21 uses for AI and digital for 21st century NHS workforce management

In addition to obvious financial constraints, there are three important factors contributing to the slower adoption of workforce management innovation in healthcare than other industries.

Firstly, there is a complexity in defining staff skills, training and experience. Many HR professionals will have recent experience of this challenge, given difficulties in identifying appropriate cover during industrial action by NHS staff;  staff with outwardly similar job descriptions are not necessarily interchangeable in the same way that might be true for other sectors.

Secondly, it is difficult to capture context specific information that is relevant to workforce planning such as acuity levels of patients being cared for or the difficulties presented by the physical layout of healthcare facilities. This has resulted in many workforce planning functions being devolved or adjusted locally to improve safety.

Thirdly, the NHS is made up of many smaller organisations which has meant that local workforce management has been the default approach. The latest wave of consolidation and the formation of ICSs means that the NHS is now well placed to adopt workforce management innovations at scale.

AI-enabled digital workforce solutions are varied and have already been deployed across a range of industries. Learning from these, we have identified these 21 use-cases (in seven categories) as key to exploring how we can improve workforce management over the coming years.

Employee scheduling and rota planning

Several solutions offer the opportunity to plan rotas more effectively, integrating historic data and predicted demand for services. Others try to engage staff in choosing shift patterns that suit them, which has been highlighted as a cause of low staff morale. Some of the best workforce platforms also optimise routes to make jobs easier for mobile workforces (e.g. porters, community nurses).

These innovations can be grouped according to functionality:

1. Shift, route and rota management;

2. Dynamic scheduling, enabling staff to fill rota gaps/swap shifts;

3. Skill mix tracking and compliance reporting.

Performance analytics and feedback

AI can facilitate continuous performance management by gathering data from digital systems, to provide real-time feedback and performance insights for teams on activity and throughput:

4. Productivity or risk prediction. The digitisation of care processes provides much more data on activity levels and work patterns for staff, helping to identify periods where staff are performing at their best. AI can assess operational risks related to workforce performance, absenteeism, or compliance with processes, allowing organisations to take preventative actions.

5. Remote workforce management and collaboration tools. Many employers outside the NHS now routinely track performance of staff working remotely, both to monitor productivity but also to offer support where needed (e.g. training on activities which take some employees longer than their peers).

6. Objective evaluations. AI can be deployed in reducing biases in performance appraisals by using data-driven approaches for evaluations based on quantifiable metrics, and by making it easier to log achievements, activity and generate e-portfolios.

Learning and development

Given the need to stay up-to-date with skills and the complexity associated with training, the opportunities offered by modern digital platforms are among the most significant opportunities in the NHS for using digital in non-clinical applications. The ability to offer courses electronically (often by tablet or phone) means that training can be offered closer to the time it is needed and hence support staff better.

Key opportunities include:

7. Personalised training. Programmes can be based on job requirements or skill gaps identified during work or appraisal and make use of a mixture of formal training and on-demand lessons or ‘bite-sized’ support.

8. Adaptive e-courses. These vary the amount of time and training material based on the needs of the individual identified through performance during assessments or in the course of work.

9. AI-enabled intranet search. More advanced search tools offer an opportunity to improve the accessibility of existing materials by providing the ability to search intranets or learning resources to find appropriate materials.

Staff wellbeing and support

Sickness absence in 2022 reached 27 million days (up 27% from 2019) which is equivalent to 74,000 full time staff. The NHS is also subject to many of the same pressures as the wider workforce in the UK, with more staff managing long-term conditions while working.

In this context, opportunities to support staff include:

10. Staff engagement and sentiment analysis. Several companies outside the NHS undertake surveys of staff on a frequent basis (often shift-by-shift) to identify patterns in stress and workload and allowing leaders to intervene early where problems arise

11. Health and wellness monitoring apps. There are several companies offering health and wellness programmes targeted at both mental and physical health.

12. Automated Employee Assistance Programmes (EAPs). Trusts currently use a variety of EAP providers, and no single company is likely to be able to support the whole NHS workforce. However there is variation in how these services are accessed, with several EAPs already making use of apps and digital approaches to engaging staff.

Automation of workforce administrative tasks

Administration of HR tasks for the NHS workforce (including transfer of staff between organisations and payroll activities) has already been automated by NHS Shared Business Services using the Electronic Staff Records (ESR) system adopted by 134 NHS providers. In addition, several regions are introducing digital passports to facilitate staff working across sites/organisations.

Further opportunities to automate these tasks or link scheduling or rota planning to other processes could focus on:

13. Payroll;

14. Benefits administration;

15. Offboarding, including analysis of themes from exit interviews and related activities.

Predictive workforce analytics

Several providers are using AI to predict workforce needs, both in the short-term and longer-term. These focus on availability of staff groups and on skills mix within groups.

Some of the best systems outside the NHS link to activity data to provide additional insights in areas such as:

16. Forecasting staffing issues and challenges;

17. Skills gaps analysis and optimisation of skill mix both within shifts and across sites and organisations;

18. Demand forecasting for staff.

Recruitment and hiring

The annual rate of turnover among NHS staff improved in the year to June 2023 to 11.2%, but this still represents around 170,000 staff transfers. Each of these transfers involves a number of processes including advertising, shortlisting, checking of documentation, DBS checking, onboarding and offboarding. With a competitive job market, many services are also experiencing higher-than-average levels of applicants, which in turn drives higher numbers of candidate interactions.

Some trusts have streamlined these interactions and many have moved to using Trac jobs (provided by Civica). In addition, HR passporting within regions has reduced the burden of administration. However, some HR service providers in other industries offer additional services, including:

19. Automated CV and candidate matching. This is usually based on skills listed on application forms or CVs, and in some cases informed by previous shortlisting outcomes. These solutions offer the opportunity to reduce bias in shortlisting (if deployed well) and to offer feedback to unsuccessful candidates.

20. Chatbots. Chatbots allow for the automation of routine interactions with candidates (such as questions around recruitment processes) and to schedule interviews and assessment centres.

21. Onboarding and document checking. Some modern systems are able to check the validity of documents such as passports or visas.

From ideas to implementation

We have identified that solutions are developing quickly across the range of workforce management activities. The large number of NHS staff, and the turnover rate within individual Trusts and services means that significant benefits can be realised relatively quickly.

Currently, there are multiple providers offering elements of AI and digital workforce solutions to the NHS, and many more demonstrating best practice in other industries. We recognise that there is an inherent tension between realising benefits across the entire NHS and innovating in smaller units. Few HR service providers have the capacity to cover the entire NHS, and while NHS Shared Business Services and large providers such as Civica have been able to offer scale, other smaller providers have driven innovation in specific areas such as learning and development, wellbeing and staff support.

To drive innovation in this sector (and hence productivity and cost reduction) across the NHS, some regions/ICSs may wish to accelerate and focus on workforce solutions and their deployment as part of their overall strategy. There may even be opportunities for the development and integration of services within tools such as an NHS staff app.

The HIN has supported several companies in this space and helped the NHS implement digital and AI solutions. We are interested in hearing from ICSs or regions aiming to invest in improving HR solutions, and from companies interested in joining our innovator support programmes such as DigitalHealth.London Accelerator.