{"id":43607,"date":"2018-12-04T11:00:22","date_gmt":"2018-12-04T10:00:22","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=43607"},"modified":"2019-02-23T19:17:38","modified_gmt":"2019-02-23T18:17:38","slug":"matt-morgan-buying-toilet-rolls-and-writing-rotas","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/12\/04\/matt-morgan-buying-toilet-rolls-and-writing-rotas\/","title":{"rendered":"Matt Morgan: Buying toilet rolls and writing rotas\u2014is this really the best use of clinicians&#8217; time?"},"content":{"rendered":"<p class=\"standfirst\"><span style=\"font-weight: 400\">Quality improvement schemes have so far been aimed at solving clinical and logistical problems, but have forgotten about the most important asset<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">staff<\/span><\/p>\n<p><!--more--><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-38937\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/04\/matt_morgan.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/04\/matt_morgan.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/04\/matt_morgan-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><span style=\"font-size: 1rem\"><span style=\"font-weight: 400\">I\u2019m staring at a screen filled with different coloured boxes, endless numbers and characters fighting for attention. As one number changes, another flashes to life. Although this has similarities to the patient monitors in the intensive care unit where I work, I am actually sitting at my desk. I\u2019m writing yet another rota for twenty people spanning the next six months.<\/span><\/span><\/p>\n<p><span style=\"font-weight: 400\">Teenagers across the land are not told when ticking \u201cmedicine\u201d as a career that an in-depth knowledge of Excel macros is a key requirement for a doctor. Fifteen years of medical training seldom prepares you for the first time you tell a colleague that they are going to work Christmas Day this year. The truth is that I actually like my role of writing a complicated consultant rota. There is a simple satisfaction when all of the cells turn green after matching fifty different study leave requests in the same month to the clinical needs of a unit. Yet a part of me worries about whether this is really the best use of my time. Is it good for the NHS that hundreds of front line clinicians are doing what non-medical others could do better?<\/span><\/p>\n<p><span style=\"font-weight: 400\">The NHS is the world&#8217;s fifth biggest employer spending over \u00a32 billion every week. It employs 1.3\u2009million people with a budget more than New Zealand\u2019s entire gross domestic product. If it were a company, the competition commission would soon be knocking at its doors. Yet this shear scale which should be a winning factor, is often a weakness.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Before improvements in central procurement, even buying toilet rolls was devolved to individual hospitals leading to hundreds of different suppliers. Even my family of four people exploit economy of scale and bulk buy ours together. Yet the NHS was doing the equivalent of popping to the corner shop every day to buy a single roll. One hospital may pay \u00a332 for 100 rolls while another \u00a366 for the very same item. Although procurement is now slowly getting into gear, there are more pressing aspects of scale that should be developed.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Richard Branson said \u201cif you look after your staff, they&#8217;ll look after your customers.\u201d There is now finally appreciation of the negative effects that shift work, poor rostering, and disturbed sleep have on the health of healthcare staff. As the NHS spends 40% of its costs on staff, it makes sense to put staff wellbeing and efficient working at the centre of what it does. This in turn will lead to profound benefits for patients.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Why then, am I reinventing the wheel, making bespoke rotas for our staff, just like thousands of other doctors are doing every day wedged between their clinical work? Although, as a computer geek, I feel I am skilled at this task, I can never be as skilled as the combined knowledge of millions of staff delivered through a software package designed for a specific purpose. Why can\u2019t we learn the lessons of efficient rostering that promotes good health and apply them across the biggest employer in Europe? This would in-turn promote better patient care.<\/span><\/p>\n<p><span style=\"font-weight: 400\">It seems quality improvement schemes have so far been aimed at solving clinical and logistical problems, but have forgotten about the most important asset<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">staff. Using the sheer scale of the NHS to automate, improve, and offload these important tasks from front line clinicians will give them more time and energy to do what they do best<\/span><span style=\"font-weight: 400\">\u2014<\/span><span style=\"font-weight: 400\">be on the front line helping patients.<\/span><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Matt Morgan<\/strong>, Honorary Senior Research Fellow at Cardiff University, Consultant in Intensive Care Medicine and Head of Research and Development at University Hospital of Wales, and an editor of <a href=\"https:\/\/www.onexamination.com\/\">BMJ OnExamination<\/a>. He is on twitter: <a href=\"https:\/\/twitter.com\/dr_mattmorgan\">@dr_mattmorgan<\/a><\/span><\/i><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Quality improvement schemes have so far been aimed at solving clinical and logistical problems, but have forgotten about the most important asset\u2014staff [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/12\/04\/matt-morgan-buying-toilet-rolls-and-writing-rotas\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":43608,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18885],"tags":[],"class_list":["post-43607","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-matt-morgan"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Matt Morgan: Buying toilet rolls and writing rotas\u2014is this really the best use of clinicians&#039; time? 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