In 2014 Brighton and Sussex University Hospitals NHS Trust introduced rota annualisation and self-preferencing of shifts, a system that had never been used in the NHS before.
This way of working has significantly helped reverse a number of issues the trust was facing including difficulty recruiting and retaining staff, medical students being deterred from a career in A&E and over £1 million a year being spent on junior locums, all things which were having a detrimental effect on patient care.
Under annualisation, foundation doctors’ rotas are calculated in terms of number of hours per year. At the start of the year the trust asks doctors when they want to be off work. Next, they factor in the three hours per week for self-development, as well as hours for annual leave, study leave and bank holidays. After this is deducted from their total, the trust can establish the number of clinical hours they must work. Alongside this, doctors, via an app, state which shifts they cannot work, and then bespoke rotas are produced. If doctors want to swap with colleagues after the rota is compiled, they can do so easily via the app.
The trust has now a full rota of junior doctors, reversed its issues around retention and has saved more than £1 million per year in locum agency costs.