Skills for Health - Workforce Projects Team's targeted support helps trusts in achieving change to meet WTD 2009. Lynne Greenwood looks at the progress to date.
The first NHS trusts to bid for the ‘intensive targeted support’ offered by the Workforce Project Team to assist with reaching Working Time Directive 2009 compliance have received their final reports after week-long assessments.
Specialist teams of five or six assessors spent a week at the trusts’ HQs conducting between 20-25 individual interviews after an initial planning meeting six weeks in advance to brief senior staff on the process.
Trusts were invited to submit bids to the Workforce Project Team for one of two levels of targeted support to help them assess their current position, identify the benefits of linking WTD compliance with other organisational strategies and look towards developing solutions.
The Workforce Project Team offered 20 trusts the chance of the ‘intensive’ package and 15 trusts the ‘streamlined support’, a less extensive paper-based analysis of their situation, followed by facilitated sessions with teams of staff.
Working with the Workforce Project Team to deliver support, Jacky Beaumont, senior workforce consultant with Workforce Programmes at NHS East of England, says:
“We understand that there are competing priorities within organisations of which Working Time is one. Our aim is to bring that to the foreground and support trusts to achieve some degree of change which enables them to meet compliance.”
She says that while in some trusts, the degree of change required is only small, in others, more major changes are needed.
“We have found that a lot of organisations have taken a limited view of the necessary changes - for example making functional adjustments by altering rotas - rather than looking more comprehensively at a range of options.
“We advise that if they look at the situation more comprehensively, their potential for achieving more sustainable changes is far greater.”
The first two trusts to receive the intensive support were Princess Alexandra Hospital NHS Trust in Harlow in NHS East of England and Central Manchester and Manchester Children’s University Hospitals trust in NHS North West.
Trafford Healthcare NHS Trust, also in NHS North West and Mid Essex Hospital Services NHS Trust in NHS East of England were the next two to be assessed in June.
The support team use an “appreciative enquiry” approach in conjunction with a model developed through the original research project in 2005-06 involving 34 trusts to determine why some were making greater progress than others towards WTD compliance.
The findings led to the design of a diagnostic tool which identified ten ‘enablers’ - ten areas against which the trust could measure their progress.
The tool was then piloted among 11 trusts. “Feedback from those trusts told us that our approach had helped them to make progress towards achieving compliance,” says Jacky.
The approach has been further adapted and refined for the ‘targeted support’ work.
“We know there are ideas within the organisations but often the right group of stakeholders do not come together to develop an integrated approach,” she explains.
“Acknowledging and including those ideas means there is likely to be greater ownership of the measures needed to make significant progress.”
The ‘intensive’ approach begins with a planning meeting at which the support team make a presentation and emphasise the need for staff to carefully think through the way they want the team to engage with them.
“To gain the maximum benefit from our support, it is important for them to use the six week period between planning and our going into the trust to work out what they need, rather than leaving it to chance.”
At the end of the week-long assessment, the team give an initial feedback, followed within three weeks by a user-friendly report.
Around two weeks later, a team from the trust usually including the clinical and medical directors, HR personnel, nominated executive lead and general managers, attends a facilitated session to determine their future plans.
“Although each organisation is very different, the principles of good organisational change and how that can be achieved successfully are exactly the same for WTD compliance as for other issues,” says Ms Beaumont. “What we are offering is a support resource to those who feel we can help them to solve this particular situation.”
Streamlined support for the 15 trusts already identified is expected to start in early summer.
Although all 35 places have been filled by successful bidders before the closing date, there is now a waiting list of trusts in case circumstances change.
Working Time Directive 2009 
