A Case Study from NHS Wales - Countdown to Job Plans in ESR
In 2012, Phill Davies (pictured left), Workforce Information Analyst for Cwm Taf University Health Board (UHB), initiated a request to enhance the functionality within ESR for recording Job Plans. This started NHS Wales’ countdown to recording and reporting all Job Plan data for Consultants and SAS Doctors in ESR.
NHS Wales employs 84,000 staff across 10 Organisations. ESR Job Plan functionality will capture data for c3,500 Consultant and SAS Doctors in Wales. In 2012 functionality was limited and did not allow the full capture of planned sessions undertaken by Consultants and SAS Doctors. This led to a case for change to address:
- Inconsistent recording of Job Plan activity in organisation
- Manual capture, reporting and analysis through multiple sources
- Job Plan compliance requests from Welsh Government
- Inefficiencies including duplications
- Missing compliance assurances
- Different contractual rules for Consultants in Wales and England
A business justification was initiated by Cwm Taf UHB in 2012 and developed in partnership with NHS Wales and five large English NHS Trusts. The enhanced functionality included additional data capture, reflecting the different contractual rules used in England and Wales and building compliance assurance was developed. Maria Scott, NHS Development Team has been essential in supporting and advising on these developments and implementing this change for NHS Wales and NHS England.
The ESR Job Plan functionality does not change the organisational Job Planning process. In February 2013, the Wales Audit Office report “Consultant Contract in Wales: Progress with Securing the Intended Benefits” highlighted the weaknesses in Job Planning.
Welsh Government Public Accounts Committee (PAC) report made further recommendations to NHS Wales in September 2013. In 2014, the Welsh Government will require organisations to consistently report summary Job Plan data via ESR.
Workforce Directors and Medical Directors in NHS Wales identified key business benefits for NHS organisations using the ESR enhanced job plan functionality:
- Enable the Consultant and SAS contract to be maximised
- Improve data governance
- Single source of data to support analysis of planned activity with payments
- Enter data at source in ESR Self Service
- A central solution across NHS Wales and England
- A consistent approach supporting benchmarking
- Improve Information Intelligence
To realise the Workforce and Medical Directors vision, a Task and Finish Group was established in June 2013, chaired by Derek Jones, Medical and Dental Workforce Advisor. The Group includes representatives from Medical Workforce Managers, Workforce Planners and Pilot sites.
ESR Job Plan functionality pilot – Cwm Taf University Health Board
Cwm Taf University Health Board employs 8,030 staff; each Job planning process involves 370 Consultant & SAS Doctors. On a monthly basis an average of 30 Job Plans will be completed requiring input from the Clinician, Clinical Director, Directorate Manager, Benefits Realisation Manager, Workforce Information Analyst and Medical HR Manager. In 2012, this process involved in excess of 20 manual process steps. With the development of ESR functionality we have been able to reduce this to 4 process steps:
Our key driver in developing ESR functionality was to achieve a lean and efficient process to support the monthly reporting of Job Plan metrics to our Executive Board. Prior to ESR being developed, information was collected on a Job Plan template and manually transferred to a local spread sheet to calculate, analyse and report the data. This process relied on onerous manipulation of spread sheets involving multiple steps and parties and so we looked to ESR to provide the solution.
Since September 2013, we have piloted the enhanced Medical and Dental Job Plan functionality on behalf of NHS Wales. Phase 1 testing involved data collection, validation and reviewing the new functionality through data entry. During this period we worked closely Job Plan Activity Record Outcomes in ESR Align Outcomes with Payments Report Compliance Page 3 of 6 with the Task & Finish Group providing progress updates and developed data standards and a comprehensive User Guide for NHS Wales.
As part of our evaluation we shared how quick and easy it was to enter the data, taking approximately 3 minutes a record. Piloting the functionality has enabled us to request further developments to enhance the user experience and further improve the flow of data entry. https://www.electronicstaffrecord.nhs.uk/kbase/download/5457/
Our strategy for delivering a lean and efficient Job Planning process within the Health Board is through ESR Self Service, this enables clinicians to have ownership of their Job Plan data. To date, we have 1,500 Self Service Users. Recognising the need to support the transition to Self Service, we will initially retain recording and reporting of Job Plan metrics within the Workforce & OD function and plan for wider rollout by 2015. We are already working with clinical departments to release Self Service.
