Staff rotas are something of an Achilles heel for many managers and can be the cause of significant stress. Preparing a rota when you are not a participant will often be seen as an imposition by an amateur. Rotas rarely land butter side up at the first stab and for every staff member who shrugs and says ‘fine’ there will be the usual suspects who grumble around the coffee machine because the rota is not ‘theirs’.
The key is to address the question of ownership. Staff are often the experts in what they do and it is important to listen to them. They are pivotal and they want to make their working day (and the running of the practice) as smooth as they can, so let them have ownership of their rota.
They experience the triumphs and the mistakes, work on through staff shortages and absences, cope with their pressures, and learn directly from them. The chances are, they already have the knowledge and the skills, want to cooperate and reciprocate with each other to make life easier and your practice manager might simply need to identify the right buttons - and when to press them.
1. Establish a practice culture of ownership.
By establishing a practice culture of ownership and empowerment, the team tend to do it themselves and have full control of the staff rota. The team know the required outputs and measures, decide on ‘the rules’, make team decisions and agree changes. Essentially, the team manages the team.
This way also lends to the team being able to accommodate flexible working, casual cover, individual requests and know each other’s restrictions.
2. Start with small wins and build from there.
Practice managers can involve staff in discussions and listen to what they have to say. Involving staff in decisions has to be based on direct benefits to them. This can also act as a good motivational tool to air their opinions about the rota. Of course, any changes need to be introduced in bite-sized chunks. With this method, your practice manager will need to be available and help with concerns. The key is to be flexible but not entrenched.
3. Monitor for a short while and then let go
Your practice manager could set some measures and outcomes based on a policy of openness with practice staff, with all rota information in the ‘public domain’. Essentially, the practice manager is equipping staff to manage their own time by giving them the tools to do so.
For instance, some of the outcomes your practice manager could set and observe are: the standard of service in reception, telephone answer time (including telephone system data analysis and comparisons to previous periods), staff under/over staffing, active redeployment of staff throughout the day, responsiveness to peaks and troughs, length of queues, and patients’ waiting time in reception. Is the budget within the set parameters (over and under spent) and is the deviation accounted for, or planned for?
You could also look at minimum staffing levels and feedback from clinical staff, ie: are the needs of doctors being attended to adequately? This way, you take an overview, watch for snags, listen to feedback and ultimately let go.
4. Let staff learn from their decisions
This method allows team members to correct themselves without the fear of criticism. The team approve their own holidays within their own rules, organise holiday cover between themselves, manage their own overtime budgets and are pro-active in arranging sickness cover.
All information, records and decisions are open and errors in planning or problems are quickly identified by anyone. This method helps the team learn different skills and adapt very quickly.
The above methods might appear controversial to some practice managers, but it can result in fewer rota mistakes as the experts do it, less time management and a more formal but flexible working system. The team reorganises who does what on the spur of the moment, to compensate for quiet periods or particular work pressures and reciprocate easily later on. A culture of more co-operative working with each other develops.
This is not a quick hit and more of a process is needed to set out the stall correctly before beginning the move towards team working, but it can reap rewards. Not least of all to the stressed manager.
Steve Morris is the general manager at First Practice Management
