Medic leave management: the critical link for improved service delivery

There is a long running argument that any leave management system is better than not having one at all. 

This is perhaps true but other arguments suggest that it is even more critical to have an electronic centrally visible leave management system rather than a ‘good’ leave management system that is only visible to a few select individuals.

There is merit in both statements, however it has become increasingly apparent that having an integrated leave management system especially for medics is an even better approach, than simply having a standalone leave management solution that has no consideration of medic planned or rostered activity.

So why has integrated leave management gained greater focus as an aspiration for many healthcare organisations in the UK in the last few years?

The management of medic leave has historically ranged on a scale from good to adequate to complete chaos.

Trainee doctors have found it particularly difficult to book leave in advance of their 3 to 4 month rotations and on many occasions, they have rotated into different departments only for the departmental manager to find out the doctor has several days/weeks of unused holiday which they have bought with them. The result is disruption to the available medic staffing requirements of the department; and the more senior a trainee doctor becomes, the greater the direct impact and risk to the delivery of clinical activity in the first place.

Consultants on the other hand have by the nature of their career training and independent critical decision making modus operandi, historically functioned as silos of clinical activity. The skill set and pressures of a consultant mean that it is not necessarily at the forefront of a consultant’s mind to consider the impact of a leave request on the department overall; and often they assume that this process is dealt with elsewhere

While some consultants still consider that the unique specialism of their respective job means that this level of independence also translates into greater independence when it comes to planning and booking annual leave.

Furthermore, instances of senior clinicians requesting study leave and immediately booking travel (train, planes or other) before approval is more of a regularity than you would expect.  Often paper heavy leave systems result in the leave approver only noticing the request after the event, so retrospective approval ends up being a process rather than a request.

There are also several instances of critical levels of clinicians in the same team being absent at the same conference at the same time, without anyone appreciating the impact until the only available course of action left is to cancel clinical activity. This repeats itself time and time and again across the UK Healthcare sector without appropriate measures being in place to monitor, restrict or prepare for such mass exodus of critical staff.

As the focus continues on controlling locum costs, it is key to look beyond the quick fixes. The time has come to ensure organisations have early visibility of gaps in rosters so that roster managers can take steps to utilise substantive staff before the answer becomes a locum. When managers only become aware of a gap two or three hours before the activity is due to be delivered there is no alternative option other than to find a costly locum.

So how does an integrated app based leave management solution help with all these challenges and most importantly integrated to what exactly?

A leave management solution which is linked to consultant job plans and by extension rosters will provide instant visibility of planned consultant activity and therefore provides immediate visibility to the leave approver of affected activity.  Subsequently, adequate decisions can be made early enough to safeguard planned clinical activity and therefore patient experience or at worst ensure minimisation of wasted resources scheduled for activity that is not required.

A leave management system that is also closely integrated to trainee doctor rotas and ultimately rosters provides visibility of the impact of trainee doctors’ unavailability, the impact on planned activity and simply safe staffing levels in a department. Most importantly a leave management system that integrates to rosters for trainee doctors provides assurance that leave for rotating trainee doctors is taken evenly across those rotations and not being weighted heavily in any one team thus placing clinical activity and safe staffing levels at risk.

Additionally, an integrated leave management system for trainee doctors that provides visibility of future rosters and rotations means that trainee doctors can book leave in advance of a rotation (up to a year in advance). This leads to a greater level of stability for trainee doctors in achieving work/life balance especially for personal everyday challenges such as child care, family events, etc.

Making the integrated leave management system available via an app that is also used to manage other aspects of a doctors working life introduces numerous benefits including ease of access but also control and visibiity.

Many departments have in the past compromised on rules around leave management as they have been very difficult to enforce in the absence of rostered activity from a macro perspective. Poor habits such as simply booking leave without regard to the departmental ability to cope becomes widespread in the absence of centrally integrated leave management solutions.

Complex rules to govern safe staffing are far easier to administer in an integrated system. It is important to remember that ntegrated leave systems are not only beneficial for leave approvers and service managers but they ultimately provide a means for clinicians to request leave in a way that balances their best interests with those of  their colleagues and patients.

Even worse for the healthcare providers, poor leave systems tend to reflect inaccurate records (or very few records at all) of leave being taken. Therefore meaning there is a lack of visibiity on the impact to care, finances or teams.

Good leave management eliminates the need in many instances to find locums, cancel clinical activities and most importantly if locum cover is still necessary, it can be addressed early enough to not become prohibitive in cost.

A leave solution that does not integrate to medical rosters, consultant job plans and junior doctor rotas – whilst certainly better than not having a leave solution at all – is still missing a very critical aspect of enabling better decision making as the Healthcare sector faces the challenges ahead.

Find out more about Allocate’s leave management tool here.