will continue to measure the impact of the new system, using a range of data, and to assess and refine our approach. We will then make final recommendations for a second round of pilots at Nottingham University Hospital and University Hospital Southampton, which are due to start in the summer.
We’re delighted with the progress that we’re making, and the lessons we’re learning from this project; we can already see the potential for building a fairer, more sustainable system that will help tackle the shortages in the nursing sector. We’ll continue to share our findings with you at every stage.
To find out more about the innovative research opportunities we offer, contact info@timewise.co.uk or call 020 7633 4444.
Published March 2018
