Charlie Carroll Cancer Centre Manager Using the outputs of the IST workload tracker: what to do next and how to make it work for you. Charlie Carroll Cancer Centre Manager Nikki Waddie, NHSI Improvement Manager

IST Workload Tracker Background Involving the team How the workload tracker was completed Collation & interpretation of tracker results Business case Going to be looking at: The background to all this happening – for me it was cancer dept but can be applied anywhere Why involving the team is important How we got the tracker completed by the team Collating the results to make sense to help build the business case Will be opportunity for questions at the end but please ask at any stage Who is from a cancer dept?

Background Compared to 2013/14, urgent GP referrals for all suspected cancers are projected to increase by 46% to 162,363 referrals by 2019/20. (PHE May 2015 - Projections of urgent GP referrals for suspected cancer until 2019/20, East Midlands) Department struggling with workload Knew activity had increased since restructure in 2010 – green line Activity continuing the increase by nearly 50% – things are only going to get worse COSD (Cancer Outcomes & Services Dataset) – now over 500 data items to collect COSD data items

Staff numbers Staffing levels compared with other trusts in the area, looking at activity, performance and even cancer tracking systems used Yellow boxes were avg for the two periods and show no. pts per tracking member of staff (Band 3 or 4) (if in a cancer dept and want to be involved in sharing data, email details at end) We were clearly handling more pts per person and would need approx 10 more to get on similar level, without increasing referral rates.

Involving the team Team briefing Not a time and motion study The hours will not add up to 7.5 per day No need to record toilet breaks! Get team to create the Activity list Agree interpretation of Value (perspective) Essential to get the team on side and even then they won’t be that easy. Organised a team meeting where Nikki, as a respected outsider, explained the process Must stress to them that it is not a Time & Motion study and that their hours will not add up, so don’t manipulate to make them. Activity list only has 12 items so agree most important (avoid ‘Other’ as they will use it all the time), how to categorise if multiple items ‘Value’ – we chose what value they saw it added to their job, ie easy for them to decide

Individual Results Actual record from one of my team. Recording was straight forward – the simpler the easier it is to collate afterwards Biggest question was around ‘Value’ Here covering an MDT for someone else is rated as of no value and PTL work as low value It gave an insight on how staff see their role

Results available in two forms – by category or by value and total number of hours doing it For this week, this member of staff spent 45% time tracking or working on MDT They also spent 31% on cover work – which they clearly thought was a waste of time as it was all graded as of no value.

Team Results Information Analyst spent a week collating the results (15 files) Tried to normalised the ‘Values’ to be set as from Trust perspective – or most selected the commonly used for each activity Start and finish times to give total number of hours (time of day irrelevant) then had to divide by 5 to get realistic day length

Pleased that 80% of time was on high value work Immediately saw activities that didn’t need Band 4 skills – some PTL work, some post-MDT work, some tracking, emails, cover (?), agendas Team were very afraid that this was a ‘restructure’ and their roles would be down-banded but through this we were able to demonstrate that a significant amount of work they deemed of little value could be taken off them

Result! Fully documented business case with detailed supporting information went forward requesting funding for 13 WTE Band 3 Assistant Cancer Co-ordinators Using the comparison of cancer team sizes in the region and the evidence from the IST Workload Tracker we were able to demonstrate we had thoroughly reviewed the skills mix needed and could prove the new role would be value for money to the Trust, ie we weren’t automatically asking for more Band 4s Though we got agreement in principle, the Trust’s financial position meant the requested level of funding was not possible. We did come away with 4 additional staff – which is four more than we had before!

Summary Background facts Involve the team Agree how to complete the workload tracker Collation & interpretation of results Business case – use the facts Understand what has made you look at this area Involving the team is important How we got the tracker completed by the team – keep them on side! Collating the results takes time but essential to help build the business case

Questions? Charles.Carroll@ulh.nhs.uk