Good Rostering - an Impossible Dream?

Abstract

Objectives In 2018, the British Medical Association and NHS Employers jointly published the 'Good Rostering Guide'1 and yet, trainees consistently highlight the negative impact of rotas on their training and work-life balance in the annual London School of Paediatrics' trainee survey (figure 1). More widely, the King's Fund data shows the number of NHS staff leaving the profession due to burnout and poor work-life balance has more than doubled in the last 10 years.2 This piece of work aims to understand the main challenges facing rota managers when designing/managing rotas and why many recommendations of the Good Rostering Guide are not being achieved. Methods Paediatric trainees teamed up with Lantum, a workforce management platform to develop a self rostering solution to try and address some of these issues. As part of this process, qualitative data was collected from a questionnaire completed by rota managers to try and establish the biggest challenges they faced when designing and managing rotas. Results 36 rota managers - (86%) of whom were clinicians - responded between April - August 2023, of which 88% managed a paediatric or neonatal rota. 100% of rota managers reported that creating rotas significantly increased their workload and required use of personal, unpaid time. The biggest challenges faced included: incorporating working preferences (100%), accommodating leave requests (95%), filling rota gaps (95%), managing rota complexity (92%), creating rotas for less than full time (LTFT) staff (90%), ensuring equal training opportunities (88%). Conclusion Managing a clinical rota is a complex and time consuming task, often dependent on rota managers using personal, unpaid time. The biggest challenges faced by rota managers stem from understaffing, an increasing number of LTFT staff and the time required to create and manage rotas. These root causes must first be addressed if we are to achieve the recommendations of the Good Rostering Guide. An increasing number of rota generating and rota management tools are becoming available. For these to truly improve medical rotas, they must increase flexibility and reduce the admin burden associated with rota creation.