Workforce Capacity Planning Spreadsheet User Guidance

Workforce Capacity Planning Spreadsheet User Guidance Introduction This spreadsheet enables you to do two things: 1. Quantify the number of lists your existing establishment can support based on existing patterns of staff deployment and skill mix. 2. Quantify the impact of changes to the number of lists and different ways of working on your skill mix profile and staffing establishment. The spreadsheet is designed so it can be completed by the senior nurse in endoscopy with responsibility for staff deployment (rostering) and they may need to liaise with the senior nurse/manager in order to complete the workforce capacity spreadsheet. The workforce capacity planning spreadsheet should be used in conjunction with the workload capacity planning spreadsheet for you to get a holistic view of the overall capacity in your unit. This is because collectively they use the principles of capacity and demand which are summarised in Figure 1. Availability of kit in minutes (Endoscopy Rooms) + Availability of skills in minutes (Endoscopists and endoscopy support staff) = Demand for service (minutes) Figure 1; Capacity and Demand The workload capacity planning spreadsheet should be completed by the team member with responsibility for demand/service improvement data and they need to work in partnership with your Consultant lead for endoscopy. 1

Contents Page 2. Getting Started 3. Understanding the layout of the spreadsheet 4. Step1. What is helpful to know before I start? 5. Step2. Entering data about your existing establishment 6. Step3. Entering data about your existing patterns of staff deployment 7. Step4. Staffing levels: In room assistance 8. Step5. Staffing levels: In unit assistance 9. Step6. Repeat steps 4-6 for each day of the week where you run lists 9. Step7. What happens once I have put our information in? 11. Step8. Can I use this information to show that we need more staff? 14. Step9. Viewing the career framework mapping and entering data about costs 15. Step10. Saving your information 18. Step11. Creating multiple scenarios 19. Step12. Screening 21. Step13. Viewing scenario comparisons Getting started Steps 1-10 explain the structure of the spreadsheet; how to input your data, based on your current ways of working and how to view the results showing the workload capacity, skill mix and costs linked to this. Steps 11-12 explain how to use your current scenario to develop new patterns of working such as to support changes which might include revised numbers of lists, changes in skill mix/new ways of working and implementation of screening. These new scenarios can be named locally as you develop them but in these guidance notes we have called the example future scenario. Step 13 explains how you can view and compare up to four different scenarios to view their skill mix profiles at any one time. 2

Understanding the layout of the spreadsheet The first page in the workload spreadsheet looks like this: B A Figure 2; the front page of the spreadsheet The names of the sheets in the workbook are shown on the tabs at the bottom of each page (as per A above). To reveal further sheets in the workbook use the left/right screen control (see B above). The sheets include: Scenario sheet : log of existing scenarios, controls for save/run macro functions and requests to generate new scenarios Current staffing profile sheet: location to enter data on your existing staff establishment Monday Sunday sheets: location to enter data on your lists and patterns of staff deployment Required staffing profile sheet: results on number of lists supported and required staffing complement CF mapping and salary costs sheet: location of career framework mapping and to enter data on salary costs WTE sheet: results of skill mix profile and costs Scenario comparison sheet: control of requests to compare alternative skill mix profiles. 3

