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Establishment Control using ESR

A case study by Derby Teaching Hospitals NHS FT

Background

Derby Teaching Hospitals NHS Foundation Trust has an annual budget of £500 million and is one of the largest employers in the region with more than 8,000 staff.  It provides both acute hospital and community based health services, serving a population of over 600,000 people in and around Southern Derbyshire.

The Trust runs two hospitals: the Royal Derby Hospital, which incorporates the Derbyshire Children’s Hospital, is a busy acute teaching hospital and London Road is the Trust’s Community Hospital.

The Trust treats a million patients each year and more than 6,000 babies are born in its maternity unit annually, an average of 17 births every day. 72,000 elective operations take place every year in the hospital’s suite of 35 modern operating theatres, an average of more than 280 operations per day.

The Project

The main aim of the project was to enable accurate reporting on establishment from ESR.   This meant that we would need to ensure all staff establishment data was entered into ESR so that we could identify notional vacancy gaps and over-establishments. This was driven by a requirement to accurately report staffing utilisation at business unit level in Trust Board Reports.

Before work on updating the current ESR data commenced, our Finance team worked with our ESR team to develop a joint process for new starters including creating new positions in ESR when necessary. The Finance team would complete a New Position form for the ESR team, identifying the position details (Including Job Title, Band, Cost Centre & subjective code and Staff Group), along with the funded establishment against the position. The ESR Team would then create any new positions identified in ESR, and record the funded establishment.  Once this process was in place, we began to update the existing position data in ESR.

Firstly the ESR team ran the Position Analysis report, identifying all current positions in ESR. The Finance team used this to match each position in ESR against the details held in the General Ledger. ESR differs to the General Ledger in that there can be several similar positions in a single Cost Centre, all of the same band, but which Finance would just identify as a single budget line/Subjective Code. In order to minimise data maintenance it was locally determined that the establishment would be recorded against a single position in that organisation, rather than against each position. This would mean that some positions showed as over established and some under established, but when reporting at the organisational (Cost Centre) level or by band, the total establishment matched the ledger at that level.

For example – All the ESR positions below are in the same Organisation, but from a Finance perspective, the Ledger simply has one line for Consultant with an establishment of 69.84.

By recording the 69.84 in ESR against only one position, all the other positions show as under-established, but when aggregated at Organisation (Cost Centre) level, it can be seen there is an under-establishment of 17.44

The reason there are so many ESR positions in this Cost Centre, is due to the fact they are all on differing Pay-scales (Due to Level of Seniority – as can be seen by the Grade column below).

Once the Finance team had completed this work, the data was returned to the ESR team, who then entered each of the identified establishments against the ESR positions.

When ESR had been updated, we agreed and embedded a new process:

• When any budgetary change is made by the Finance team, which changes an established position, they access ESR and amend the establishment to maintain a match with the General Ledger.
• A monthly control report is run which the Finance team use to ensure the ESR details reconcile with the General Ledger details.

As well as enabling accurate reporting, having the establishment recorded against each position means ESR advises if the entry being made takes a position over its established total - see the screenshot below.

 

This then leads to a question as to whether this over-establishment is expected.

Due to the process that our Trust has implemented, recording establishment against selected positions (rather than all) we do receive the above message for most amendments made in the system, and users are aware of this. The messages would be of benefit however, if recording the establishment against individual posts.

Key Benefits

The main benefit of embedding the ESR Establishment Control process is the ease at which reports can be run, clearly identifying over and under establishments.

Example Oracle Business Intelligence Report:

Recommendation 12 of the Carter Report stated that: "NHS Improvement should develop the Model Hospital and the  underlying metrics, to identify what good looks like, so that there is one source of data, benchmarks and good practice."

One of the Key items identified for trusts was:

Trust boards ensuring that the Electronic Staff Record (ESR) is reconciled to the financial ledger on a weekly basis, with a minimum reconciliation of 95% from October 2016. 

Having the Establishment Control process in place in ESR enables us to meet this requirement, and our quarterly validation checks between the finance ledger and ESR ensures that the establishment remains in line. Monthly meetings with Finance Managers ensure Cost Improvement Programme’s (CIP) and any changes to establishment are mapped accordingly.

