Simplify the rota – removed historical shifts, and made everything as homogenous as possible as it will make hour calculations as easy as possible
Acquired every doctor’s work schedule – obtained the work pattern of every doctor. The majority of trainees may work 100% and this will be easy but all the LTFT trainees should have a pattern as well. This may be thought of as unnecessary, however, work patterns may vary from trainee to trainee and doctor to doctor. As such, acquiring schedules should be done regardless of if you are doing self rostering or not and should not represent any extra work for the department.
Declared that things are going to change – informed staff of upcoming changes four months in advance. Some people may need reassurance or the chance to discuss what these changes will mean. Many trainees may be moving in from another area of the country or moving trust and as such will need informing on the upcoming changes in advance, especially the first time this is done.
Set a date that people can begin self rostering and write down a list of FAQs that people ask – as people invariably have the same questions, a manual was created with a list of common questions, queries and answers. The manual was sent out to all trainees at the same time. It also included a list of all regional training days so people could book these well in advance of their actual dates. The rota was planned for 16 weeks followed by a review. This is because the rota patterns runs for 16 weeks at a time. There is no reason why it couldn’t be done for any other number, 26 weeks may be far more ergonomic.
Sent out access to healthrota – while other systems are available, healthrota is the system at use in Leeds. Everyone’s rota slot was pre-populated with nights and weekends. These were pre-filled to reduce the amount of work required. With an otherwise blank rota it is very easy to swap nights and weekends around. We managed to easily rearrange nights and weekends for everyone who needed it
Any trainee who doesn’t want to self rota was permitted to opt out – should a trainee not want to self rota, for instance, if they wanted their rota in advance as far as possible, this isn’t a problem. If a few trainees want fixed patterns, we simply populate their slot with the appropriate rota they had agreed with medical staffing. If 3 or 4 trainees want to do this it isn’t a problem but if there are too many the resulting lack of flexibility would become an issue. Anecdotally, a few trainees were concerned that a flexible rota might adversely affect LTFT working but the opposite has been found to be true so far and requests have been accommodated easily.
Arranged for drop-in rota clinics – Although Dr Bircher advocates for meetings in his self-rostering guide to arrange the rota, for a 3 department trust with so many trainees this approach would be impractical. Rota clinics were found to be effective in such an environment.
With nights and weekends rearranged, everyone was encouraged to request annual leave and study leave. My promise was that, if people requested it prior to me doing the rest of the rota, they would get the time off. If they didn’t and then they requested it after the rota was finished, I would do my best to approve it but couldn’t guarantee their leave. People made all kinds of requests, 4 weeks off to go to India for Diwali – sorted! One of our less than full time trainees wanted to take all their days off in one chunk so they could go do some remote medicine – easy. One of our trainees wanted to swap working Fridays for Saturdays for childcare reasons – not a problem. Flexible working worked.
Late shifts were then distributed to cover the department as evenly as possible. At Leeds we aren’t allowed to take annual leave on late shifts so it’s quite easy to distribute these shifts to get as much department cover as possible. Once everyone had had their late shifts allocated, people simply had the correct number of day shifts and non clinical shifts populated into the rota. That was then it done. It was about a day’s work to write the rota, some time was spent before and after answering e-mails and creating resources but hopefully as people become better with the systems this time should decrease.