Key tips for a trust implementing WTD 2009

Understand your rotas early

• Review and diary card all rotas early - focusing first on those with large numbers of doctors (potentially requiring activity audits) and those requiring external input (eg rotas shared among several hospitals)

Multidisciplinary solutions

• Review the impact of potential changes on other professional staff groups - minimise the risk of transferring work in a way which could overload another staff group.

Provide generous estimates of how long it will take to plan and implement change

• Trialling and evaluating any solution will take months - be realistic in setting goals
• Schedule changes around junior doctor rotations - trialling rota solutions early in a new rotation may not provide the most useful analysis.

Be flexible with timeframes

• Rigid deadlines do not work well for busy clinicians - remaining flexible with the timing of outputs allows staff to balance project goals with clinical commitments, maximising the chances of achieving a successful endpoint in the long-run.

Quantify the effect of task re-allocations on junior doctor hours

• Activity audits before and after a task re-allocation will help guide whether a reduction in hours is achievable
• Ensure the analysis reflects both changes in hours and other service improvements which also benefit the trust. ‘Selling a change' can be facilitated if a chance can be seen to provide an additional service improvement element.