The NHS staff shortage? – ‘manage it or measure it’ that is the question.

NHS Short StaffedAround six years ago the NHS was being challenged to reduce costs by around £1.52B and an estimated reduction in 30,000 staff. If reports of today are to be believed the targeted savings are now £20B. One can only imagine how that will translate into “aligning” the headcount – to use a modern day management euphemism.

All this represents the backdrop behind one of the most controversial report ever published on the NHS and its duty of care to patients:  The “Review into the quality of care and treatment provided by 14 hospital trusts in England: overview report” by Professor Sir Bruce Keogh KBE.

The report has generated quite a stir politically, professionally, and continues the almost endless media frenzy about scandals in the British healthcare service; the NHS own web site a good place to start for further reading.

Out of the 14 nhs hospitals subject to rigorous review every one had short staffing ‘flagged’ as an underlying issue. Of particular concern was staff felt they could not speak openly about staff shortages. These staff felt unable to share their anxieties about staffing levels and other issues with their senior managers, which suggested that staff engagement at some of the trusts was not good.  Four facilities in particular are taking forward actions to improve whistle-blowing policies.

Given  staff shortages are a hallmark of poor management at senior level these revelations are hardly surprising, and neither are the responses which are as predictable as they are going to prove expensive.

All 14 hospitals have recommendations in their action plans relating to workforce issues; and NHS foundation trusts are planning to recruit 10,000 more clinical staff in a £500m recruitment drive. The moves are being linked with these growing concerns over the quality of hospital care in the wake of another landmark Francis report into the Stafford Hospital scandal.

I wouldn’t hold out much hope for action plans relating to workforce issues, or the vast  amount of cash about to be thrown at the problem. In fact the NHS has been exhibiting this kind of behaviour for years, it’s just the numbers are getting bigger. So if you were running a NHS Trust and wanted to do something about reducing the risk of ‘staff shortages’ where would you start?

Let’s start with two basic observations before looking at some practical action:

  1. A new way of thinking is needed where staff deployment rosters are concerned. For example, statements like “The [rostering] system must produce a roster that allows individual preferences to be a primary consideration …” is unlikely to be a sentiment that is shared by patients and their families. The notion of “The ‘Off-Duty’ roster” similarly is outmoded and outdated where team skill  coordination is key.
  2. It is a fact poor staffing levels at weekends and on nights, is always a problem not just in the NHS; and the high absence revealed in the review is a strong indicator of staff compensating for higher levels of fatigue. Put another way, what hours are being worked are poorly structured.

With this in mind we can make a start:

  1. Appoint someone to manage the staff duty schedule for the healthcare facility or unit, and above all has the authority to make it ‘stick’. Get away from the ‘free for all’ and  underlying ‘buddy’ systems. This part has to be right. Get it wrong and everything else that follows will be. Believing staff can work out their own roster is naïve and generally a management ‘cop out’.
  2. A computer aided rostering system will enable this to be done faster and better. It does not have to be expensive, and should be easy to understand.  One of the most powerful feature sets available including training can be obtained for a 50 staff facility for less than a couple of days unplanned overtime costs.
  3. Publish duty schedules at least 6 months in advance, 12 months or more so much the better. This will significantly reduce short notice changes and ‘swap around’. Short scheduling horizons are expensive, longer scheduling horizons are not. 
  4. Define the service delivery and demand. Sometimes referred to as staff supply demand match (SSDM) analysis. This is not as difficult as it sounds, and is usually well understood by managers anyway. Experienced observation will point to how many staff are needed at different times of the day – weekends should be treated no differently to weekdays.
  5. Have a record of every member of staff as well as name and contact numbers include their work availability schedule or any flexible working agreement that may have been agreed. Once staff levels can be counted in double figures you need a formal and comprehensive system to manage working arrangements. Relying on memory, ad hoc notes and ‘understanding’ simply does not work. Corporate HR systems rarely support staff deployment strategies.
  6. Adopt a structured scheduling approach that maximises rest periods, and incorporate shift patterns that are ‘body clock’ friendly – these are well documented. This is where the greatest gains are likely to be made and well worth the investment. Too often the simplest spread sheet arrangement dominates because it’s easy, unfortunately they are generally the worse and will constantly invite change because it never looks finished – it signals a ‘free for all’.
  7. Monitor staff working hours and rest periods, or other scheduling conflicts against any agreed working arrangements. This can be done automatically allowing you to change things in good time. It is unlikely this can be done manually save for a basic hours count. The modern day workplace is way too complex to manually track flexible working arrangements in the context of due beneficence to the rest of the team. Flexible working all too often becomes a game of ‘winners and losers’ and it’s getting a bad name.
  8. Publish to the web and by email to keep staff updated and enable them to access their schedules at any time. Convenient access to scheduling information reduces costs and the administration burden.

