Jackie Beaumont Senior Workforce Consultant

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Jackie BeaumontSenior Workforce Consultant

• 10 Key Enablers for EWTD compliance

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Working Time Directive 200910 Key Enablers for
WTD Compliance

• Jacky Beaumont
• Senior Workforce Consultant

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National WTD 2009 Project2006 2007 Workstreams

• Research- Based Assessment involving 34 Hospital
  Trusts across England, undertaken during
  2005/2006.
• Diagnostic Assessment Tool identifying 10 key
  practices which increases the likelihood of
  achieving EWTD 2009 compliance.
• Diagnostic Assessment involving in-depth criteria
  based assessment of 11 hospital Trusts using the
  diagnostic tool to better inform what action
  needs to be taken to move towards EWTD 2009
  compliance, undertaken during 2006/2007.

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Research- Based Assessment

• Burton
• Chelsea Westminster
• Essex Rivers
• Hillingdon
• Norfolk Norwich
• Northumbria
• Royal Berkshire Battle
• Royal Cornwall
• Salford Royal
• South Tees
• West Suffolk
• Calderdale Huddersfield
• East Kent
• Frimley Park
• North Staffs
• Portsmouth
• Doncaster Bassetlaw
• Homerton
• North Middlesex

• Poole
• Royal Bournemouth Christchurch
• Royal United Bath
• Salisbury
• Royal Brompton Harefield
• Royal Wolverhampton
• South Tyne Wear
• United Lincolnshire
• St Georges Tooting
• York
• East Sussex
• Hereford
• Morecambe Bay
• Basildon
• Barnsley

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Diagnostic Assessment

• Northumbria
• Royal United Bath
• Salford Royal
• Sheffield Teaching Hospitals
• Royal Berkshire

• West Suffolk
• Frimley Park
• North Staffordshire
• Essex Rivers
• North Middlesex University Hospital
• Basildon University Hospital

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Benefits Realised

• Raised the profile of EWTD 2009 within Trusts
• Focussed where action was required
• Brought an external perspective
• Energised Trusts to deal with achieving
  compliance
• Produced strengthened Leadership
• Lead to more comprehensive examination of areas
  of non compliance
• Brought improvements in governance through
  establishment of project steering groups
• Resulted in active management of change required
  through development of implementation strategies
  approved at a Board level
• Contributed to Trusts achieving a higher average
  increase in compliance when compared with the
  national average

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National WTD 2009 Project2008 2009 Work
streams

• Intensive Targeted Support
• Offered to 20 Trusts
• Delivered between April 2008 and April 2009
• Purpose
• To support Trusts, through a process of
  diagnostic assessment and options appraisal, to
  develop and implement plans for EWTD 2009
  compliance.

• Streamlined Targeted Support
• Offered to 15 Trusts
• Delivered between June 2008 and May 2009
• Purpose
• To provide focused support to Trusts to enable
  them to develop options for compliance within
  specific areas.

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Targeted Support

• Intensive Targeted Support
• Princess Alexandra
• Central Manchester Manchester Childrens
  Hospital
• Trafford
• Mid Essex
• Doncaster Bassetlaw
• Whipps Cross
• Barking, Havering and Redbridge
• Coventry Warwickshire
• Portsmouth
• Bristol
• Newcastle
• United Lincolnshire
• Ealing
• Buckinghamshire
• East and North Herts

• Streamlined Targeted Support
• Royal United Bath
• Salisbury
• City Hospital Sunderland
• Tameside
• Ipswich
• North Tees Hartlepool
• Cambridge PCT
• Taunton Somerset
• Epsom St Helier
• Kingston
• Weston
• Peterborough Stamford
• Oxford Radcliffe
• South West Midlands Newborn Network
• George Eliot
• Poole
• West Herts

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Diagnostic Assessment
10 Key Enablers that Increase the Likelihood of
Achieving WTD 2009
6. Technological Solutions 7.
Service Redesign 8. Workforce Plan
9. Finance 10. Communications

• Leadership
• Management of Change
• Rota Design
• New Ways of Working
• Training Development

Phase 2 Diagnostic Assessment
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Key Enablers 1. Leadership

• There is real Leadership Commitment at a Board,
  Directorate and specialty level.
• You can
• Present the facts to the Board and Directorate
  teams
• Legal requirements
• Enforcement and penalties
• Junior doctor hours that will be lost
• Release of funding through banding changes

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Key Enablers 2. Management of Change

