Lord Carter review highlights the importance of e-rostering technology

Lord Carter

Lord Carter’s review of hospital productivity was published today, offering fifteen recommendations aimed at saving the NHS £5bn a year by 2020. The recommendations encompass most aspects of hospital spending, including clinical workforce management, hospital pharmacy, procurement and imaging services. The core theme of the report is focused upon how the NHS can improve and standardise the use of data to identify and eliminate unnecessary expenditure.

To optimise quality and efficiency across the entire care pathway, Carter recommends organisations adopt a single integrated performance framework, centred on customers, workforce and finances. This should incorporate the established CQC regulatory of framework on five areas with developments of the well-led questions and a new sixth area.

Carter calls for the use of two metrics to create a “model hospital”; adjustment treatment cost (ATC) and weighted activity unit (WAU). Associated best practice guidance in line with these metrics “will give trusts a single version of the truth on what good looks like from board to ward, to help trusts understand what good looks like”.

Carter notes:

  • The review team were told of the difficulties trusts face in recruiting nurses and how this has resulted in increased use of agencies; therefore, it is a priority to ensure they optimise their won nursing resources through improved productivity
  • Variation found in managing A/L, shift patterns and flexible working, through to the use of tech and good practice such as ClarityROSTER
  • Despite national electronic staff record, many trusts did not have a full picture of where all their staff are and what they are doing
  • Few trusts use full functionality and benefits from e-rostering. This could help to reduce dependency on bank and agency staff
  • All trusts should have the key digital information systems in place including fully integrated and utilised e-rostering systems, e-prescribing systems, patient-level costing and accounting systems, e-catalogue and inventory systems for procurement, RFID systems where appropriate, and electronic health records by October 2018, and NHS Improvement should ensure this happens through the use of ‘meaningful use’ standards and incentives

Carter recommends that all trusts use an e-rostering system and implement the following practices:

  • Effective approval process by publishing rosters six weeks in advance and review them against trust key performance indicators such as proportion of staff on leave, training and appropriate use of contracted hours
  • Formal process to tackle areas that require improvement, with escalation paths, action plans and improvement tracking
  • Cultural change and communication plans to resolve any underlying policy or process issues
  • NHS Improvement should develop and implement measures for analysing worker deployment during 2016 – adhering to agency rules is part of this
  • DH should make some of the Spending Review investment for IT available for trusts to meet standards of systems such as for e-rostering


You can read download the complete review on the gov.uk website.

Interested to know how ClarityROSTER can help your organisation support Lord Carter’s recommendation? Read about our intuitive health roster or call our team today on 08450 063 752.

February 5, 2016

Lauren Kavanagh

Marketing Manager