Where a structured staff deployment and monitoring system is locally absent in the workplace, up to around 64% of staff costs in that facility (not including training and equipment) can fall victim to wasted energy and inefficient production hours due to uncoordinated team work.

For further reading:

Posted in Industry Spotlight Tagged with: , , , , , , ,

Friendly Shift Patterns

This is the second publication in as many weeks about the latest research reinforcing the impact shift working has on women’s’ health. Last week it was about night shifts doubling the risks of breast cancer and now this week the University of Southampton has identified causal links between shift work and fertility problems.

people-transitBoth pieces of research do conclude nothing is certain and more research will be needed before anything more conclusive can be declared. In this latest research the fertility outcomes of over 119,000 women working non-standard working hours i.e. shifts, were compared to women working what is described as regular hours e.g. 9-5d or ‘office hours’.

It concluded women working shifts had a 33% higher rate of menstrual disruption than those working regular hours and an 80% increased rate of subfertility.

However the research does ‘home in’ on one factor  worthy of further study: the impact on circadian rhythms or our “body clock” referred to in this research as “clock genes”.

For sure, there are such things as ‘friendly’ and ‘unfriendly’ shift patterns. This research concludes the optimal shift pattern required to maximise reproductive potential is yet to be established. In fact, when we start considering the word “optimal”, or “optimization”, for any shift pattern we are in very hard problem” territory.

We can however, take a look at what makes a shift pattern more ‘friendly’ in the context of this research. There are essentially two factors you need to consider when tuning shift work to your internal body clock:

  • The Direction of Rotation (DOR). This is about the order you work different shifts; and
  • The Speed of Rotation (SOR). This is about the speed you change, or swap, from one shift to another.

These are simple concepts however, except for the most trivial shift pattern, they are very difficult in practice to manually work out in spreadsheets.

As far as the DOR goal goes you need to order the different shifts so when you change, or swap, from one shift to another the shift start times are getting progressively later. For example, 7am-3pm followed by 3pm-11pm; and finally 11pm-7am before taking days off. This is known also as ‘forward’ of ‘clockwise’ rotating shift pattern. The opposite to this would be 11pm-7am followed by 3pm-11pm; and finally 7am-3pm followed by days off. In other words shift start times are getting progressively earlier; and is known as the ‘backward’ or ‘counter clockwise’ rotating shift pattern.

As far as the SOR goal goes a faster rotation is to be preferred than a slower rotation. For example, two days working 7am-3pm followed by two days working 3pm-11pm; and finally perhaps two days working nights. This is only an example to get this point across, much more is involved in designing friendly shift patterns that are practical in the real world. It can be contrasted with a week working 7am-3pm, followed by a week of 3pm-11pm and finally a week of nights – probably the worse combination you can think of for increasing the effects of sleep deprivation, fatigue and risk.

In this example we have used three types of shift. If you have five or more to deliver flexible working patterns then it is much harder to work out. To do this efficiently and effectively you will need to use something like the Schedule24 Excel Add-in. This has the chronobio controls that manages these two factors automatically; and generate any number of shift patterns that will tune out the worse effects shift working may have on your ‘body clock’. It also enables you to stay with what for many is their favourite spread sheet environment to make further modifications and formatting staff schedules.

So to summarise:

  1. Your employer needs to be aware; and know what can sensibly be done;
  2. Adopt a forward or clockwise (DOR) rotating shift pattern;
  3. Adopt a faster rather than a slower (SOR) rotating shift pattern;
  4. Avoid 12 hour shifts. These are technically ‘alternating’ not rotating shifts and chronobio benefits much harder to achieve;
  5. Publish and keep to the schedule in the long-term;
  6. Avoid breaking pattern routine with short notice changes and shift swapping; and finally
  7. Don’t blame it on the shift pattern when your WADES lifestyle compromises common sense.