We are incorporating the compliance data from ESR Business Intelligence into our monthly reports to our Executive Board. This will provide us with a clear indicator of our Job Plan compliance levels and where we need to take action.
“Job planning helps to drive measurable and sustainable improvements in patient care aligned to organisational, team and individual objectives. With data readily available from ESR, it provides greater clarity on what our doctors are doing and helps to ensure we get maximum benefit from Consultant and SAS contracts”
Mr Kamal Asaad
Cwm Taf University Health Board
We are working with the Task & Finish Group to develop a report to enable us to assess the payments made against the commitments in the job plan.
“Job plans held centrally in one system enable the Executive Board to understand the time commitment by Consultant and SAS Doctors to direct patient care for individual specialties and Organisation wide by accessing the data in real time through ESRBI.”
Director of Workforce and Organisational Development
Cwm Taf University Health Board
Making the change happen across NHS Wales
Terms of Reference were developed for the Task and Finish Group together with a communication strategy identifying key stakeholders including:
- Consultant and SAS Review Groups
- Consultant Contract Link Group
- Wales Audit Office Task and Finish Group
- Directors of Workforce & Organisational Development
- Medical Directors
One of the first communications was to publish a Case Study in the August 2013 ESR News Special Edition
The case for change identified a need for a single source to record Job Plan outcomes. Following a process mapping session we developed a process to support organisations with local implementation.
Recognising the need to record data in a consistent and timely way, a data field dictionary, minimum data set and Job Plan standards were developed. The data dictionary aligns to the Consultant Contract in Wales (2003) and Associate Specialist and Specialty Doctors (SAS) (2008) and includes clear definitions for each data field.
In NHS Wales, our standards outline how data will be recorded in ESR including recording data in Hours and utilising ‘Signed at Last Review’ data field to differentiate between Job Plans that are complete (signed) and those that are complete but awaiting sign off by the clinician and NHS manager. Our standards enable Business Intelligence reports to clearly show compliance levels enabling the lead clinician to address any non-compliance at source via Self Service. We are working with the NHS Development Team to further develop the ESR BI NHS Medical and Dental Dashboard.
To support local delivery, the Task & Finish Group developed guidance for users which includes an Implementation Plan, Data Dictionary, Minimum Data Set, Process Map and FAQ’s. To further support users with data input, the NHS Development Team has provided an excellent e-learning Medical and Dental Job Plans captivate session https://www.electronicstaffrecord.nhs.uk/kbase/entry/225/. Early feedback confirms the e-learning is ‘very straight forward and user friendly’.
A Single Job Plan Data Source for NHS Wales
The work of the Task & Finish Group led to a Communication Event in January 2014, attended by 45 people including Medical Directors, Consultants, Directors of Workforce & OD, Organisational Job Plan Leads, Workforce Information Managers and Medical Workforce Managers from across NHS Wales. The Communication Event shared the pilot lessons learned and set out how Organisations can effectively use the new ESR functionality. Presentations included: Developing ESR to Record Job Plan Outcomes; Cwm Taf UHB Case Study; Reporting Job Plan Outcomes using ESR Business Intelligence; Best Practice and Data Standards; Benefits of using ESR Job Plan functionality and Implementation Plan for NHS Wales. Presentations are available on the WfIS website. http://nww.wfisprogramme.wales.nhs.uk/job-planning
Pictured (left to right):
Debra Lewis, WfIS Programme Manager, Lisa Williams, NWSSP Service Improvement and Development Manager; Maria Scott, NHS Development Team; Derek Jones, Chair of Task & Finish Group; Hilary Hopkins, Benefits Realisation Manager, Cwm Taf UHB
Following our Communication Event, Job Plan Leads from each Organisation have joined our Task & Finish Group. Over the next few months, NHS Wales will:
- Adopt the NHS Wales Job Plan Standard and record Job Plan outcomes for all Consultants and SAS Doctors in ESR
- Record Job Plan data by Summer 2014
- Develop local reports to link Job Plan Outcomes with Payments made
- Develop e-learning to support the National Job Plan process which will complement the use of captivate Medical and Dental Job Plans e-learning
After a successful pilot and a review of the new functionality, a second business justification, including proposals to enhance the user experience and to improve the ESR data warehouse reporting, have been submitted for consideration by the National User Group in April 2014. The approval of these changes will facilitate our aim to report compliance data to the Welsh Government direct from the ESR Data Warehouse.