Step 1. What is helpful to know before I start? 1.1 Do I need to undertake a period of data collection to complete this? No. There is no requirement to do any prospective data collection. You can complete this exercise based on the normal working routine in your endoscopy unit. The normal routine can be found by asking questions such as: What lists run in which rooms each day? Whose lists are they? Who is rostered a) in the rooms and b) in the units to support these lists? Do not allow for cancellations such as those caused by bank holidays, audit meetings and last minute lack of availability of endoscopists/support staff. The impact of these is picked up elsewhere within the methodology. Where there are multiple sites/endoscopy units within one trust, you need to treat each unit separately for this exercise. 1.2 Can I collect the data on paper? It is best to complete this spreadsheet electronically as the data has to be entered into the spreadsheet in order for the calculations to run. However if the person providing the information about the normal working routine prefers to work on paper you can print the relevant sheets for filling out by using the print tables for completion button on the scenario sheet (button C in figure 10). 1.3 Why Monday Sunday sheets? There is a page for each day of the week. These are designed to mirror your clinical practice and BSG guidelines in terms of how you deploy staff in the endoscopy rooms and units. A separate page for each day allows you to pick up the daily variations in working patterns; reflecting both variations in when and the type of lists run. If you do not run lists on any given day such as Saturdays (or Sundays) you do not need to complete the sheet for the corresponding day except when staff come in to support an out-of-hours list as part of an on-call rota. 1.4 How will I know where to input the information? The cells where you need to add data (the input cells) are coloured yellow. Mostly they have predetermined options for the information choices and so drop down menus are available. From these you can quickly select the information you need to add (see figure 3). 1.5 What should I do if the buttons controlling the scenarios don t work? The most likely reason for this is that the security settings on your computer do not allow macros written by anyone else to run. In order to change these settings, go to the Tools menu at the top of the Excel window and scroll down to the menu labelled Macro (you may need to press the small button with arrows at the bottom of the Tools menu to reveal the Macro option). Follow the right hand arrow and click on Security. Select Medium security level and then select OK. Now, close the spreadsheet and open again; this time there will be a message box asking you whether you would like to enable the macros before the spreadsheet loads up, select Enable Macros and the workbook will now function normally. 4

Figure 3; the drop down menus Step2. Entering data about your existing establishment 2.1 Select the tab labelled current staffing profile Add the details of your staffing establishment by working across columns 1-4 (see section 2.2 for instructions on getting more space for adding extra staff). The sheet will add the totals showing wte and headcount for you. Include all posts including any that are currently vacant. (An example is given below see figure 4) 2.2 I need more space in the current staffing profile tab, how can I do this? You can add rows to this sheet if you need more space under any of the staffing group. You need to highlight the position for adding the row and then select the insert menu and from the drop down menu select the row option. 5

Figure 4; Example current staffing profile sheet Step3. Entering data about your existing patterns of staff deployment The schedule of lists in your unit 3.1 Select the tab labelled Monday Work only within columns A-F as determined by the total number of rooms you have available within the unit. (Remember to treat multiple units in one trust separately by using two separate Excel workbooks.) Example: i. If your unit only has 1 room use column A ii. If your unit has 2 rooms use columns A-B iii. If your unit has 3 rooms use columns A-C iv. If your unit has 4 rooms use columns A-D v. If your unit has 5 rooms use columns A-E vi. If your unit has 6 rooms use columns A-F Please note that if your staff support any lists which occur outside of the endoscopy unit, such as in X-ray, ITU and theatre then you may use one of the spare columns to denote these lists which occur elsewhere. 3.2 Identify the row called line 1 In this row you enter data about lists which run on Monday mornings in your unit. Place the cursor over the first yellow cell (ref E5). You will see an arrow appear. Click on this twice to bring up the drop down menu. The options are 0, 0.5 and 1. Only enter either the numbers 0.5 or 1 if you have a list at that time on that day. Where you want to indicate a session is held each week select 1, then proceed and complete the process described 6