To learn more about our automated shift pattern generator for Microsoft Excel, click here.

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Latest research “Night shifts can ‘double’ breast cancer”

“Women who work long-term night-shift jobs … are twice as likely to develop breast cancer,” is a headline which will naturally cause concern for many women working night shifts. And like most things a closer look brings things into sharper focus.

First this latest research repeats what is already known; and the tone about the outcome is overplayed. For an excellent review of the research findings you can check out the analysis by Bazian for NHS Choices. Even so the conclusion WADES through the usual albeit sensible preventive steps of Weight, Alcohol, Diet, Exercise, and Smoking. However there are additional and practical steps that can be taken directly on the cause of all this concern about women’s health – the shift pattern itself.

The description ‘Night shifts is not that helpful’. Depending on the pattern, night shift working can be the difference between ‘chalk & cheese’. For example there is a big difference working 7 night shift straight thru and two days off; and 4 night shifts separated by a 24 hour break followed by four days off. You can check out an example of what we mean here.

In addition to the NHS Choices review, one of our contributors Sue Woolfenden offers practical advice about reducing the risks of shift pattern working on women’s health. Sue has many years experiencing researching shift work in the field and her findings are based on first hand experience.  You can access the article here Coping with Shiftwork: The Impact on Women’s Health


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Employee Scheduling is Dangerous…

In the wrong hands!

Employee scheduling is probably the most complex task a team leader or line manager will have to contend with in the workplace. It is also the most important because it has direct impact on the bottom line; and it is the worse neglected because it is hard. It gets more complicated because it gets mixed up with ‘Cloud’ speak, mobile “App” and all the technical ‘Gizmos’ that in the end are simply channels of communication. When little or no thought is given to what is being communicated you just get more efficient at creating a mess.

Employee scheduling is rarely easy in fact, except for the trivial, it is never easy; and neither is there any benefit making it unbelievably complicated whereby you feel you have to sink a few million dollars into a system that regresses back to ‘under the counter’ spreadsheets a year or so later.

So a word of advice. Stop looking for a system that is ‘easy to use’ and start thinking about a system that is easy to understand. Easy enough to understand and competently manage the relationships between four fundamental areas of employee scheduling practice: Staff Count; Staff Costs; Production Hours; and finally Fatigue & Risk – including the commute to and from work.

Less than these four and you are messing around wasting business dollars – or worse as the fatigue and risk index goes off scale. More than these four and you are already too expensive for the business and delivering diminishing returns.

The problem with ‘easy to use’ is it will almost certainly not be up to the reality of the task . Whereas ‘easy to understand’ means you can learn something useful and be more productive. If you don’t have the time for any of this, then get somebody to do it for you and click here!

Here is one example about those relationships demonstrating ‘worse case – best case’ outcomes from an extract of a medium sized healthcare facility.

over staff count blog

‘Worst Case – Best Case’

One final example about the impact of costs. The numbers can be staggering. We reviewed the proposed working arrangements of an IT group in the Financial Sector. The Senior Management Team (SMT) couldn’t put their ‘finger on’ what they thought was wrong. A couple of Team Leaders had managed to introduce a “new” shift pattern for a small team of technicians, and was about to be adopted more widely by around 100 technicians’. Had they done so they would have added an additional $428k to the company ‘tab’ without adding one production hour of benefit to the business; or even adding one hour of ‘happiness’ to staff time-off – a ‘lose-lose’ situation if ever there was one.

OK so perhaps you think ‘dangerous’ is too strong a word for something as innocuous as ‘Employee Scheduling’. As more businesses run to the cost-cutting expedient of reducing the headcount as their first choice option, there are many that think it is exactly the right word.

Work is all about the shift pattern.

Click to learn more our about our employee scheduling software
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Avoid the Most Common Workplace Stress Generators

Another and latest poll by Ipsos MORI on behalf of the European Agency for Safety and Health at Work (EU-OSHA) reinforces “hours & workload” as the biggest stress generator next to “at risk” of losing a job. And closely on the heels with over half of any given workforce experiencing lack of workplace support from managers and colleagues – and I would argue it is usually in that order – followed by lack of clarity and responsibilities; and finally, limited opportunities to managed work patterns.

