Effectively planning and scheduling district nursing across the NHS

Like so many industries and bodies, the NHS had to adapt in several ways during the Covid pandemic. The frontline of its efforts to tackle the virus made the headlines, but away from Covid wards there was a necessity for the NHS to adapt its processes and practices around the threat posed. One such example regards district nursing – how was the NHS able to effectively and efficiently plan and schedule its nursing workforce in the face of meeting the challenge of delivering vital services away from hospitals?

In short, there was something of a struggle across some NHS Trusts to meet this challenge. The usual routine of bringing vulnerable patients into the hospital environment for the administration of care had to be reviewed in order to reduce the risk of exposure to Covid for such patients. This meant putting more nurses out on the road to deliver care in residences and care homes. This change also fulfils part of the NHS’s Long Term Plan: “Over the next 10 years, health and care will change significantly. We have a roadmap in the NHS Long Term Plan which sets out a new service model for the 21st century: increasing care in the community; redesigning and reducing pressure on emergency hospital services; more personalised care; digitally enabled primary and outpatient care; and a focus on population health and reducing health inequalities.”

There was a sudden increase in demand for domestic patient visits thrust upon NHS Trusts with the Covid pandemic, meaning that processes and protocols had to be drawn up and adhered to in a short space of time. The process of planning and scheduling district nurses to carry out these additional tasks meant that a vast number of clinical hours had to be diverted to scheduling and planning. On top of that, there was the inevitable rescheduling of appointments to contend with, too.

This is a largely manual process at present for many NHS Trusts, with others relying on old software which isn’t suitable for handling the modern scheduling demands of district nursing. Operating hundreds of nurses to fulfil thousands of appointments in an efficient and effective manner is a huge undertaking. Doing this manually requires a monumental effort on the part of those responsible and using outdated software only makes the challenge harder.

Furthermore, each appointment must also take into consideration the skillset of the nurse conducting the appointment, ensuring that they are appropriately qualified to undertake the task. This requires careful planning and oversight and was a process that could be shattered in an instant with a positive Covid test for a district nurse. Operating this manually, simply put, is unsustainable given the hours being diverted to it, the strain of efficiently managing the workloads of every district nurse and the requirement to consider each nurse’s competency for each visit. So, there is an opportunity to implement new technological systems which will bring about lasting benefits – the healthcare world will be a different place even once Covid is a memory.

Automated planning and scheduling software can bring about a multitude of benefits for NHS district nursing including:

• Reducing the clinical time spent on scheduling appointments – automating the process massively reduces the workload, leaving administrative time to focus on exceptions
• Reducing travel time and expenditure – efficiently scheduling district nurses to maximise the number of appointments they can fulfil reduces the burden on the Trust by ensuring each nurse is fulfilling as many appointments as possible
• Enabling demand and capacity modelling – identifying demand gaps and knowing exactly how many district nurses are required at any given time based on actual demand
• Supporting the identification of skill gaps – spotting skill shortages based on future demand means a proactive and accurate approach to future workforce training and recruitment can be adopted
• Meeting Lone Working Policy requirements – where staff are working alone there is the potential for them to face hostile situations; having a robust system in place enables them to raise an alarm where such scenarios arise
• Increasing assurance that service delivery is meeting the requirements and needs of patient demand – reports can be generated to see the effectiveness of service delivery and to identify any shortfalls in staffing required to deliver services in line with patient demand
• Reduction in missed or delayed visits (and associated clinical incidents) – by efficiently planning rosters, travel time allowances can be factored in, lowering the risk of external factors disrupting your schedule and making it more likely that appointments are met, reducing the risk of clinical incidents occurring as a result of staff scheduling
• Improved communications with patients and carers regarding visits – automate messaging through your system to inform patients and guide nurses

All these benefits from a system can be used to shape a more consistent and reliable future for NHS Trusts in delivering vital services. CACI works across the UK with community care teams who use our Cygnum software to help deliver a huge range of centrally and domestically located services, helping to keep vital care and community services running. The software is also used by the Care Quality Commission to schedule their inspection workforce.