below. Where you want to indicate a session is held alternate weeks select 0.5, then proceed and complete the process described below. 3.3 Identify the row called line 2 In this row you enter data about the type of list being run. Place the cursor over the yellow cell (ref E6) you will see an arrow appear. Click on this to bring up the drop down menu. The options are the types of endoscopy lists you might schedule. Select the option which shows the list type. Use other for any lists which run in the room but are not otherwise listed. 3.4 Identify the row called line 3 In this row you enter the data about the name of the endoscopist who has responsibility for this list. Place the cursor over the first yellow cell (ref E7) you will see NO arrow appears. This means you can enter free text. Please add the name of the endoscopist responsible for this list. 3.5 Identify the row called line 4 In this row you enter the data about the staffing group of the endoscopist responsible for this list. Place the cursor over the first yellow cell (ref E8) you will see an arrow appear. Click on this to bring up the drop down menu. The options are the types of endoscopists who can perform independent lists 1. Select the option which shows the staffing group of person doing the list. 3.6 Identify the row called line 5 In this row you enter the data about the purpose of the list. Place the cursor over the first yellow cell (ref E9) you will see an arrow appear. Click on this to bring up the drop down menu. Select the option which shows the main purpose of the list planned. 3.7 Repeat this process for each session held on that day The spread sheet will automatically calculate the number of sessions and endoscopists (WTE) required for each day. Step 4. Staffing levels: In room assistance Now consider the staff that provide direct support in the endoscopy room. Based on BSG guidance three roles are identified: airway support, endoscopist assistance and other. How you actually deploy staff will vary according to your model of care or the type of procedure being undertaken. 4.1 Identify the row called line 6 In this row you enter the data about staff that provide airway support during the list. Place the cursor over the yellow cell (ref B26) you will see an arrow appear. Click on this to bring up the drop down menu. The options are the grade of staff. Select the option which reflects the grade(s) of staff you use for this role. Continue along the row called line 6. Place the curser over the yellow cell (ref E26) you will see an arrow appear. Click on this to bring up the drop down menu to reveal options of time spans at 30 minute intervals. Select the time span which most closely reflects the length of time you deploy staff into that room for airway management against the scheduled list. Important If your list is one which only runs alternate weeks you should only enter half the hours normally rostered to 1 Where trainee endoscopists (medial or non-medical) perform independent lists it is expected that there ability to work independently has been formally documented by the responsible supervising endoscopist. 7

airway management for this list to reflect the bi weekly demand for staff from this list. If you do not deploy any staff for airway management enter 0 or leave the cell empty. 4.2 Identify the rows called line 7 and 8 In these rows you enter the data about staff that assist the endoscopist or perform other support during the list. Complete the same process as in 4.1 to show both the grade of staff that might perform these roles and the length of time you deploy them into the room. Remember to halve the hours if the list only runs biweekly. 4.3 Repeat this process for each session held on that day The spread sheet will automatically calculate the hours and wte required for in room support for each day. Step 5. Staffing levels: In unit assistance Now consider the staff that provide support in the endoscopy unit. The roles which are identified are based on the patient pathway and patterns of working known to exist in endoscopy units. These will vary according to your model of care and so you may not use all the available options. Typical examples are as follows: The function of scope cleaning may not be undertaken by any staff in your unit if you have central decontamination facilities. Equally the scope cleaning role can be undertaken by individuals who are allocated as the third person to support in the room or there may be dedicated or floating scope cleaners who support more than one room. You may have no dedicated staff for the recovery or clerical parts of the pathway if your endoscopy service is situated within a day case surgery unit or if the clerical function is supported by a centralised clerical/booking team. If you do not have staff in your team/establishment to roster to cover these functions then do not include them when you complete this section of the staffing workforce spreadsheet. 5.1 Identify the row called line 9 In this row you enter data about staff involved in clerical support for the endoscopy unit. Work through the same process as above to show their grade and hours they are rostered to support all the lists in any given session. The spreadsheet will automatically calculate the hours and wte required for each day. 5.2 Complete the same process for the remaining headings identified for in-unit support These include: Floating or dedicated support for scope cleaning Lead role history taking/preparation on admission Patient admission Preparation Pre-admission Lead role recovery/discharge Support role for admission/recovery/discharge Floating support/runner Operational unit co-ordination ( operational issues include addressing staffing allocation for the shift, list management dealing with emergencies, calling patients from wards, clinical supervision/procedure related staff development etc.) 8