This has enabled us to submit more accurate returns, and in particular has been beneficial for providing the monthly Monitor staff information, providing detailed staff and vacancy information for the Sustainability and Transformation Plans (STPs) and has given us a clearer understanding when reviewing staff details in relation to the Carter metrics.

Close working between our ESR and Finance teams over a number of years has given us a much better understanding of the true level of vacancy in the organisation. There are still “differences” between the two systems with regards to Maternity leave and other absences, and also with the treatment of CIP/vacancy factor in the Ledger the difference now is that we understand these areas.

“The joint working has also allowed ESR Occupation Codes to be fed into the General Ledger to make the reporting of cost and WTE by staff types easier in the many returns now required by the Trusts regulators.” 

Scott Jarvis, Director of Operational Finance.

Lessons Learned 

The implementation of an Establishment Control process does take time, and does require a very close working between your Finance and ESR teams.

It is vital that the maintenance of the establishment data in ESR is kept up-to-date with changes made in the General Ledger. If they are not, this will lead to a further reconciliation exercise being required to realign the two data sets.

Further Information 

If you want more information about the Establishment Control project at Derby Teaching Hospitals, please contact Greg Chambers, Workforce Systems Manager – 01332 258141, greg.chambers@nhs.net or Chris Broadhurst, Head of Finance Systems - 01332 789531, chris.broadhurst1@nhs.net directly.

For information about ESR Establishment Control functionality and best practice please contact your NHS ESR Functional Advisor or Account Manager or access the HR Best Practice guide on Kbase https://www.electronicstaffrecord.nhs.uk/kbase/afile/223/6215/

Are you accessing your ESR online payslip?

In June we made some improvements to the online payslip in ESR.  The most obvious change for employees was that we had made the payslip look exactly the same as the printed payslip that is distributed around many NHS organisations before pay day.

Making the payslip easier to read on line and exactly reflect the printed payslip was an important user requirement.

In October we launched ESR via the internet.  By making myess.esr.nhs.uk widely accessible at home or on the move, one of the key barriers to accessing the online payslip, within Employee Self Service, was immediately removed.  For NHS organisations this now means that they can:

• Build on the benefits offered by Employee Self Service with wider access to ESR;
• Remove the cost of printed payslips;
• Increase staff engagement;
• Increase staff productivity;
• Reduce the amount of time spent dealing with individual employee queries.

In 2015 Derby Teaching Hospitals had identified the efficiencies and benefits of moving to online payslips, so when access became even easier for employees, they seized the opportunity to go one step further...

Implementing the ESR Online Payslip at Derby Teaching Hospitals NHS Foundation Trust

Background

Derby Teaching Hospitals NHS Foundation Trust has an annual budget of £500 million and is one of the largest employers in the region with more than 8,000 staff.  It provides both acute hospital and community based health services, serving a population of over 600,000 people in and around Southern Derbyshire.

The Trust runs two hospitals: the Royal Derby Hospital, which incorporates the Derbyshire Children’s Hospital, is a busy acute teaching hospital. London Road is the Trust’s Community Hospital.

The Project

All our employees have access to ESR Self Service (Limited Access), but in September 2015 we established a project to implement the ESR online payslip, and selected a small number (161) of clinical and non-clinical trust employees to participate in a pilot. 

The main aim of the pilot was to assess the benefits for our employees, but also the overall benefit to us as an organisation.  We knew the on line payslip would bring the following benefits:

• Access all of their pay-slips since their employment commenced with the Trust (these are held securely within ESR)
• Ability to print or download copies
• There would be no more lost pay-slips or delays in the post
• Reduction in time for the Payroll team in sorting & distributing payslips
• Reduction in time for teams within the Trust in distributing pay slips
• Reduced Information Governance risk of distribution of paper pay-slips

We held two awareness sessions that included a Q&A and a brief overview of what the online payslip functionality looked like.

Following the awareness sessions, we produced a guide to accessing your on line payslip for the employees taking part in the pilot and also developed  frequently asked questions answering the most commonly asked questions that came from the sessions (all of these resources were accessible on the Trust intranet).

The pilot employees were advised they would not receive a paper payslip from October 2015 and they were sent the guide and FAQs. Throughout the pilot we encouraged our employees to provide feedback on the functionality.

