The Countess of Chester project team have drawn on their experience of the first phase of their WTD project to support them with the second phase: To work cooperatively across neighbouring trusts to deliver compliance in ophthalmology and for SPRs within ENT, radiology and plastics.
Successes of the first phase which ran from June 2006 until June 2007 included:
Banding savings identified of £564k against an estimated net cost of £230k
Reinvested in 7 nursing posts and 9 medical posts
65 percent compliance with action plans in place to achieve 98 percent compliant rotas
Multidisciplinary team working
Improved leadership skills for doctors in training.
There have been additional challenges in the second phase due to the geographical spread for example, of the current ENT rota, which is spread across three trusts with a travel area too extensive to be covered by the SPRs. Despite this Chester will be 98% compliant by August 2008.
In overcoming the challenges, Chester identified the need to share knowledge and not to underestimate the need for strength in your internal team. Dr David Ewins, clinical director at The Countess of Chester stressed the importance of leadership being given right from the top of the organisation: “Top down commitment, bottom up involvement has been critical to the success of the project” he commented, “Our chief executive saw the initial problem and recruited a strong team.”
There have been many lessons learnt throughout the course of the two phases: it’s imperative to have a strong project lead driving the changes forward, it was crucial to make the time and effort to meet consultants and juniors face to face, look to partnership working with neighbouring trusts - you can help each other to deliver a robust, good service whilst meeting WTD compliance. The decision from NHS North West to ‘go early’ has also helped put pressure on neighbouring organisations - so WTD is firmly on their agenda.
Top five tips for implementing WTD solutions:
Leadership is given right from the top of the organisation
Involve all stakeholders and utilise networks (internal and external) and communicate across the trust
Make plans early and don’t be frightened of adapting the plans
Understand your current services/background and problems
Look beyond the trust - call in expertise from people with a wider knowledge.
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