Overall unit management (overall management such as staff appraisals/development, policy/procedure development, audit, managing capapcity plans/waiting lists, budget and business managment etc.) Screening practitioner (this includes aspects of the specialist role for the specialist screening practitioner. Further guidance on this is included in steps 11-12 which cover how to create new scenarios). Step 6. Repeat steps 4-6 for each day of the week where you run lists Don t forget to include any instances where you know staff on the on-call rota come in to support emergency lists. For example staff may be on-call all weekend but probably only do one emergency list on a Saturday/Sunday. Entries for staff that come in might include in room support for airway management and assisting the endoscopist. Show the grade of staff and time required for them to do this. They may also assess the patient, clean scopes and recover the patient. Show the time for all aspects of care they are expected to support when they come in to provide on-call cover. Step 7. What happens once I have put our information in? Once you have completed the data entry into the Monday Sunday sheets the information will be calculated automatically to produce data about the number of lists your schedule supports and the staffing capacity needed to support your normal list schedule. This information can be found on the page called required staffing profile. 7.1 Select the tab labelled required staffing profile 7.1.1 At the top of the page is a table called Endoscopist workforce (see figure 5). A B Ci, ii Figure 5; the required staffing profile 9

You will be given information to show the wte 2 number of endoscopists required to support your current list schedule (A). Below this the spreadsheet has the capacity to show you the number of endoscopists (headcount) responsible for delivering your schedule of lists. To obtain this information you can return your spreadsheet and have it customised to include the names as a data field (B). Below this you will be given information to show the number of lists you are trying to support with your current establishment based on i) 52 weeks working and ii) 50 weeks working (Ci, Cii). 7.1.2 In the centre of the page are tables for the in-room and in-unit support staff. These give a numerical breakdown of the wte of staff needed for each of the roles included in the spreadsheet. Initially we hoped this information would help you begin to think about skill mix but we concluded that this was not fit for purpose and later developed a better way to enable this to happen. We have left this part of the table in as it is the data from which the totals required for staffing are derived. 7.1.3 At the bottom of the page is a table called totals for required staffing Ai Aii B C D Figure 6; tables for required staffing 2 Please note 1wte = 10 sessions/10 PAs. Also the calculation is based on working sessions so it is relevant to consider the local contract as these may vary between 38 and 42 week contracts. 10

You will be given information to show the working wte number of support staff required to support your current list schedule based on on i) 52 weeks working and ii) 50 weeks working (Ai, Aii). 7.1.4 Why have we included both a 50 and 52 week working wte? The first priority is to show the staffing establishment required to work the roster. 50 weeks working per year is the target that endoscopy units should strive to achieve in order to make best use of their room capacity. However, if the establishment is only set to service this then staff must always be engaged in service delivery in order to ensure this is achieved. This is not good working practice and staff must have access to time-out for professional development and updating. The importance of staff appraisal, professional development and involvement in service development and the links between this and staff sickness absence, morale and turnover are upheld by the 10 high impact HR 3 changes and for this reason we use 52 weeks in order to create protected time within the working establishment to support these activities. You will be given the information to show the employed wte number of staff required to be to maintain your current list schedule. This is based on 52 week working figure as explained above and allows a 20% increase on the working establishment in order to provide cover for annual leave and sickness (B) Below this figure you will be given information on how this employed establishment compares with your existing establishment (C). The difference is shown both in actual wte and as a percentage (D). Any negative number means that based on your current list schedule and pattern of staff deployment you have a deficit in your existing establishment. Step 8. Can I use this information to show that we need more staff? Ultimately this model can be used to demonstrate the room and skill resources required to meet the 2008 referral to treatment target. However do not try to use this information to demonstrate to management that you are short of staff at this stage. There is further work to be done as part of the methodology. You need to consider both the staffed list capacity against demand first and consider your skill mix. 8.1 Links to the workload spreadsheet The importance of link the staffing requirement to workload is illustrated by this example. In one test site the workload capacity planning spreadsheet indicated that the site required 17 lists to meet local demand but the workforce spreadsheet showed the unit was trying to support 19 lists per week. Whilst the unit data did show a deficit in the working and employed establishment clearly this was due in part to the fact that they were planning for a situation of supporting more lists than they actually needed at steady state to balance capacity and demand. In this case the justification of staffing 19 lists could only be in the shorter term, for example to clear a backlog in the waiting list. (For further help see the Endoscopy Workload Capacity Planning Spreadsheet and Guidance notes for completing the Endoscopy Workload Capacity Planning Spreadsheet.) 8.2 Reviewing your skill mix It is important to link the staffing requirement to skill mix and to think about different ways of working. It is unlikely that you will be able to make an effective case for resources without considering this. To enable you to do this we linked the methodology in this work 3 A national framework to support local workforce strategy development: A guide for HR directors in the NHS and social care DH 2006 11

