Introduction
In recent years, the NHS has been under pressure in ways never seen before in modern times. As the Covid-19 pandemic raged around the world, staff were pushed to their limits and NHS organisations battled to maintain adequate staffing levels. Even today, as many hospitals try to recover the backlogs, demand continues to outweigh capacity and managing the number of patients that need care and treatment in hospital is unsustainable.
Ineffective resourcing and rostering solutions has stifled progress in many organisations. The emergency department at the Northern General Hospital (NGH) in Sheffield has faced similar challenges. However, new ways of working pioneered by Emergency Consultant, Dr Thomas Bircher, supported by the e-rostering solution – HealthRota, has enabled the department to break free from these challenges while empowering staff to thrive.
Here’s how they did it.

About The Northern General Hospital, Sheffield
The Northern General Hospital (NGH) is a large teaching hospital in Sheffield with a large adult-only emergency department that sees approximately 115,000 new attendances each year. It also acts as the major trauma centre for South Yorkshire.
Download Sheffield Hospital tackles capacity issues (15.35 MB)

Challenges
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Rotas managed in Excel and Google Sheets
Up until 2018, medical rotas for the emergency department were historically managed on Excel and Google worksheets. As well as being inefficient and time consuming to produce, it also compromised patient safety.
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No real-time view
Without the functionality to consolidate rotas to provide a real-time view of the staffing situation, shifts and workforce teams could not be easily flexed to match the current demands of patient care.
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Inability to attract and retain staff
Insufficient capacity made it impossible to fill shifts, and the challenging and unpredictable schedules made attracting and retaining staff within the department an unrealistic prospect.
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Compliance with Regulations
Balancing contractual rules and regulations, such as the European Working Time Directive (EWTD) and the Working Time Regulations (WTR) in the UK, poses a significant challenge for rota coordinators. The absence of an automated system makes it challenging to monitor the regulations and ensure compliance for a sizable team of junior doctors.
Solution
With overall responsibility for the deployment of 82 staff including consultants and registrars/ SHOs, Dr Bircher introduced the concept of self-rostering using a paper-based flip chart system. After several months of piloting the approach, the benefits were clear and he opted to digitalise the process with HealthRota. This immediately enhanced the flexibility of scheduling, increased staff utilisation and provided teams with a better work-life balance.
As a rota planning application for NHS healthcare trusts, HealthRota offers leading-edge rostering solutions to ensure a fair, transparent and sustainable working schedule for the long-term. The team began the implementation using a carefully planned approach:
We’re able to support personal development and Sheffield becomes a more interesting and attractive place to work. e-book
Emergency Consultant, Dr Thomas Bircher
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Highlight hotspots with e-Rostering
The system highlights hotspots and allocate staff with the right skills to each shift
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Filterable grid view
Easily view where individuals are deployed i.e., by filtering the grid view by location, day, week, month, or for the entire rota period.
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Real-time deployment
HealthRota enables users to flex the rota to easily redeploy resources in real-time.
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Improve fill rate and reduce locums
Implementation significantly improve the rota fill-rate and reduced the reliance on temporary locums.
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Cut bureaucracy
HealthRota removes the bureaucracy associated with allocating shifts by enabling staff to pick when they want work.
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Rota viewable on-the-go
Creates complete rota transparency with shifts and activities available in one easy-to-read schedule, viewable on desktop, tablet and the mobile app.
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Improved compliance
HealthRota enables monitoring of individual and contractual compliance for admin teams.
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Seamlessly calculate absence
Seamlessly calculate and record scheduled/unscheduled absence and programmed activities (PAs), saving admin time and removing the expensive surplus associated with creating false redundancy to accommodate annual leave.
Results
New ways of working and the adoption of HealthRota’s e-Rostering platform has seen the team reap substantial benefits:
For the first time, clinical teams have achieved a more optimal work-life balance. The emergency department has been expanded, with a mix of ful and less than full-time employees who have greater flexibility and access to valuable professional development opportunities.
Other results have also included:
- significant savings leading to a successful business case for recruiting a tier of eight junior clinical fellows (something that they had not been able to achieve for the previous four years)
- additional margins to increase the number of SHO’s by 18 full-time positions (from 27 to 45), allowing the team to reduce the weekend frequency limit to one in three, which is the legal maximum in the UK
- the elimination of earlier recruitment and retention challenges, enabling the department to attract more highly trained and experienced staff
- better flexibility and greater work-life balance with staff able to select shifts around their other commitments.
Dr Bircher explains, “We had someone who did anatomy demonstrating for one day-a- week and so, only wanted to work 60%. Fitting someone like that into a rolling rota was impossible before, but with self- rostering and the allocation of shifts that staff can put ni themselves, it actually becomes really easy.”
“Previously, we tried to attract SHO’s on a variety of different contracts -and even offered a trip to South Africa to undertake trauma work, but no-one would really take us up on it because essentially the work-life balance wasn’t right. Now, skilled staff are coming to Sheffield and they are staying here.”
Benefits
- Rotas filled with staff that have the right level of experience and skills
- More attractive employment opportunities that also help to retain staff for longer
- Improved staff utilisation with live PA calculations and the removal of excess scheduling for leave redundancy
- Ability to assess and plan for gaps and increases in demand
- Increased the number of SHOs by 18 full-time positions
- Reduced the weekend frequency to 1 in 3 (the legal maximum)
- Savings generated for recruitment, training and innovation
- Self-rostering leads to greater autonomy and improved work-life balance
- No more bureaucracy associated with shift allocation
- Increased professional development and mentoring opportunities
- Greater staff satisfaction and utilisation
- Ability to easily select shifts on-the-go
Conclusion
Over two years, the emergency department has been unshackled from the vicious cycle of shortages and increased pressures on staff. Led by Dr Bircher, workforce management has been revolutionised with new ways of working and a rostering system that is fit for the future. As a result, outdated systems and processes are a thing of the past and staff are appropriately allocated to provide high quality and efficient patient care.
Capacity has increased across the department, which Dr Bircher says has made it “easy to innovate.” The department has filled 18 full-time positions to create a full registrar rota, leading to a happier team who are empowered with the freedom and flexibility to manage their work alongside achieving their personal and professional goals. This has allowed staff to take time of when they need, and allowed seven clinical fellows and eleven higher speciality trainees to pursue their training with the Sheffield deanery, with others also able to fulfil secondments and rotations in other areas.
The journey to self-rostering has been extremely rewarding for the NGH’s emergency team. “Self-rostering is easy to do”, concludes Dr Bircher. “It allows us to accommodate lots of complexities that would otherwise create gaps. And, because the direction of travel in the future will be more doctors being less than full-time, or with more longitudinal training required, HealthRota is able to manage that level of complexity while other systems or even knowledgeable rota coordinators with Excel spreadsheets, won’t be able to manage – so, ti is very, very beneficial.” He adds,
“Consultants like it, registrars love it, and 90% of SHOs’ say that self-rostering is better.”
Consultants like it, registrars love it, and 90% of SHOs’ say that self-rostering is better.
Emergency Consultant, Dr Thomas Bircher