by By Dr Nicholas Andreou, Co-Founder of Locum’s Nest – 6th January, 2021

As a result of the COVID-19 pandemic and the increased adoption of technology solutions, it is only logical that interoperability is now back on the top of the agenda. Indeed, there is a clear need for more effective information sharing between care settings, organisations and geographies, as well as between professionals and citizens, to optimise patient outcomes and quality of care. This depends entirely on the ability of IT systems across health and care to be interoperable and communicate with one another; it is also key to the delivery of the future vision of care in England, on top of saving time and money and increasing accuracy by reducing human error.

Currently e-rostering systems used within the NHS do not tend to consistently interact with other key systems, such as staff bank management platforms, through bi-directional application programming interfaces (APIs). APIs are packages of data exchanged between two systems through a software intermediary that sits in the middle. That software is typically written by the two integrating suppliers or conform to a common standard set out by a regulator or an authority. This is why NHS Digital has made it a key objective of theirs to develop open API standards for workforce interoperability which we’re actively contributing to. A key challenge when it comes to designing an API integration is translating each other’s language. We call this ‘mapping’ – for example, a ‘shift’ in a bank system might be called a ‘gap’ in a rostering system. A specialist engineer, known as a Data Architect, typically leads such a project. We’re fortunate that our Chief Technology Officer is an accomplished one himself.

Without APIs, this segregation of platforms is creating unnecessary inefficiencies within healthcare organisations’ processes for doctors, admin staff and other NHS front line staff groups. Other methods of integration used in the past such as file sharing servers and robotic scraping processes tend to be less real-time and reliable than APIs. Roster management has come under significant pressure in responding to the demands of COVID-19, and it is now paramount that the principle of interoperability is applied to HR systems, as well as systems supporting the delivery of care. Successful integration will relieve NHS staff of burdensome administrative processes and enable them to focus on more patient-orientated tasks. On this topic, Health and Social Care Secretary, Matt Hancock, said last month that the COVID-19 pandemic had proved there’s bureaucracy in our healthcare system which it could do better without. And as NHS Providers Director of Policy and Strategy, Miriam Deakin, rightly commented, “for a workforce that is severely overstretched and facing the combined pressures of COVID-19, winter activity and work to clear the treatment backlog, simplifying day-to-day processes can help alleviate the load. We recognise that cultural and behavioural change will be needed to drive these improvements as well as support from a national and local level to ensure change is sustainable.”

As an organisation that provides technology solutions for the NHS, these challenges have long been on our radar and, with enough agility to respond and develop interoperable solutions in a matter of days, we understand how key our role is in helping develop an interoperable future between workforce software. Our advanced two-way API link with rostering services provided by Rotageek – the revolutionary rostering solution designed by healthcare professionals, for healthcare professionals – is now live at Ashford & St Peter’s Hospitals NHS FT and has been used successfully for the last two months. Any gap within a rota produced using Rotageek is automatically sent to the Locum’s Nest system and is shared with our 30,000+ strong community of healthcare professionals with one click. Once filled, the information feeds back in and populates the rota. Debbie Beck, Project Manager at Ashford and St Peter’s (ASPH) leading the integration’s implementation explained, “for us, providing for our patients is our number one priority, but, alongside this, we wanted to give our team at ASPH better access to manage their rota, reduce the effort in maintaining these rotas and joined up systems for managing staffing including those sourced via bank and agency. This truly interoperable solution ticked all those boxes, helping us to make the most efficient use of our resources.”

We know that good IT infrastructure and interoperability capabilities will translate into increased productivity, improved staff morale and more time for patient-facing activities. As Chris McCullough, CEO of Rotageek, put it, “as a former doctor, I know first-hand that it’s vital for organisations to work collaboratively with staff to help them manage their work/life balance and how great an impact getting this wrong can have on engagement and wellbeing. Through this integration we’re offering them input into their schedules, allowing them to swap, change and pick up extra shifts, thus allowing managers not only to support their staff with demands like childcare or family commitments but also ensure patient care and safety standards are met.”

As we keep on bridging technology gaps, we also have an exciting upcoming integration with Allocate software which means that NHS Trusts using Allocate’s rostering solution will be able to automatically advertise hard to fill vacancies on the Locum’s Nest platform for fulfilment. Once a bank worker has been sourced, the worker information will be seamlessly transferred back to Allocate solutions and booked to the duty. Nick Wilson, Allocate’s CEO said, “every month the NHS fills over 1.2 million temporary staffing shifts. Even so, with the global demand for clinical staff outstripping supply, our customers often have to use other sources to staff some hard to fill shifts. Through interoperability with partners like Locum’s Nest we aim to do all we can to reduce the administrative overhead of accessing these sources of staff and most importantly, as has proved critical during the pandemic, ensuring that all staff booked are visible in the live roster so that organisations have a clear picture of all staff at any given time.” The Allocate software integration with all bank suppliers will be ready in 2021 with a number of Trusts actively preparing for it today.

Considering that IT infrastructure is a priority and because our instinct is to offer healthcare organisations choice irrespective of our commercial interests, we thought long and hard about what our role should be as a technology provider in the NHS. We have therefore developed Link, a standalone hub, separate to our shift-matching software, which allows organisations to manage all third-party integrations in one place for free. Link takes API interoperability a step further by showing a non-software engineer what happens behind the scenes and how that API information is exchanged by translating the code into meaningful English. We felt that this hub was key in helping NHS Organisations develop trust in an otherwise invisible process. For this reason, Link is made available to all who need that extra sense of control, audit trail and reassurance

Have you had some thoughts about how your e-rostering system communicates with other key systems? To find out how your organisation can benefit from cutting-edge interoperability capabilities get in touch with Dr Ahmed Shahrabani at ahmed@locumsnest.co.uk

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