Picture a typical NHS trust on a Tuesday morning. The cardiologists are tracking their annual leave in a shared Excel file. The anaesthetists use CLWRota for rostering and leave. They've used it for years and you couldn't prise it from their hands. The nurses use the HealthRoster system. Some of the consultants store their leave on SARD alongside their job plans. And somewhere in the Doctors' Mess, laminated to the wall by the kettle, is the on-call rota.
That's the tip of the iceberg. Hundreds more rotas, systems, inboxes, spreadsheets and documents containing workforce data. Several of these systems contain a record for Dr Sarah Adebayo, but finding her among the mountain of data is a challenge.
As illustrated below, she appears as Payroll #4471 in ESR, Adebayo, Sarah J in SARD, S. Adebayo in e-Job Plan, Dr A in the Cardiology leave spreadsheet, yet none of these systems know it's the same person.
This isn't a niche technical problem. It's the daily reality for the majority of NHS trusts and has real consequences. There is no single workforce view or cross-system answer to: ‘is this doctor's job plan capacity matched by their roster?' or ‘which doctors are due for appraisal this quarter?'
Previous integration programmes
Previous integration programmes have often been costly and complex. More recently, trusts have pursued single-supplier platforms, but these require major procurement exercises and force compromises because there is no silver bullet system that does all workforce management functions well.
Trusts don't want wholesale replacement or another massive transformation programme, they need interoperability and flexibility. AI and modern integration approaches are now stepping in to make it possible to do it faster and at the fraction of cost. It offers an opportunity to rethink how the NHS manages its greatest asset across a unified platform.
The best of breed philosophy
We can now create an integration engine enabled by AI and automation that sits over the top of multiple systems and connects them together. Systems can be adopted based on a best of breed model so trusts can retain specialist systems while multiple suppliers coexist.
The integration layer provides a framework that can incorporate whichever system is best suited to each workforce management function, creating a comprehensive unified workforce view. It avoids a complete rip and replace, losing good functionality, unhappy users and being locked into a single provider.
How a best of breed approach can work technically
The integration engine acts as a smart directory, creating one coherent workforce view and single source of truth. Instead of storing copies of everything in one place, it tracks where information lives and how records from different systems are related to each other. So, if we refer back to Dr Adebayo, her unified record would look like this:
The engine maintains a directory of connected systems, storing references and linking records so it can recognise that the same doctor exists across multiple applications. Detailed workforce information remains in the source systems that manage it, whether that is a SARD product or a third-party platform such as Lantum or Locum's Nest.
When a user needs information, the engine retrieves it directly from the relevant system in real time. This avoids duplication, keeps data up-to-date and allows different supplier systems to work together seamlessly. Each system acts as a connected service, providing summary information for dashboards, returning detailed records when requested and applying its own access and permission rules.
Day-to-day impact
The breakthrough in consolidated data will have a huge impact on directors of workforce and HR who require data from multiple systems and spend hours per week, along with their team, reconciling spreadsheets to inform day-to-day workforce decisions. They can aggregate and analyse data from a range of reports such as doctor capacity vs rostered shifts, appraisal compliance trended by speciality and unfilled shift rates linked to leave patterns.
It streamlines appraisal and revalidation for medical directors and directors of medical education, a currently clunky and frustrating process which often leads to deadlines being missed. The engine can support appraisers with consolidated information about each appraisee without switching between systems and presents a revalidation pipeline, months ahead of deadlines.
For chief information officers, each siloed system demands separate integration work, identity and access controls, and its own reporting. It is a constant integration challenge and a considerable security overhead. An integrated platform with a unified workforce view can be achieved for less than a quarter of the annual budget needed for an alternative SaaS-suite procurement.
Creating the right conditions for transformation
The quest to unify NHS workforce data is heading in the wrong direction because wholesale system replacement won't address the underlying problem. The real issue is unlocking the valuable workforce data that exists in current systems, bringing it together and being able to interpret it meaningfully, with minimal disruption and cost. This collaborative ecosystem will initiate a serious paradigm shift for NHS workforce management and enable transformation to flourish. Only then will we be able to find Dr Adebayo at the click of a button.