to the idea of Christmas trees. This is a methodology which was developed by the NHS Modernisation Agency to show visually the distribution of skill mix by levels on the career framework. We enhanced this for endoscopy and have added an extra dimension to show a breakdown of endoscopy tasks undertaken at the various levels within the career framework. The Endoscopy staffing model will automatically produce your Christmas tree once the tables for the current scenario have been completed. 8.3 Select the tab labelled WTE (Whole Time Equivalent) This will display the Christmas tree for the pattern of staffing deployment that has been entered in the sheets for Monday to Sunday. This endoscopy Christmas tree graph (see figure 7) is a visual representation of the workforce profile, showing the relative distribution of staff at each level of the career framework (A) along with the tasks they perform (B). A C Figure 7; the Christmas tree B The Christmas tree profile generated based on your current pattern of working will be unique to your unit and it can help you think about your current ways of working and how you might work differently by asking questions such as who is doing what tasks? Are they the right people with the right experience and with proper training and education could others be developed to do more? The publication Workforce Matters: A Guide to Role Redesign in Cancer Services 4 provides and excellent summary of how to assess the potential for working differently, how to plan the role and develop the business case. 4 NHS Modernisation Agency 2004 12

Using the creating multiple scenarios facility (see step 11) you can plan different working patterns and staff working differently so you can test the impact and benefits of new ways of working before you implement them. At present there are barriers to working differently in endoscopy but nationally work is in progress to address this. Nationally we have found two common problems inhibiting endoscopy services implement changes to skill mix; these being no nationally agreed qualification for endoscopy support staff which can lead to concerns for delegating tasks currently done by qualified staff to them. This results in few support staff at career bands 3 and 4 with Christmas tress profiles showing skill mix profiles with more than 70% of staff being qualified. There are also problems releasing trained nurses working as endoscopy assistants to undertake training to progress into endoscopist roles to address shortages in endoscopist capacity. These problems are connected as during the 9-12 months that qualified staff take to develop as endoscopists, their assistant roles need to be backfilled. In response to these problems the National Endoscopy Training Programme is currently developing a Vocational qualification to enable the development of roles at bands 3 and 4 and so plans for new ways of working can now become a reality. Thus to help you keep track of your plans the graph also provides a prompt to remind you which scenario you are viewing (C). This is important once you create multiple scenarios. Linked to the graph is a table which provides a numerical breakdown of the wte and proportion of staff at each level on the career framework and by roles performed (see figure 8). The spreadsheet will also calculate a cost for each scenario and display the result in cell D36 on the WTE sheet. It will generate the total cost of this working profile providing that you have entered reference data for the costs (see step 10). Figure 8; the table for the Christmas tree (WTE tab) 13