• Change required to deliver WTD 2009 is
  Quantified, Integrated, Managed and Monitored .
• You can
• Develop a directorate team approach
• Set-up a project framework that identifies when
  directorates should have change proposals
  prepared
• Arrange for proposals to be shared and discussed
• Undertake a risk assessment to understand the
  impact of WTD on other aspects of organisational
  business

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Key Enablers 3. Rota Design

• Rotas are organised to achieve Safe, Sustainable
  and Compliant Working Patterns.
• You can
• Set-up a team approach to reviewing working
  patterns, understanding issues and developing
  solutions.
• Access resources from the healthcare workforce
  portal
• Use workload analysis tool
• Use an options appraisal approach
• Access the rota database on the portal
• Come to the Designing Rotas Workshops
• on 10th 12th or 24th February

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Key Enablers 4. New Ways of Working

• New ways of working, extended or supporting roles
  are introduced to provide Sustainable Benefit and
  Contribute to WTD 2009 compliance.
• You can
• Introduce/review your H_at_N model of working using
  the H_at_N resources available
• Review the contribution of existing new and
• extended roles
• Consider the contribution of extended
• consultant working
• Utilise the workload analysis tool
• Access the healthcare workforce portal for
• the new roles micro site showcasing
• anaesthetics and theatre paediatrics
• obstetrics gynaecology medicine surgery.

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Key Enablers 5. Training and Development

• Training and Educational Needs are Factored in to
  solutions that are developed.
• You can
• Ensure the involvement of Clinical Tutors with
• reviewing rota design
• Look at opportunities for increased e-learning
• Ensure appropriateness of junior doctor duties
• Consider the Liberating Learning strategy on
  the
• COPmed website (www.copmed.org.uk)
• Consider the contribution of extended
• consultant working
• Separate elective and emergency care into
• modular blocks
• Duplicate structured training twice in a week to
• ensure all trainees can attend
• Arrange whole day teaching on a less frequent
  basis
• Rotate the day of teaching to maximise possible
  attendance

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Key Enablers 6. Technological Solutions

• Technological Solutions have been Implemented to
  support new ways of working and compliance.
• You can
• Access information on iBleep and electronic
  handover on the healthcare workforce portal
• Register for iBleep software
• Access information on Salisburys electronic
  handover
• Access information on Royal Bournemouth and
  Christchurchs implementing iBleep Project
• Extend use of DRS or RotaWorks for rota modelling

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Key Enablers 7. Service Redesign

• Plans for Service Redesign form part of the
  proposals for WTD compliance.
• You can
• Access and share information on pilot sites that
  have introduced 24/7 models of care including the
  Homerton Guys and St Thomass the Royal
  Liverpool, on the healthcare workforce portal
• Consider hot and cold site solutions
• Identify and progress network arrangements for
  those areas that will not achieve sustainable
  solutions in isolation
• Ask directorates to identify service redesign
  solutions for compliance

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Key Enablers 8. Workforce Plan

• Workforce requirements to achieve compliance are
  Identified and risk assessed.
• You can
• Pull together a consolidated workforce
  implications document based on the submissions
  from each
• Directorates options appraisal
• Ensure that it is costed
• Produce a workforce risk assessment based on
  cost, likelihood and lead time for recruitment
• Ensure across organisation and Board level
• engagement in agreeing the outcome.
• Adopt a planned approach to deliver the outcomes
• agreed

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Key Enablers 9. Finance

• The financial implications are Identified and
  managed.
• You can
• Ensure that the finance team or part of the
  process
• Ensure that the cost of existing rotas are
  clearly identified, together with monies that
  will be released from banding changes
• Ensure that banding changes are managed and
  tracked
• Ensure that the options appraisal process is
  supported by adequate financial information to
  enable robust decision making
• Have proposals for change ready to access the
  funding

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Key Enablers 10. Communication

• Changes required for WTD compliance are
  Communicated to Raise Awareness and there is
  genuine Staff Involvement to develop solutions.
  
• You can
• Use existing methods of communication to raise
  awareness about changes required for WTD 2009
  compliance
• Develop an intranet page for WTD where staff can
  access information on WTD and links to other
  sites
• Encourage a team approach within directorates to
  building solutions
• Develop a process to share information on
  proposals for change across the Trust.

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Remember

• The experience from other Trusts shows that
  there is unlikely to be just one solution for
  achieving WTD 2009 compliance within a Trust.
• Layers of solutions are much more likely.
• Some may need to be interim solutions with a
  slightly longer timeframe for a more sustainable
  solution.

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Contact Details
JACKY BEAUMONT
Jacky.beaumont_at_eoe.nhs.uk
07979801591
www.healthcareworkforce.nhs.uk/workingtimedirectiv
e.html
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Any Questions?