The feedback we received was very positive. The only real criticism was that ESR could only be accessed from an NHS location, and so did not allow easy access for busy clinical staff that didn’t always have access to a computer during their shift.

The only other area of concern raised was in regard to Bank & Building Societies accepting a print-out of the online payslip (NOTE – at this time, the online payslip was in a different format to the new online payslip that was introduced in June 2016). Several staff involved in the pilot were in the process of applying for new mortgages, and they were asked to use the online payslip print-outs and advise if these were acceptable to the banks. In each case, the banks were happy to accept the printout of the online payslip. We updated our FAQs , to provide guidance for other employees.

Following the conclusion of the pilot, we embarked upon a wider rollout in May 2016 where a further 590 employees across various clinical and non-clinical departments were advised that they would be able to access an online payslip and would not receive paper payslips from June 2016.

In terms of timing, the introduction of the new improved online payslip (being an exact copy of the paper payslip) in June, was an added bonus for us and our employees gave positive feedback.

With the introduction of ESR Self-Service being available for staff to access remotely, from non-NHS locations, the issue of staff not being able to access a PC to view their payslip at work has in effect been removed, and a wider rollout of the online payslip functionality is now underway, with over 20% of Trust employees no longer receiving a paper payslip (as from November 2016), with further rollouts scheduled in January, February and March 2017.  It is our long term objective to remove paper payslips altogether. . From January 2017 onwards, all new employees joining the Trust will be advised as part of their Induction process that they can access their on line payslip via our = Intranet ESR pages.

Key Benefits

The key benefit of moving to online payslips is the reduction is time and resource to sort and batch payslips for onward distribution around our departments.

The introduction of ESR via the internet means that in terms of our long term objective, there is no reason why the majority of our employees should continue to receive paper payslips.

“Access to the online payslip was well managed and smoothly implemented. Staff had the opportunity to ask questions and raise concerns. Not only prior to the introduction of the online service but during the period of the pilot staff were encouraged to share their experiences of using the system and to comment on how it was working for them. All suggestions were taken on board and acted upon to improve the process. Personally I have found this invaluable; to have instant access to information without the need to search for paper payslips has been most useful. The monthly distribution of payslips, working out who works where and making sure that those who have moved on get their payslip has stopped. This has saved time and worry for the admin team.  It has been a positive experience for myself and for my team.”

Grace Pearn, Service Manager, Specialist Medicine

Lessons Learned

Engaging your workforce at the earliest opportunity is a key tip for anyone planning to implement a change like this.  Allow employees time to access the system, and resolve any IT issues if they are unable to access their ESR account, and to also allow time for them to ask any questions they have.

We have found our internal guide and FAQs essential resources for ensuring that our employees feel supported and can raise queries.

Further Information

Please contact Greg Chambers, Workforce Systems Manager – 01332 258141 or greg.chambers@nhs.net for more information about the project at Derby Teaching Hospitals NHS Trust.

If you want to know more about using ESR Self Service there is a Self Service section on our Kbase. Just log on and click the following link:  https://www.electronicstaffrecord.nhs.uk/kbase/entry/27/ 

If you want to know about how to make the online payslip available to your employees via myess.esr.nhs.uk please log in to Kbase and follow this link:  https://www.electronicstaffrecord.nhs.uk/kbase/entry/523/ you’ll find helpful resources including a presentation slide pack.

Pilot and Implementation of Nurse Revalidation in ESR

A Case Study by Newcastle Upon Tyne Hospitals NHS Foundation Trust

Background

In October 2015 the Nursing and Midwifery Council (NMC) introduced revalidation for all nurses and midwives in the UK: the most significant change to regulation in a generation.

Revalidation means that everyone on the register will have to demonstrate on a regular basis that they are able to deliver care in a safe, effective and professional way. All nurses and midwives will have to show they are staying up to date in their practice and living the values of the Code, by reflecting on their practice and engaging in discussions with colleagues. For the first time, they will also have to obtain confirmation that they have met all the requirements before they apply to renew their place on the register every three years.

Because Nurse Revalidation was seen as a significant change to the nurse/midwife regulation process by the nurses and midwives in our Trust we very quickly decided to support staff through this new process.

