1. 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

2. 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?

3. 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 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

4. 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, 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.

5. 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

6. 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

7. 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.

8. 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

9. 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, s, 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

10. 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!

11. 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

12. Questions?