Occupational Therapy News OTnews April 2019 | Page 32

FEATURE SERVICE REDESIGN
•
data capturing – a recognition that more
standardisation within teams is needed.
Another theme was structure and skill mix, where it was
found:
• are the right staff (that is, clinical staff, support staff
and administration staff) doing the right activities?;
• team leaders in small teams struggle to prioritise
non clinical activities;

• a band seven role review is needed;
• senior staff are the most productive clinically, but
are having to undertake non-clinical activities;
• there is a need to upskill staff and improve flexible
working; and

• there is a need for more collaborative working
within teams and externally with community
colleagues.
Benefits to managers, staff and patients
This new evidence can be used to compare and
quantify a team’s clinical capacity for workforce
planning and deployment when there are changes in
demand.
Increasing productivity and clinical capacity can
improve financial recovery, as well as patient care,
and the tool has enabled staff to identify a number of
service improvements for improved productivity.
The use of technology enables metrics to be
captured for the Model Hospital, which is important for
benchmarking. In addition, capturing externally-funded
activity shows evidence of income generation, as well
as the potential to expand this further.
The tool can also be used to describe therapist
contributions, which can be used for Health and Care
Professions Council registration, as well as activities
that add value and quality to patient care, such as
teaching and training.
Leaders can use the tool to evidence team
performance, or where additional resource is needed
to deliver patient care and meet the demands of the
service. For team leaders, they can now challenge
current ways of working to increase productivity, such
as skills mix, and ‘right staff, right place, right time’.
Staff have been able to identify opportunities for
productivity improvements, such as integrated working
between occupational therapy and physiotherapy, so
that additional staff are not needed, leading to cost
savings.
Finally, managers have more visibility of evidence
to redeploy staff to respond to changes in patient
demand, such as winter pressures, and agregate
planning can be used to predict staffing needs when
new wards open, or change bed capacity.
32 OTnews April 2019
In addition, they can evidence if recruitment is
needed or not when there are vacancies, again leading
to potential cost savings.
One occupational therapy team leader is quoted
as saying: ‘Job planning has enabled me to really
understand the skill mix within my team. I am more
aware of questioning if staff are in the right place at the
right time.’
While a therapy service manager added: ‘Job
planning enables me to workforce plan for when new
wards are opening and staff can be redeployed as
demand changes. They can also be used to evidence
where vacancies need to be filled.’
Another team leader dietician said: ‘Job planning
and measuring performance can evidence why we do
not always have time for team meetings and teaching
when clinical demand is raised.’
On the importance of data, one of the productivity
champions said: ‘When you are so busy you don’t
always have the time to stand back and reflect on how
things can be improved. Productive therapies has made
me realise how importance capturing accurate data is.’
While a team leader physiotherapist summed up the
challenges faced by staff with: ‘I was terrified of using
excel spreadsheets. Since learning how to use job
planning, I can look at activity dashboards, and analyse
performance. I’m much more confident with IT.’
Occupational therapy skills are transferable to project
management for successful transformational change.
This project has shown that it is essential that the
right staff are in the right place, at the right time, to
see patients, and that improving staff productivity and
removing unwarranted variation will ultimately improve
patient care.
The project recommendations can also be used in
other departments and other trusts as an enabler to
improve productivity.
References
Lord Carter of Coles (2016) Operational productivity and
performance in English NHS acute hospitals: unwarranted
variations. London (UK): Department of Health. Available
online at: https://bit.ly/2G9D2mo [accessed 27 March
2019]
NHS Improvement (2017) Allied health professionals job
planning: a best practice guide. Available online at: https://
improvement.nhs.uk/documents/919/Final_AHP_job_
planning_FINAL_3a.pdf [accessed 26 October 2018]
Laura Garratt, team leader occupational therapist
elective orthopaedics and Productive Therapies Project
lead, Nottingham University Hospitals. Email: laura.
[e-mail]