You can find the information on how the roles have been mapped to the career framework on the sheet labelled with the tabs CF mapping and costings. This is also the sheet on which you can input the reference costs for your staffing profile. Step 9. Viewing the career framework mapping and entering data about costs 9.1 Select the tab labelled CF Mapping and costings This page displays the staffing groups (columns B and F) and shows how they have been mapped to the career framework. Columns C and G, coloured yellow, can be used to enter the reference salary of the staff used in the scenario. This information is used to generate the cost of the working staff profile shown on the WTE sheet (see step 8) and costs will be proportionate based on the actual wte used for that pattern of deployment. 9.2 You can determine your reference salary costs You can decide whether to put your reference salary costs in as basic salary, or salaries which include on costs (see figure 9). You can also decide if you want these to reflect the actual pay points of staff in post, or if you want to use a specific pay point in any pay scale to reflect the spread of staff who may be included within that particular band. You should also note that if an annual reference salary cost is entered then the profile cost displayed will be for a year and likewise, if weekly reference salary costs are entered, then the profile cost displayed will be per week. Figure 9; career framework mapping and salary costs The costs included in the table above are for illustration purposes only. They have been calculated by assuming that posts will be paid on the same Agenda for Change band as 14

the post is graded on the career framework. The costs above are the mid-point of the 2005 Agenda for Change pay bands. On your spreadsheet columns C and G have been left blank for you to enter your own reference costs. Step 10. Saving your information Now you have completed your data entry you need to save it (see step 12). Once the sheets labelled current staffing establishment and Monday Sunday have been completed for the current pattern of lists and staff deployment it is possible to save the data as a Scenario ; so that new configurations, such as to support revised numbers of lists, changes in skill mix/new ways of working and implementation of screening, can be entered into the same spreadsheet and compared. All functions related to saving, creating and retrieving scenarios are controlled from the sheet labelled scenario sheet (see figure 10 below). The buttons (A, B, C & D) on the right can be used to control the different scenario functions. A B C D Figure 10; the scenario sheet 10.1 Button A: just save (overwrite existing) The top button, Just save (overwrite existing) is used to store the values entered in the spreadsheet, in effect, it is simply a save button. When the button is pressed the following message boxes will appear (see figure 11). 15

Figure 11; the first message box in the just save macro Answer yes to the first message box. Then, the second and third message boxes will ask for the directory (see figure 12) and then the file name required for the document (see figure 13). The spreadsheet is set up so as it will automatically find the current directory and file name, so these will always appear in the message boxes. Once this has happened the data will be stored as a scenario and the spreadsheet will have been saved. 16

Figure 12; enter the directory in this message box Figure 13; enter the filename 17

Step 11. Creating multiple scenarios 11.1 Button B: make new scenario This button allows you to create a new scenario. Upon pressing this button the following message box will appear (see figure 14). Figure 14; enter your name and a description of the scenario Enter your name and a description of the new scenario. These will then appear in the list of scenarios box on the page, the version number in column B, your name in column C, the date in column D, and the description in column E. The workbook will then ask if you want to save. This will perform the same operation as the Just save (overwrite existing) button (button A in figure 10) and store the scenario. Note that the sheet will still display the data from the scenario that was being viewed at the point that the new scenario was created. Do not worry about this, the data will be stored in a hidden sheet, as long as you have run the Just save (overwrite existing) macro, by agreeing to save the sheet when asked. The new scenario can now be entered over the data from the first scenario. You can keep or change as much as you want for the first scenario and so avoid undertaking the complete data entry exercise from scratch. Once the data for the new scenario has been fully entered the Just save (overwrite existing) macro can be run (by pressing on button A in figure10) to store the new data as above. Important: Note that the data will be lost if another scenario is retrieved before this macro is run and the data saved. 18

11.2 Button C: Retrieve another scenario The button labelled Retrieve another scenario (button D in figure 10) enables the user to call up saved scenarios for viewing and editing. Once the button has been pressed a message box will appear asking which scenario you want to look at (see figure 15). Enter the number of the required scenario in the box and press OK. The scenario that has been requested will now be displayed on the spreadsheet Figure 15; enter the number of the scenario you would like to view Step 12. Screening If you want to create a new scenario to show the impact of screening then you can use the Monday Sunday sheets to plan the staffing requirements. 12.1 Background information to support planning The pathway for the screening programme is for all people in the age group 60-69 to be sent invitations to participate in screening by completing an FOBT. (Patients in this age group normally make up 10% of the total population). The screening cycle is over two years with half of the target population called each year. Up to 60% response rates were found in the pilot sites. From these 2% were found to have a positive FOBT and these patients were offered the opportunity to come to a screening pre-assessment clinic. Subject to patient consent and protocols these patients proceed to a screening colonoscopy list. Post colonoscopy, patients are invited to attend a follow up clinic to discuss the findings. Some 40% of those who undergo colonoscopy will have significant pathology and require the screening practitioner to arrange the next steps in the care pathway. This may include referral to an MDT. 19

