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ESR - squeezing it until the pips squeak 2010 HPMA Award Winner for Best Practice and Innovation Using ESR The HPMA awards have been part of the Human Resource Managment (HRM) calender for many years now, celebrating exemplar HR practice. Since 2009 the NHS Electronic Staff Record project (ESR) has sponsored an award – ‘Best Practice and Innovation Using ESR’. This year Heart of Birmingham Teaching PCT won the award.

Heart of Birmingham Teaching PCT receiving the Best Practice and Innovation Award presented by Paul Spooner, NHS ESR Director of Operations at the 2010 HPMA Awards Dinner in London

About the Trust Heart of Birmingham (HOB) PCT employs 1,500 staff, delivering services to 300,000 people living in Central Birmingham. The Trust went live with all ESR functionality including OLM and Self Service in November 2006 and they were a pilot for NLMS in September 2008.

The Strategy From the outset HOB’s approach to the implementation of ESR was to capitalise as much as possible on the benefits that ESR could bring. Rather than treat it as a unavoidable IT project they recognised that the Trust could reap benefits from this powerful, sophisticated solution to help them manage their workforce as they deliver safe high quality care to patients. Chris Heward, HR Project Manager explains: “We believed that we should maximise the potential of ESR: squeezing this exotic fruit until the pips

squeaked : to make sure we got the greatest benefit out of the programme whilst it was still ‘free’ to Trusts”. “Treating some of the powerful functionality of ESR as an ‘expansion module’ suggests that these functions are optional. We treated the ‘expansion module’ as essential. Essential to the trust in the way we managed staff information, essential to managers, giving them the tools to manage their staff and essential to employees, facilitating their access to the development and training needed to perform their jobs”. Prior to implementing ESR HOB, like many organisations in the NHS, rarely engaged with the payroll/HR functionality of the legacy system (PRISM). It was there working in the background and was left to it’s own devices to ‘just pay staff’. The PCT recognised the deficiencies in this approach and this encouraged them to embrace ESR more completely. Their success in the implementation of ESR in the areas of Oracle Learning Management (OLM) and Self Service was recognised with awards at the 2009 West Midlands ESR awards for innovation and best practice. Key to their vision was the complete use of all components of ESR. The PCT went live with of Manager Self Service (MSS) (used by all managers) and Oracle Learning Management (OLM). At the time, no other Trust had made this decision so they were the first organisation to fully use ESR in this way. Using the legacy systems they recognised that they were ‘information poor’. Chris explains: “Yes we knew the headline facts, numbers of staff employed for example, but even here it was difficult to report on this other than in a cost centre driven manner. Worse than this was the awareness that our sickness reporting was inadequate. The hurdles in the paper based legacy process resulted in a Trust reported sickness rate that was significantly lower than the NHS average. MSS allowed us to promote the idea that the Managers are the ‘owners’ of the data on their staff. We felt that managers, rather than any central team, should be responsible for all staff information, not only the transactional absence recording, job changes etc. but also, using OLM, the added value 'Career Management' functionality of Learning, 'competences' and Development Reviews”. Using standard project managment methodology HOB defined project boards, project roles, and documentation. With frequent project board meetings the progress of the project was monitored by their ESR Executive Sponsor and the Trust Board.

Benefits and achievements • The Tusts’s reported sickness rate is now closer to the NHS average. This is a consequence of a behavioural change due to Managers being more aware of their responsibilities in recording absence - this awareness being a valuable benefit of the MSS training that not only teaches the IT ESR lessons but also covers the Trust HR policies.

ESR also allows the Trust to capture and monitor sickness reasons; for example they can track stress/anxiety and monitor the effectiveness of their anti-stress campaigns, they also followed the Swine flu absences with weekly reporting. Cost savings are significant. With the help of ESR in recording and monitoring sickness in the Children’s Service the Trust has achieved a reduction in sickness from 7.06% in 2008/9 to 5.35% in 2009/10. This saved £80,000 in just this one service area. Using ESR reporting they now aim to achieve sickness levels across the Trust to match those of their best service (3.6%) to yield a £1.25m saving in salary and agency costs. •

HOB fully utilise NHS jobs and the interface to ESR, this direct entry by applicants allows them to manage a busy recruitment campaign with one less administrator saving £30,000pa. This is helped by their complete ‘Establishment’ in ESR (judged by a independent consultant to be ‘the most advanced’ implementation) that means they only recruit to vacant positions.

Further direct data entry using Self Service is saving 500 repeated entries per month, these would previously have been noted on paper forms before entry to the HR/payroll system. The number of HR change forms processed every month has reduced by 50%.

The administration of training attendance has also allowed the Trust to reduce the ‘waste’ of places by non-attendance. The Did-not-attend (DNA) figures were reduced from 10% to 5%. This saves the Trust the equivalent of half the training time of one trainer. The completeness of Training information, from OLM, for staff allows them to closely manage mandatory Training - they are using ESR 'Competences' to generate automatic reminders to Managers when staff need refresher training. They have also started using the same functionality to manage job specific training, for example in Child Safeguarding. This ensures that the PCT staff are trained to deliver the appropriate safe care to patients.

Key Messages from HOB PCT ESR touches all parts of an organisation. The implementation, therefore, requires team working between many departments - HR, Finance, IT, Operational departments etc.. More importantly as employees use the functionality, for example to manage their own training, the ‘team’ working with ESR becomes 100% of the organisation. The leadership required to ensure that all in this team are heading in the same direction is significant. More importantly, the vision required to define where the road is leading is invaluable. Within the Heart of Birmingham this leadership has been with the Project Manager. It has been important to understand what this big IT solution of ESR can actually deliver to facilitate

not only the basic Trust processes (recruitment, absence recording, training administration) but also how it can impact on patient care; by the better management of staff, ensuring they are appropriately trained, qualified and registered. Implementing the ‘expansion modules’ of Self Service and OLM is not difficult. It does require effort but we believe these extra modules bring 80% of the benefits of ESR. For more information about this case study and the work within HOB PCT using ESR email Chris Heward, HR Manager at

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