The principles of the three ‘C’s’ in the workplace: coordinate; control & communicate has never been more relevant. They are also the first principles Schedule24 enables the team leader or line manager to deliver: effective planning of working arrangements delivers coordination; the fact the manager gets involved delivers the assurances of control team members want; and finally swift clear communication keeping everyone up to date completes all that is needed to sweep away this malaise of stress generators in the workplace.

The key thing isn’t an HR,  HSE or even OSHA thing it is about giving the tools to the person who can do something about it other than debate it – the manager at the front line!

The manager – at whatever level – that doesn’t care about what OSHA has to say about these stress generators and which is costing $billions in lost production hours is already ‘halfway out the door’ – they are too expensive. The future of the successful workforce is already moving away from “corporate HR” back to key and competent operations managers that can deliver the three C’s in the workplace – where people management skills are having to be re-discovered.

Posted in Industry Spotlight, Shift Patterns Tagged with: , , ,

7 Important Factors to Consider When Moving to a 12 Hour Shift Pattern

As a manager of a business you will encounter at some point requests from the workplace to move from 8 hour to 12 hour shift working. Having spent many years observing and documenting the effects of moving staff from 8 hour shift patterns to 12 hour shift patterns and back again, this seven point checklist will help you think through the pros and cons.

  1. Carry out a staff supply demand (SSDM) analysis. This means you work out when the work demand is more or less throughout the 24 hour period. It is not as difficult as it may sound and can be carried out by manual observation if need be. In fact you may already have that information. You need to know if you have a ‘variable’ demand which changes over a 24 hour period; or a ‘flat’ demand which never changes and remains the same. If you have a variable demand then you will need overlapping 12 hour shifts – a harder problem. If you have a ‘flat’ demand you do not need overlapping 12 hour shifts – an easier problem.
  2. Fatigue in the workplace increases risk. Longer shifts mean tired staff in the workplace; and when staff are tired the risk of accidents and mistakes increase. So what is the workplace tolerance level for accidents and mistakes e.g. observation and monitoring may not have the same consequences as an invasive medical procedure.
  3. The Commute. The duty of staff care extends beyond the workplace so you need to know if commute times are reasonable especially if staff drive to and from work. Driving home after 12 hours is significantly different to driving after 8 hours – especially after a night shift. Those extra days off a week just may not be worth the risk. Public or even corporate transport poses much less of a risk.
  4. The Noise. If the workplace has higher levels of noise throughout a 12 hour shift this will accelerate fatigue levels.
  5. The Breaks. More frequent breaks are needed during longer shifts; and you need to be prepared to demonstrate you have a regime in place to ensure those breaks are taken.
  6. The Shift Pattern is key. For achieving a successful transformation from 8 hour to 12 hour shifts. There are good, bad and downright ‘ugly’ 12 hour shift patterns. As with most things in life, the easiest to work out are probably the ones to be avoided. The good ones are not simple but they do exist.
  7. Reduce Sleep Deprivation. 12 hour shift patterns technically alternate, they do not rotate. These two techniques will ameliorate the worse effects of 12 hour shifts especially where night shifts are involved:
    – Work no more than four consecutive 12 hour shifts before a day off; and
    – Follow a 12 hour day with a 12 hour night to maximize a 24 hour rest period between shifts’

This 12 hour shift pattern is a good example of an efficient and effective 12 hour shift pattern:

Other factors to consider:

  • 12 hour shift patterns are preferred by younger staff, ‘forcing’ 12 hour shift pattern can be cited as discrimination in the workplace ;
  • Longer shifts mean more days off but that does not mean quality as longer ‘recovery’ time is needed;
  • Any improvement in absenteeism is likely to be short lived, and will invariably return to previous levels;
  • A return to 8 hour shift pattern after a few months working 12 hour shifts is not uncommon; and finally, remember
  • It is not the hours you put in that count, but what you put into the hours. You do not want tired people on the payroll!

Schedule24 Excel  Add-in has been designed with consultants, business analysts, operations and HR Managers in mind. Automatically generate popular 8 and 12 hour shifts or any other custom shift patterns. To find out more visit our website.

Posted in Shift Patterns Tagged with: ,

Intellicate Launches First Automatic Shift Pattern Add-in for Microsoft Excel®

New Add-in Quickly Creates Shift Patterns with Excel® Spreadsheets, Eliminating Programming and Analysis Hassles.

