#005 Wins in the Workplace: Recruiting an extra rota coordinator - Dr Secker & Dr Bodimeade

Improving the rota coordination service to make it easier to book annual leave

Grievance/initial motivation

There had been consistent complaints made throughout 2020 regarding doctors dissatisfaction with the organisation of their rotas in the departments of A&E, Medicine and Care of the Elderly (COE). Problems included delays in doctors receiving their rota, inability to book annual or study leave, poor communication and repeated rota gaps leading to abrupt requests to cover unfamiliar wards.

Research – what information did you have to find out to ensure that you had all the necessary facts and couldn’t be tripped up at any point? How did you go about finding this information?

We devised a questionnaire to provide data on doctors’ experiences of their rota. The questionnaire was distributed to all current junior doctors in COE, Medicine, A&E formally through the medical education department email list and informally promoted on departmental WhatsApp groups.

Target – as a result of your research, which individual, group, committee or organization did you identify as having the power to enact the change you wanted to see?

The single rota coordinator as well as the medicine service manager were contacted and asked to participate with the Junior Doctors Forum. They were sympathetic to the concerns of the junior doctors. There was an appreciation that the workload of organising rotas for >100 doctors of all levels in 3 departments was too much for a single individual to maintain and that it was an issue of understaffing.

Allies – who did you identify as potentially on your side?

The Junior Doctor Forum (JDFs) and Guardian of Safe Working. JDFs are mandatory bodies which exist within every NHS Trust, working with the Guardian of Safe Working to address contractual concerns and to safeguard the working conditions of junior doctors.

The rota coordinator and medicine service manager were also very supportive. We were keen to emphasise that it was not a personal criticism of the individual rota coordinator in question, but rather a structural problem related to understaffing.

Resources – what resources were available to help you win? This could include volunteers, online survey tools, social media skills, negotiation skills etc.

A Survey Monkey was used as the survey tool. However Google Forms is another useful alternative as it is completely free, whereas for Survey Monkey many of the features are restricted unless you pay.

Contacting people via Whatsapp with a survey link was a big help in terms of getting a good response rate from junior doctors.

Barriers – what were the main things in your way? This could include apathy amongst your supporters, push-back from your target or anything else that you found challenging.

At times, it was difficult getting a good response rate to the survey.

Strategy – Based on your research and an understanding of your target, allies, resources and barriers, what strategy did you then employ to win?

The JDF devised a questionnaire to look at different aspects of the doctors rota. The questionnaire was distributed to all current junior doctors in COE, Medicine, A&E formally through the medical education department email list and informally promoted on departmental WhatsApp groups.

Outcome – what happened?

In February 2021 the new rota coordinator was employed on a 6 month temporary contract. Our strategy was to have the results of this intervention evaluated before their temporary contract expired in July 2021.

The questionnaire was distributed twice - Survey 1 in February 2021 before the addition of the new rota coordinator and Survey 2 in June 2021 after the additional rota coordinator had been employed. Junior doctors were asked to answer each questionnaire in reference to the current rotation they were on. Final results were available from July 2021.

Evaluation

What went well?

• The follow-up survey showed that doctors’ satisfaction with their rota rose from average 2.78 to 3.57 (1 - dissatisfied, 5 - very satisfied)

• There was a 37% increase from 29.3% to 66.7% of doctors receiving their rota 6-weeks in advance as required in the junior doctor contract

• Ease of contacting rota coordinator improved from 3.41 to 2.31 (1 - very easy, 5 - very difficult)

• Ease of booking leave improved from 3.10 to 2.48 (1 - very easy, 5 - very difficult)

• Ease of booking study leave improved from 3.37 to 2.69 (1 - very easy, 5 - very difficult)

• There was a small decrease in people being asked to move wards to cover rota gaps from 46% to 40%

• There was also a decrease in people exception reporting rota gaps from 14.6% to 4.8%

What went not so well? Gathering data and ensuring a good response rate was tricky at times.

What could be done differently next time? Earlier identification of key allies

What could the BMA do to help support and replicate the success of this campaign in future in other locations? Make it more widely known to junior doctors that this kind of win is possible via the Junior Doctor Forums.

What advice would you give to other doctors wanting to do something similar?

Be persistent in gathering data from junior doctors. People are busy and you need to make it clear that 1. The survey is very short so won’t take up much of their time and that 2. The outcome will have a concrete benefit to the every-day working conditions for themselves and their colleagues.

Communication involved emails from the Guardian of Safe Working to all juniors, plus messages put out in departmental Whatsapp groups. However, direct Whatsapp messages sent to individuals with the survey link was also essential.

If you’d like to try this in your own Trust and want to find out more, you can contact either:

Khalil Secker - khalil.secker@nhs.net or

Chris Bodimeade - chris.bodimeade@nhs.net