In order to use this information for planning the work of the screening practitioner in a 500,000 population (some 25,000 patients) will be sent FOBT tests each year with 15,000 then responding. With the 2% positive rate this gives rise to 300 patients per year needing to attend screening pre-assessment clinics and screening colonoscopy. If you plan based on four patients attending each screening pre-assessment clinic session then you need 1.5 clinics only per 500,000 in your screening population. As fewer patients attend the follow up clinics, one of these is required for the same population size. The screening practitioner will also follow the patient through to colonoscopy and in the job plan you should allow for 1.5 lists per week where a population of 500,000 is served. The job plan should also include provision to attend all the local MDTs and should have one session of clinical administration. If your local plans as a screening centre include for the screening practitioner to be involved in health promotion then you should include provision for this. By the time the screening programme has completed one full cycle in the target population it is anticipated (with surveillance requirements) the number of colonoscopies required will be 600 per 500,000. You can use this information to plan the staffing requirements for a screening practitioner; however do not forget to add in the additional lists. You can calculate the requirement for lists according to the population your screening centre will serve using the workload capacity planning spreadsheet. On the workforce capacity planning sheet you will need to add the requirements for in-room staffing, in-unit admin and clerical and overall management support arising from taking on screening. In order to plan for the workforce requirements of a screening practitioner: 12.2 Select the tab labelled Monday Work within the section called Endoscopy support in unit and add data to the table called screening practitioner. Enter data to show the grade and hours you plan to roster for each of the component parts of this role. The spreadsheet will automatically calculate the hours and wte required for each day. 20

Figure 16; the screening practitioner 12.3 Completing the remaining tabs Complete the same process for the remaining days of the week making sure you plan to meet the needs of the population served by your screening centre. Step 13. Viewing Scenario comparisons The last sheet in the work book contains a Christmas tree template that can display up to four of the saved scenarios at one time in order for you to compare them (see figure 17). The scenarios must have been saved using the Just save (Overwrite Existing) button (button A on figure 10) in order to view them on the scenario comparison sheet. 21

B This button for the drop down menu A Figure 17; select the scenarios to be compared from the drop-down lists in the blue cells 13.1 Select the tab labelled Scenario Comparison Identify the blue cells on the table below the Christmas tree (A). Place the cursor over the blue cell; you will see an arrow appear. Click on this to bring up the drop down menu. The drop down boxes will display the numbers of all the scenarios that have been saved. Just select a number from this list and it will appear on the Christmas tree. The name given to that scenario profile will appear in the legend (B). In order to display a second, third and fourth scenario select the required scenario numbers from the drop down boxes in the four different blue boxes of the table. You can a view up to a maximum of four scenarios at any one time so you can assess the impact of your plans to change your working patterns and skill mix profile. Using this information you can assess if your dependence on qualified staffing grades increases or decreases by using both the visual representation and by adding up data on WTE s in the table (C) for bands 5 and above. In the example shown above the total wte for their current endoscopy staffing is 16.18 of which 10.97 are in bands 5 and above. This can be used to compare with subsequent scenarios. You can combine this with information from other pages such as the more detailed information from the WTE page of the relevant scenario to show further detail about the changes in skill mix including the impact on the cost of the staffing profile (see figure 7). The information about the total number of lists per week the staffing profile can cover, compared with the number of lists required to meet demand is also important then you can be clear about workforce needs to meet demand in line with the 18 week referral to treatment target. C 22