LONDON, United Kingdom February 13, 2013. Intellicate Ltd, developer of Workforce Scheduling software, is now shipping Schedule24™ Excel® Add-in, their new automatic shift pattern generator for Microsoft® Excel®.

“We feel Schedule24 Excel Add-in is a breakthrough for workforce analysts and consultants using Excel spreadsheets.” said Timothy L. Mills COO of Intellicate Ltd. “It manages the complexity of shift pattern design in the familiar surroundings of Excel, enabling multiple shift patterns to be explored discovered and analysed in a fraction of the time it takes to even think about doing just one of those tasks manually.”

Schedule24 Excel Add-inSchedule24 Excel® Add-in has been designed with consultants, business analysts, operations and HR Managers in mind to deliver insight into the most complex shift pattern solutions. Schedule24 Excel Add-in requires no scripting, and definitely no programming, to generate shift patterns for 24 and extended hours working. It also incorporates chronobio control enabling rotating shift patterns to be tuned to the body’s circadian rhythms making it unique for analysts and consultants to offer solutions that significantly reduce fatigue and risk in the workplace.

The Schedule24 Excel® Add-in goal is always to deliver a staff supply matched to a business demand, whether a ‘Flat’ supply for production lines or ‘Variable’ supply for fluctuating retail trends. Multiple shift pattern solutions can be explored using the same dataset, and displayed across multiple spreadsheets. Re-keying of data is eliminated. If you have a different dataset simply open a new Excel® work book and launch Schedule24 Excel® Add-in again. No limits.

“Intellicate have been providing comprehensive staff scheduling solutions for over 20 years; and our shift pattern ‘know-how’ is now available for Excel® without users having to sacrifice their favorite environment” said Tim Mills. “There has been a strong trend away from traditional working toward longer hours, to deliver services and products in a global economy — shift patterns are the key to successful business operations.”


INTELLICATE is a employee scheduling software company headquartered in the UK. Intellicate’s vision is to remove the knowledge and cost barriers that prevent most workforce scheduling projects from succeeding. Intellicate have had the pleasure of supplying ‘blue chip’ organizations and small family businesses; hi-tech services and law enforcement; finance institutions and retail stores in countries around the world with their employee scheduling solutions.

Intellicate customers include market leaders like Aurecon, HSBC, Coutts, DHL, Japan Airlines, MyFerryLink, RIM, Boeing, BULL, RBS, and Cadbury. Visit us at | info(at)intellicate(dot)com | +44 (0) 20 8906 6793

Posted in General, News, Shift Patterns Tagged with: , , ,

Intellicate Software Releases Schedule24™ Excel® Add-in

Today Intellicate announced the release of a Schedule24™ Excel® Add-in, a new addition of the company’s flagship employee and workforce software, Schedule24. With this new add-in application, Microsoft Excel users are able to explore, discover, and try out more shift pattern variants than you would have thought possible in a fraction of the time doing the task manually.

Schedule24™ Excel® Add-in has been designed with consultants, business analysts, operations and HR Managers in mind. The core of shift pattern ‘know-how’ is now available for Excel® without having to sacrifice your favorite environment.

When we say Automated we mean it – from Start to Finish!
Fully automated and an integrated component of your Excel® spreadsheet. It has one launch button and from thereon in everything you need is in the “App”, no configuration files, no scripting and definitely no programming skills required.

To discover more about Schedule24™ Excel® Add-in, please visit our website.

Posted in General, News, Shift Patterns Tagged with: , , , , , , , ,

Introducing Automatic Shift Pattern Add-In for Microsoft® Excel®

Introducing Automatic Shift Pattern Add-In for Microsoft ExcelSchedule24™ Excel® Shift Pattern Add-In for Microsoft® Excel® has been designed to solve a big problem for Excel users trying to create shift patterns, especially where their business operation has to cope with extended hours and 24/7 working.

Invariably where extended hours and 24/7 working is needed, staff usually have to rotate not only their shifts but also their days off to ensure an adequate staff supply as staff finish and start work at different times of the day – or night. A major headache is ensuring shift patterns are fair and equitable to all.

