St Helens and Knowsley Teaching Hospitals NHS Trust

Implementation of ESR Self Service to Partner Organisations

A Case Study by St Helens and Knowsley Teaching Hospitals NHS Trust


St Helens & Knowsley Teaching Hospitals NHS Trust (STHK) is an acute Trust based in Merseyside employing circa 4,500 staff. The Trust covers two sites one at Whiston Hospital and one in St Helens. Both sites underwent major re-building in recent years with new Hospitals now operating on the existing sites.STHK went live with ESR in April 2007. The Trust achieved RA5 status in February 2008, becoming the first acute Trust in the North West to do so. At the time this was required before an organisation could implement Manager Self Service (MSS). Following the acquisition of RA5 status the Trust implemented MSS with the backing of the Executive Team, and the Director of Human Resources and ESR Executive Sponsor, Anne-Marie Stretch. MSS was introduced to the Trust in August 2008 with full roll-out completed in 2009. The Trust also fully implemented Oracle Learning Management (OLM) in 2008 which complemented the roll out of MSS. The Trust utilises ESR interfaces with NHS Jobs, COHORT, GMC and Intrepid (the Mersey Deanery System).Since implementing Manager and Employee Self Service and OLM in 2008 we have successfully implemented Manager Self Service to a further three organisations across the region – the total number of employees is approximately 13,600.

The Project

John Foo, Head of Workforce Planning and ESR explains; “Since the inception of ESR, STHK have been at the forefront of utilising and expanding the use of ESR.

STHK is the Lead Employer Organisation for the Mersey Deanery and employs 2,300 Junior Doctors across Cheshire and Merseyside. These Doctors can be based in any one of 198 locations from a small GP practice to a large Teaching Hospital.

In order to manage absence more effectively the use of ESR Self Service has been implemented to all Hospital sites and is currently being rolled out to GP practices. This gives host Organisations access to current and historic sickness data and training records. This has not only improved the accuracy of the data it also ensures that staff can be managed more effectively with real time absence information supporting the proactive management of absence.

In 2013 we completed the implementation of MSS including OLM for Warrington and Halton NHS Foundation Trust. This gave us the opportunity to further hone the skills learned at STHK and develop a ‘standardised’ approach to implementing MSS for other users. This includes Standard templates for Project Plans, Training Manuals, Intranet Guides, Captivate Training Sessions and ESR Supervisor Hierarchy Manuals.

We are currently implementing MSS and ESS for Alder Hey Children’s Hospital. This approach of offering practical help and expertise has a number of benefits for the implementing Organisations, including having experienced NHS staff who know how to implement MSS and to ensure that common mistakes are not repeated. Using the ‘standardised’ approach mentioned earlier this ensures that together, we get it right first time, saving time and money for the Organisation.

The implementation of MSS at Alder Hey Hospital has further developed our skills in the challenges faced with working with out-sourced Payroll and Recruitment providers. Through the close working relationships and the development of agreed process maps, the in-built flexibility of ESR ensures that working with external Payroll and Recruitment providers is no barrier to the implementation of MSS.

The implementation of Self Service across the NHS is essential if we are going to improve efficiency and reduce costs across the service. The savings that can be made by reducing central administration and giving managers access to real time data, including training and sickness absence are substantial for one Organisation. Multiply this across the NHS and this will be a significant amount of time and money”.

The Drivers for change are:

  • Cost reduction by increased productivity and cutting down on overpayments
  • Increased patient safety
  • Central Control of Absence data and reporting capability
  • QIPP Agenda
  • Francis Report

Although ESR was rolled out to managers at STHK in 2008 it was not until the publication of the Francis Report in 2013 that the full value of the Information available to managers was realised. Whilst implementing ESR MSS and ESS at other local Trusts, as part of our engagment with Senior Managers we focus on ESR as a key source of information in measuring their performance against the Workforce elements of the 230 recommendations within the Francis report.

For the Lead Employer roll out In November 2011 a three month Self Service pilot was rolled out with Aintree University Hospitals NHS Foundation Trust and Warrington and Halton NHS Foundation Trust. We met with Medical Staffing Managers at both Trusts to understand how each Trust captured this information.

STHK then worked around these structures to ensure that Self Service fitted in with this hierarchy whilst remaining as flexible as possible.

In the three Trusts where we have implemented full Self Service a Standardised Project Plan was developed with Key tasks and milestones identified. A project Group was established at each organisation with key stakeholders from HR, Payroll, Finance, Education and Training, and IT.

