NHS workforce retention: The role of e-rostering in empowering clinicians

For any workforce, retention is a complex matter and the NHS is certainly no different. The difficulties the healthcare sector has faced regarding retention have been well documented. Recently, there has been a constant stream of headlines and statistics highlighting an exodus of clinicial and non-clinical staff, and the NHS Staff Survey released last year reported that over a third of respondents (636,348) were thinking about leaving their organisation too.

This figure sadly may not surprise many. Working culture has changed, and gone are the days where the majority of people spend 10+ years working at one institution, however, to see talented, passionate staff leave the healthcare system entirely is placing pressure on all NHS organisations. The impact of a high turnover of staff is vast and creates a number of complicated challenges.


So, why are people leaving the NHS?

The BMJ conducted a study which cited stress, staff shortages and work intensity as key reasons for clinical staff leaving the NHS. Working on the frontline in healthcare is a challenging role, and if you were to ask clinicians directly, many would likely note that they signed up to work for the NHS knowing it would be a challenging environment. However, the stress clinicians cite isn’t just minor or generated by ordinary day-to-day grievances – it is more complex and deep-rooted than that. Amongst other factors, clinicians often feel there’s a lack of autonomy over their schedules, with little-to-no flexibility when it comes to managing their rotas. 

The inflexibility of current workforce planning systems lies at the heart of the issues clinicians are facing, which is then compounded further by increasingly heavier workloads and longer hours as a result of other individuals leaving the service. Clinical and non-clinical staff are not afforded some of the same luxuries other industries are in regards to flexible working, but that does not mean we cannot make changes to improve their experiences.

Currently, rostered clinicians are generally locked into a rigid schedule, where shift patterns are predetermined and inflexible. As a result, a clinician’s schedule can feel constrained, with little room for deviation or personal choice, which in the long term can culminate in many seeking alternative employment. 

To tackle the structure of how those within the NHS are rostered is no simple tweak – it relies on a solution that itself is agile and robust, with an organisation’s and clinicians’ unique needs at its core. 

Why is retention in the NHS so important?

A main priority for the NHS, as outlined in the Long Term Workforce Plan, is retention. Yet, retention is not merely about keeping people in the NHS, it’s about empowering and supporting them in their roles too.

Focusing on retention as well as recruitment is crucial for many reasons. A key one is cost. High turnover rates are expensive due to subsequent recruitment, training, and onboarding costs – reports state that training a nurse costs £37,287. By retaining staff, the NHS can save on resources that would otherwise be spent on frequent recruitment drives. 

Another reason is around enhancing innovation. Long-term employees often contribute significantly to innovation and quality improvement initiatives, which could be something like a roll-out of a new system, where feedback from trusted and valued voices is essential. 

Lastly, and by no means is this an exhaustive list, is consistency in care. Retaining experienced staff ensures continuity, which can lead to the delivery of more effective and personalised care. The longer a clinician works at an organisation, the more they are able to understand and appreciate their responsibilities and relationship with colleagues, which is crucial if workers are to also make the most of long-term teaching programmes or shift swapping opportunities. 

Prioritising staff retention within the NHS will not only secure a strong workforce but also foster a culture of innovation, cost-effectiveness and the delivery of consistently exceptional care through its dedicated and valued clinicians.


How can e-rostering in the NHS support this?

As aforementioned, fixing the current retention crisis is not simple. However, a clear pathway to improving the experience of those working within the NHS is to look at how we are rostering our workforce. 

E-rostering systems provide real-time visibility of schedules, which can also be published much further in advanced, allowing staff to plan their personal lives more effectively. They can also facilitate better communication between team members and management regarding worker availability and shift changes, reducing uncertainty and last-minute stress. 

Effective e-rostering also enables a much more transparent and personalised allocation of shifts, which can prevent situations where certain individuals receive a rota that doesn’t account for personal preferences, such as child caring responsibilities. An e-rostering system should promote fairness and take all preferences from staff members into account where possible, without relying too heavily on administrative staff to manage this process. Not only should a system empower clinicians in this way, but alleviating the burden on rostering teams should also be championed. 

Another capability of an effective e-rostering solution is helping organisations to meet the levels of attainment, by automatically matching available personnel to workload demands. Some e-rostering systems consider factors like skill sets, preferences, and availability, ensuring there’s an appropriate staffing mix without overburdening certain individuals. 

Flexibility and control are additional benefits that e-rostering should offer. Referred to as “self-rostering”, this functionality grants clinicians the ability to input their own preferences for shifts and work patterns. This level of control allows for better alignment with personal schedules and offers a sense of autonomy and control, allowing clinicians to actively engage in shaping their work schedules according to their preferences, expertise, and personal commitments. By granting this level of agency, self-rostering fosters two things: a better work-life balance, reducing stress amongst staff, and enhanced job satisfaction, as individuals feel more responsible for, and invested in, their schedules.

It is not only clinical staff who can benefit from e-rostering. As touched on above, the automation and assistance rostering can provide goes a long way in alleviating some of the administrative burden from rostering teams too. Manual rostering can be time-consuming and prone to errors. E-rostering automates many of these processes, for example, enabling teams to automatically broadcast a vacant shift to bank, alleviating pressure on managers, ensuring accuracy in scheduling, and freeing up time for the non-clinical staff to offer more pastoral or personal support to frontline teams.


In conclusion, the retention of clinical and non clinical staff within the NHS is paramount.

E-rostering in the NHS is becoming more widely adopted, and as time passes, systems must provide effective functionality and features that organisations need to retain their staff, including: Rota building, rostering, exception reporting and leave management.

Clinicians deserve a process that gives them autonomy and a system that encourages them to not only stay within organisations but to feel empowered in doing so.

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