Every nurse or midwife is very important to us and we did not want to lose one because they had to revalidate and didn’t know what to do. At the time of the new regulation process it was and still is a challenging environment for nursing recruitment, so the Trust Board agreed to second a Senior Nurse to lead and project manage the new process, supporting our established Nurses and Midwives.

Initially the NMC stated that the revalidation process had to be via an electronic portfolio and the Trust commenced a scoping exercise to review electronic portfolios; during this exercise we became aware that the ESR solution could facilitate the revalidation process. We engaged with the NHS ESR Central Team and compared the benefits of ESR and the other revalidation providers. ESR was chosen to pilot Nurse Revalidation within the Trust at the end of November 2015.

The Approach

When we commenced our pilot of Nurse Revalidation, the national Nurse Revalidation template in ESR had not been released, so we created our own template using HTML code. In preparation for the pilot and to make the best use of ESR the organisation moved from Employee Self Service Limited Access (ESSLA) to Employee Self Service (ESS) for the nurses/midwives in the pilot. During the pilot we asked the nurses/midwives to give feedback on the revalidation process and ESR. It was important for us to have a system that our nurses and midwives could trust and that they had the support to undertake the new process.

Some of the feedback we received from the nurses and midwives was really encouraging, with our nurses valuing ESR as a ‘one stop shop for information’. Training dates relating to mandatory training was easily accessible and helped the nurse/midwife and manager with the process, which helped ‘to take the pressure off the nurse during revalidation’.

The feedback from our nurses midwives and managers during the pilot supported the use of ESR and gave us assurance about our agreed approach to the Nurse Revalidation process. This assurance enabled us to monitor the process, with the ability to intervene if a risk occurred during the revalidation period. This was very useful for our Senior Nurses, who were confirmers as well as managers of those undertaking revalidation. We had assurance at all levels within the organisation.

We concluded the pilot in August 2016, making the decision to rollout Nurse Revalidation using ESR to all our Nurses and Midwives (4,500 +) and at the same time we transferred all our staff from ESSLA to ESS to support Nurse Revalidation in ESR.

Benefits

Using ESR for Nurse Revalidation has us given the right assurance about the nurse revalidation process, and that our nurses and midwives have a system that meets their needs linked to the NMC guidance. 

“As an existing ESR & Business intelligence user, it was simple to navigate to the information I needed. The report provides assurance that staff that have completed the tracker have begun the revalidation process. It was easy to identify those in year 3 of the cycle who should be ready for their confirmer discussion”.

Matron ICCU / Pre-assessment

Lessons Learnt

Communication is key.  A steering group with relevant stakeholders and an Executive lead, provided leadership for the implementation. Very quickly we realised that we should never miss an opportunity to communicate to staff via as many channels as possible. We used drop in sessions, workshops and any meeting that had managers, nurses or midwives present as well as using word of mouth across the organisation.

We developed an intranet site which provided information and examples, but also directed staff to the NMC Revalidation page. 

We engaged as many of our Senior Nurses as possible to spread the word, using a standardised approach for a consistent message. By targeting the Nurses due to revalidate

12 months in advance we were able to support them as well as monitor their progress. This also provided ongoing assurance to the Trust Board.

Even though a lot of our nurses and midwives can and do use IT equipment on a daily basis, it was a cause of concern for some so we gave them support to use the system as well as support to navigate through ESR.

Watch our You Tube video here:  https://www.youtube.com/watch?v=GZGWphEEQvQ

Looking Ahead

• We are delighted that the NHS ESR Programme has launched ESR via the internet. We feel this is a real game changer, giving our Nurses and Midwives 24/7 access, at any location.
• We are supporting our Nurse Managers to utilise the Revalidation Business Intelligence reports via Manager Self Service providing a robust monitoring process, for the organisation.
• As more Nurses and Midwives use ESR for Nurse Revalidation, we are collating the feedback to share with the NHS ESR Central Team.
• We are reviewing the external learning function within ESR, to record the CPD for our Nurses and Midwives during the revalidation.

For more information

If you want to know more about how Newcastle Upon Tyne Hospitals are using ESR for Revalidation please contactuzanne Medows, Senior Nurse Practice Development at Suzanne.Medows@nuth.nhs.uk or by telephone on 0191 2139414.

There is information about using ESR for Revalidation on the ESR Website.