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A&E clinical staffing is one of those areas where less is certainly not more.
Proving this point to execs and managers can be very challenging
.
This is because A&Es are often seen from the outside to be relatively well staffed compared to other services.
/start
Proving this point to execs and managers can be very challenging
. This is because A&Es are often seen from the outside to be relatively well staffed compared to other services.
/start
A&E staffing business case recipe
Ingredients
:
1. Hourly patient arrival rate per day, split into triage priorities.
2. Staff efficiency, as in the average number of patients seen per hour per clinician.
3. Standard job plan DCC agreements.
4. Current rota.
5. Excel
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Ingredients
:1. Hourly patient arrival rate per day, split into triage priorities.
2. Staff efficiency, as in the average number of patients seen per hour per clinician.
3. Standard job plan DCC agreements.
4. Current rota.
5. Excel
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Method 
1. Obtain your hourly patient arrival rate per day (split into triage priorities) from your EDIS.
You can decide the collection period (years, months, weeks), as long as it is averaged over a day.
Use Excel to create a figure to show your daily arrival variation.
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1. Obtain your hourly patient arrival rate per day (split into triage priorities) from your EDIS.
You can decide the collection period (years, months, weeks), as long as it is averaged over a day.
Use Excel to create a figure to show your daily arrival variation.
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2. Calculate your staff efficiency (this has been de-emphasised by the college, but is still useful for a business case).
Divide the number of patients seen over a specified period, by the rostered clinician hours over the same period.
It is likely to be between 0.8-1.2
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Divide the number of patients seen over a specified period, by the rostered clinician hours over the same period.
It is likely to be between 0.8-1.2
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3. To calculate your staffing needs per hour you can simply multiply your hourly attendance rate with your efficiency rate.
4. Use triage priority to define seniority.
P1-2 and half of P3 patients, times efficiency are your senior staff need
The rest is your junior need.
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4. Use triage priority to define seniority.
P1-2 and half of P3 patients, times efficiency are your senior staff need
The rest is your junior need.
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6. Calculate patient compounding.
This is a very powerful way to share your staffing gap.
Subtract your current staffing per hour from your staffing need per hour.
Divide by efficiency. This shows the number of patients that cannot be seen within an hour...
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This is a very powerful way to share your staffing gap.
Subtract your current staffing per hour from your staffing need per hour.
Divide by efficiency. This shows the number of patients that cannot be seen within an hour...
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... Patient compounding (cont)
Add these excess patients to your hourly patient attendance rate.
Build a figure showing
Hourly patient attendance rate
Hourly estimated patient numbers seen (using current rota)
Hourly patient compounding
This is an alarming figure.
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Add these excess patients to your hourly patient attendance rate.
Build a figure showing
Hourly patient attendance rate Hourly estimated patient numbers seen (using current rota) Hourly patient compoundingThis is an alarming figure.
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7. Use this figure as the main talking point in your business plan presentation.
8. You'll be asked what your actual staffing needs are.
Your business manager can calculate this using methods step 4.
It'll be much more than you expect.
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8. You'll be asked what your actual staffing needs are.
Your business manager can calculate this using methods step 4.
It'll be much more than you expect.
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9. To really highlight the challenge, obtain your annual A&E growth.
Use this to inflate your daily numbers to reflect attendance in 5 years.
Calculate your staffing needs in 5 years using the method above.
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Use this to inflate your daily numbers to reflect attendance in 5 years.
Calculate your staffing needs in 5 years using the method above.
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10. Recommend a business plan to increase staffing over the next three years.
11. Recommend investing in a bespoke A&E rota, such as @healthrota to better manage existing staffing.
(the answer to why efficiency is so low relates to the high number of trainees in the NHS).
/end
11. Recommend investing in a bespoke A&E rota, such as @healthrota to better manage existing staffing.
(the answer to why efficiency is so low relates to the high number of trainees in the NHS).
/end
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