NHSi's Workforce Plans : digital ecosystems

Ed Schroeder - 11 October 2021

This is the second article concerning our approach to interoperability and APIs and how that approach reconciles with NHS England/Improvement's intentions for the NHS workforce deployment systems market. The first article summarised NHS England/Improvement's mandated standards, their proposed approach to interoperability for NHS workforce deployment systems, and the conformity of our services to those standards.

Index

Index to this document:

Summary

NHS England/Improvement have determined that the workforce deployment system market is best comprised of a diverse group of providers with competing and complimentary specialities interoperating over APIs. When NHS England/Improvement refer to "an e-rostering system" with relation to workforce deployment they are referring to the interoperating group of services procured by a Trust, working together to collectively fulfil the requirements and interface specifications set out by NHS England/Improvement.

Introduction

The NHS Long Term Plan has committed NHS Trusts and Foundation Trusts to utilising electronic workforce deployment systems focusing on rostering, job planning, junior doctor and related services such as bank or staff agency services. This effort is supported by NHS England/Improvement, who set out in 2018 to shape the rostering and related services market by setting out protocols for workforce deployment systems such as contracts and software feature sets, and arguably most importantly, by working with providers to design application programming interfaces (or APIs) utilising common data standards.

The promotion of interoperability between suppliers both of competing and complimentary services strongly supports the Department of Health & Social Care's Policy for technology in healthcare (October 2018). The policy includes the following statement:

"We need to focus on getting the basics right: the digital architecture of the health and care system – the building blocks. Open standards, secure identity and interoperability are critical to the safe and successful use of technology, ensuring that systems talk to each other and that the right data gets to the right place at the right time...
We need modular IT systems, where any module can be easily switched out, to create a market where providers compete on – and are rewarded for – quality."

This document summarises our current approach to interoperability and the uses of APIs within our Medirota, CLWRota and Central Reporting services, and how that approach reconciles with the views and intent of Andy Howlett and Alison Kingston, respectively the previous and current Directors of Clinical Workforce Optimisation at NHS England/Improvement.

What is "the system"?

The published NHS England and NHS Improvement documents in relation to workforce deployment systems frequently refer to "an e-rostering system", the need for which was originally highlighted in Lord Carter's 2016 report.

In February 2019 Rotamap wrote to Andy Howlett, then Clinical Productivity Operations Director for NHS Improvement, expressing concerns that the approach taken by NHS Improvement would encourage Trusts and Foundation Trusts to purchase a monolithic 'one size fits all' system. In March 2019 Andy Howlett provided the following clarification on NHS Improvement's aims:

"Our goal is to establish a digital "ecosystem" for workforce deployment systems which features modularity, and interoperability between products from different suppliers, enabled by common data standards. Within this ecosystem, we envisage a space for specialist/uni-professional rostering and/or job planning solutions to be able to co-exist alongside multi-professional tools."

Additionally, Andy Howlett was also able to confirm that:

"...the definition of “the system” referenced in requirement ROSD019 in the current draft specification should be interpreted as the overall system functionality and not to an individual component or application, as defined in multiple other sections of the document (section 1.3, section 2.1)."

Consequently, when the Regulator refers to the "Trust's Workforce Deployment System", they are referring to the composite of services procured by the Trust, ideally made up of a set of best-in-class, interoperating, providers.

In October 2021 Alison Kingston, the current Director of Clinical Workforce Optimisation confirmed that this approach continues to represent the position of NHS England/Improvement.

Encouraging interoperability

NHS England/Improvement has led its policy implementation through its work with its Supplier Reference Group (of which Rotamap is a member), and its User and Customer Reference Groups, whereby it has consulted with a wide array of service providers to design common data standards and open APIs. The consultation process is used to facilitate interoperability in support of the concept of a "modular IT system". As of the time of writing in October 2021, the consultation process is ongoing and so far the draft API standards for temporary staffing and job planning have been released.

Rotamap's Approach to APIs

In line with these goals, and to support our efforts to provide best in class online doctor rostering services that work responsibly within the digital ecosystem in the NHS, we are expanding on the PublicAPI we have already been providing for several years to support the interfaces and interoperability required.

We are working closely with two Shelford Group NHS Trusts, along with various related suppliers, to develop useful APIs that solve immediate problems within the organisations. These include, but are not limited to:

  • Direct integration with ESR, utilising our status as an ESR hub provider to send and receive ESR data without the need for any other third party.
  • Expanding the services "bids" feature in our services for covering rota vacancies to provide those vacancies to agency or bank staff providers, and to receive proposed workers from them.
  • Providing summarised rota data to job plan providers for more informed job planning of staff, and to receive summarised job plan data to help rota administrators make more informed decisions when configuring work assignments.
  • Receiving junior doctor work patterns to help rota administrators make more informed decisions when planning work.
  • Providing rota data in a centralised manner to internal Trust data warehousing and master index systems and databases.

These APIs will provide the fundamental set of "core interfaces" set out by NHS Improvement and NHS England in their Workforce Deployment Systems Software Requirements Specification document published in July 2019.

A fundamental tenet of our business is that everyone using our services has access to the same functionality, as such any APIs we develop are open and available for anyone using our services at no additional cost. We also intend for these APIs to evolve to meet the emerging NHS Improvement and NHS England common data standards as they are published.

Conclusion

NHS England/Improvement's intention is to encourage a vibrant and competitive software market, allowing Trusts and Foundation Trusts to pick and choose different suppliers and different services, each meeting a specific need or purpose, with each contributing to a dynamic composite ecosystem through interoperation.

We consider that our CLWRota, Medirota and Central Reporting online doctor rostering services provide best in class tools for enhancing communication and collaboration within and between clinician-led departments and wider Trust teams. We look forward to continuing our collaborations with NHS Trusts and providers to provide integrations that help them meet the NHS Improvement levels of attainment.

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