One major shortcoming of creating shift patterns manually in Excel, is in almost every instance we think of shift patterns based on the 7 day week. That’s how we think about our time in every other ‘walk of life’ and so it is understandable, and this is OK as far as it goes. However, there are many shift pattern solutions that are not weekly based and are sequence based so we never think about them, except the most simple patterns. For example 4 days on and 4 days off is a sequence based shift pattern. It has an 8 day cycle before it repeats itself not 7 days.

Another quirk of rotating shift patterns is you can never get an acceptable pattern when the number of days on (working) and the number of days off equal 7 days e.g. 3 days off 4 days on; or 2 days off 5 days on etc. If you do you will find staff always have the same days off each week; great if your days off fall at the weekend, not so great if they fall on Monday and Tuesday.

So it is hardly surprising why the path of defining a shift pattern in Excel is a tortuous one; and can involve many hours, if not days just to work out a mediocre shift pattern. Schedule24 Shift Pattern Add-In for Microsoft® Excel® can deal with this kind of ‘brain twisting’ complexity in seconds. It also computes what for many are the hallmark of industry best practice in shift pattern design including control over the direction of rotation (DOR); and the speed of rotation (SOR). Factors that maximize rest periods, reduce sleep deprivation, and tune shift patterns to our ‘body clock’ or circadian rhythms for healthier shift working options.

Designed specifically and optimized for business analysts, and consulting professionals to work out combinations of shift patterns faster than it takes to format your next worksheet. Through a seamless integration, Schedule24 Shift Pattern Add-In for Microsoft® Excel® adds a new dimension to your Excel® shift pattern designs and staff scheduling.

Schedule24 Shift Pattern Add-In for Microsoft® Excel® is scheduled to be released in the next few weeks.

Microsoft, Microsoft Office, Excel, and Windows are trademarks or registered trademarks of Microsoft Corporation. Schedule24 is a registered trademark in the United States of America and other countries.

Posted in General, News, Shift Patterns Tagged with: , , , , , , , , , , ,

Short Staffing “We can get away with it…”

The recent CQC report into the care of the elderly has raised quite serious concerns as we are told our complicated world gets ever more complicated and our means to deliver good services weakens by the day – so it would seem.  I just pick on this report as another in a long line of examples that bemoan deteriorating standards among services – across both the public and private sector. As always I immediately look  for the tell-tale sign of “short staffing” and sure enough there it was tucked away in the body of the report.

Do not be fooled “Short-staffing” is a symptom of an underlying cause. It is the number one symptom of a cost cutting management that has reasoned on a balance of probabilities “we can get away with it”. Next time you are stood in that shopping queue think about it, is it really a complicated problem or is it that the one check-out operator really should be three. The principle is just the same when it comes healthcare and nursing, or border control, or policing, or marshalling sporting events, or IT support centres, or staffing that call centre so 80/20 calls get picked up before being ‘slammed’ down.

The business that gets its staffing levels right will maintain profitability and stay in business. If you have not over-staffed and have the right staffing levels to deliver your products or services then you need to be looking at what else is wrong if business is not too good.

The truth is “short-staffing” is a hallmark of mismanagement and in reality you can’t get away with it for long. So what can you do about it. Here are principles that will enable you to get it right:

  1. Staffing levels need to be based on delivering a business model – make sure you understand what you want to deliver;
  2. A line manager, or equivelant, needs to be not only responsible, but accountable for those staffing levels – without a “ruler” the people scatter the saying goes;
  3. Ensure line managers have access to employee scheduling software that is easy to understand – yes they might have to invest 3 or 4 hours to learn a new skill;
  4. Installing software on existing office computers and laptops avoids recurring costs – maximise your existing investment;
  5. Plan and publish staff deployment schedules at least 6 months ahead; 12 months is even better – transform your business into a proactive not reactive operation;
  6. Staff schedules need to be accessible any time from anywhere e.g. email and web schedules – communicate, coordinate, control;
  7. View staff deployment as an operational  management skill – not an administrative IT or HR chore.

You do not have to  invest in expensive corporate software.  Companies have spent millions on corporate enterprise staff scheduling systems only to discover more effective outcomes at a fraction of the cost around a year later. It is not necessarily a fault with the software, but understanding  the staff scheduling problem is resolved at line management level nowhere else.

In fact one rule of thumb I adopted a long time ago is the further away a staff scheduling solution is from ‘frontline’ management and closer to corporate management, the greater the likelihood of it not succeeding

Posted in General Tagged with: , , ,