Expanding the use of ESR to Junior Doctors

A Case Study by St Helens and Knowsley NHS Foundation Trust

Background

St Helens and Knowsley have been the sole Lead Employer Organisation for Cheshire and Mersey Deanery since 2010 and manages 2100 junior doctors who rotate not only to any one of 27 Host Trusts but across specialties within Trusts.

400 GP trainees based in any one of 175 GP practices located from Cumbria in the North to Derbyshire in the South form part of the 2100 junior Doctors, and management of this group of staff presents a range of challenges; not only geographical but also around areas such as IT infrastructure and the lack of ESR knowledge.

In April 2016 the trust was invited to tender for Lead Employer Services for GP trainees from Health Education West Midlands (HEWM).  Our experience of managing the GP trainees for Cheshire and Mersey Deanery provided us with the knowledge to manage this group of staff, and although the numbers of trainees were higher the basic principles of our Lead Employer ESR model was seen as transferable.

The GP trainees within HEWM were employed directly by the individual GP practices and managed by the practice managers, with payroll outsourced to numerous external providers. They did not appear on the national ESR Database.

The practice managers would carry out a range of administrative tasks for each trainee; 

• Carry out ID Checks and maintain records.
• Carry out DBS Checks and maintain records.
• Calculate Pay, Grade, Banding paperwork for Payroll Providers.
• Calculate Leave entitlement.
• Complete Absence information, Holidays/sickness/special leave for Payroll Providers.
• Completion of Training/Appraisal data.
• Complete the Termination Process.

The above process would be necessary each time a trainee rotated (up to two rotations per year per surgery) X 470 surgeries.

Our tender involved becoming the lead Employer for the GP trainees and utilising eSolutions such as ESR, not only because of our previous experience with Cheshire and Mersey but also the much larger geographical footprint of the GP locations (Crew to the North and Gloucester to the South).  We demonstrated the need for change and how this could be managed by the streamlining of services and the use of ESR.

Our approach included identifying the benefits of:

• HR and Payroll services provided directly through ESR
• Managing Training and Appraisals through OLM
• Greatly improved Absence Management through ESR
• ESR BI Reporting
• E-Expenses via ESR
• Occupational Health clearance using ESR
• DBS/Right to Work recorded and monitored through ESR
• MSS and ESS and the planned remote Access via My ESS

The reporting capabilities of ESR and in particular absence reporting were an area of interest for the tender panel. With 470 GP practices all independently recording sickness assurance around the reliability, detail and accuracy of this information is a key challenge.

We have developed suites of BI absence reports which we run for the Cheshire and Mersey Deanery.  Being able to provide this level of detailed reporting from ESR was seen as a big positive in our tender and we were successful in our bid, being awarded the contract by Health Education West Midlands starting in August 2016.

The Project

With the contract for GP Services in West Midlands commencing on the 1st August 2016, we initially set a target of introducing ESR MSS and ESS within 12 months.

A Project Team was established involved Key Stakeholders from HEWM to develop a project plan which enabled the implementation of ESR and the Streamlining of services.

One of the major challenges was the geographical spread of the 470 GP practices and their lack of knowledge and understanding of ESR.   Working with HEWM the project team attended GP Practice Manager and Medical Staffing Manager events throughout the West Midlands to present our proposals for the introduction of a Lead Employer model and the streamlining of services through the use of ESR and eSolutions.

These events were well attended with upwards of 50 to 100 Managers attending each event. The response was excellent; with Managers quickly buying in to the proposal, seeing how the model of using ESR as HR and Payroll solution would greatly improve efficiency allowing them more time to manage other areas of the Practice.

We use a Web Based information portal called HR Direct for Managers and Junior Doctors in Cheshire and Mersey Deanery and agreed that this would be ideal platform for training Practice Managers on the functionality of ESR. We uploaded the ESR captivate training video’s onto HR Direct and provided each Practice Manager with access to the captivate files.

The trainee GP’s were set up with access to ESR ESS using a Username and Password, and from September 2016 the trainees began accessing MyESS by first logging into ESR through the secure N3 connections within their practices, and then setting up remote access to ESR ESS via smartphones or iPads.

By adopting this approach to implementing MSS and ESS through remote e-Learning, 80% of the practices were accessing and interacting with MSS and ESS within 4 months of the contract starting, way ahead of the original 12 month target.

The Benefits

There are many benefits of implementing a Lead Employer model using ESR as the main driver for change; these include:

• We have reduced the time needed by Practice Managers on the administration of GP Trainees. This has been conservatively estimated at 12 hours per trainee per rotation. This equates to 12 hours per trainee X 470 Surgeries X two rotations per year X £24 per hour based on Band 8 = £270,720 Per Annum Savings;
• GP trainees appear within the National ESR Data Warehouse, enabling greater scope for central workforce planning for trainee GP’s;
• Central control of absence data enables staff with underlying medical problems to be identified quickly and interventions planned;
• Enables ‘hot spots’ of sickness to be identified, these could be individuals or problems within certain practices;
• Access to MSS and ESS for Managers and Trainees;
• Access through MyESS remotely via Smartphone/iPad empowers GP trainees and managers to access to their own data remotely; they can manage their own information in a quick and easy way; giving them more time to focus on delivering high quality care.

Shared Learning

Our innovative use of ESR functionality has now become the driver in developing the Lead Employer model for managing Doctors in training on behalf of HEE.  With NHS England keen that the remaining other five HE regions for GP’s in training should have a Lead Employer Organisation by the end of 2017, we are working alongside them to promote the model and highlight the vital role that ESR plays within that.  Part of that work involves us developing a help desk facility that the other five HE regions can access for help and guidance whilst they are establishing their Lead Employer model.

“The benefits of using Self Service has enabled us to view and input trainee data in real time. Being able to view sickness history means we can monitor activity and act swiftly should the need arise.  We can also keep track of annual leave and ensure that a trainee has taken the correct allowance.”

Julie Stokes Practice Manager Audley Health Centre North Staffs

The Next Steps

Having recently become the Lead Employer for HE East Midlands with circa 750 GP’s based over 208 GP practices and 14 Acute Trusts we plan to roll out Manager Self Service across these organisations, including a Trust that doesn’t currently use ESR.

As part of the new portal release we will also be looking to implement MSS via the internet to add flexibility of access.

For more information

 If you would like to talk to the team about our Lead Employer model please contact Joanne Powell Head of Workforce Planning ESR and HR Systems Development on 0151 290 4342 or email Joanne.Powell@sthk.nhs.uk.