The project group is chaired by The Executive Sponsor (usually the HR Director), this ensures that everyone takes responsibility for key actions in the project and ensures that communication is maintained. STHK provide updates to the Project Group at regular meetings and also maintains a risk register. A review of each stage of the rollout plan is undertaken by STHK and reported back to the Project Management Group.

Benefits and Achievements

Ann-Marie Stretch, HR Director says; "As an organisation we have been enthusiastic supporters for ESR as we could see the benefits that we could achieve from full utilisation which included Manager Self Service.

The driver for implementing Self Service was the desire to ensure that the real time functionality could be used by the organisation, allowing Managers access to their staff's data electronically means that they can manage their staff much more efficiently and effectively."

Implementation of Manager Self Service to 28 ‘Lead Employer’ Organisations

Host Trusts:

For the first time Host Trusts have access to ‘Lead Employer’ doctors working within their Trusts. They no longer need to keep separate databases on the trainees within their Trusts; this is beneficial to the Medical Staffing, Finance and Education & Training Departments. As STHK invoice Host Trust for over £12 million pounds each month in Doctors pay, each host Organisation can see just who they are paying for. This has led to a vast improvement in the financial recharging process.

Lead Employer Organisation:

Recording of absence at point of origin is more accurate and negates the use of additional spreadsheets to record sickness absence and training, reduces duplication of data input as the Payroll Department no longer have to manually enter absence data information into the payroll system.

Trusts Implementing Manager Self Service:

Real time reporting of sickness absence leads to early intervention and better management of sickness absence. A pilot scheme for the daily monitoring of sickness absence has seen the following improvements;

  • the use of ‘Other’ as a reason for sickness reduced from 8.87% to 1.02% a reduction of 88%;

The table below shows the top 10 reasons for absence. All reports can be filtered by either Host Organisation, Specialty (or even both!).

  • the Automated process for referrals to Occupational Health has increased from 99 per month in 2012 to 246 in 2013 an increase of 148;
  • a 76% increase in return to work discussions recorded over a three month period;
  • direct recording of Appraisals and Monitoring Training and individual competencies via OLM. This provides assurance to the Board that staff meet the regulatory requirements of quality and safety. (Since the introduction of Self Service via OLM for training courses there has been a reduction in 2.5 WTE a saving of over £40,000.
  • since the implementation of MSS and the introduction of a new Absence Management Policy, STHK has seen a reduction in sickness absence of 0.75% over 18 months. Achieving a cash saving of £750,000 (CIPD figures for an Acute Trust;

The graph below illustrates the current sickness absence percentages (12 month figures) by Host Organisation. This can be sorted by Host Name or by Sickness Percentage.

  • implementation of MSS can lead to a reduction in costs by achieving a higher NHS Litigation Authority Rating. This has a twofold effect of reducing insurance costs but more importantly improviing patient safety

“SHKT managed the roll out of MSS at our Trust in a very professional and efficient manner. Deadlines were achieved and the overall project delivered on time. Their expertise and experience was a major factor in deciding to use them and was a decision we did not regret”

Mick Curwen, Associate Director of HR Warrington and Halton Foundation Trust.

Lessons Learned

Many organisations have restructured their HR Departments as part of their work to streamline ‘Back Office’ services, and this has meant that they no longer have the knowledge or resources on site to undertake the implementation of ESR Self Service. However demonstrating to organisations the benefits that they can gain from the implementation and giving them the confidence that they can do it is vital to encourage more organisations to implement Self Service. However this can only be done by demonstrating enthusiasm and commitment to ESR in general and Self Service in particular. The key to the success of any project is getting the Executive Sponsor to support the project and ESR is no different. Convincing the Executive Sponsor of the benefits of implementing Self Service gives added support to the project and allows the implementation to go ahead.

Having the testimony of other Managers who have experienced the benefits and can extol the virtues of Self Service are important, as it is easier for Managers to relate to their experiences. It is also important to demonstrate to users how it will make their lives easier by making managing staff easier and more efficient. Employees are our most important asset and ensuring that we manage them efficiently is important for any organisation and Self Service enables this.

If a Trust is going to implement Self Service then it is important to have the main Departments involved in the project including IT, Payroll, HR, Education and Training, Finance and Executive Sponsor. This will ensure that everyone is committed to delivering the project and that all those that are affected are signed up to making Manager Self Service a success.

Communication is a vital part of any implementation and explaining to staff why you are implementing MSS and what benefits they will get from it are vital to winning the hearts of minds of staff.

We hope that by sharing our experiences about how we have approached implementing Self Service this will encourage others to grasp the nettle and give them the confidence to implement Manager Self Service.

For More Information

For more information about the project please contact John Foo, Head of Workforce Planning and ESR, St helens and Knowsley Teaching Hospitals Trust at