Workforce & Rostering — Roster Design
St. Vincent's University Hospital used scenario-based roster modelling to understand the workforce impact of removing 24-hour shifts for anaesthesia NCHDs while protecting theatre and ICU services.
The Anaesthesia Clinical Lead and Perioperative Directorate Clinical Director needed to understand the workforce impact of meeting national rostering rules for NCHDs. The redesigned roster had to eliminate 24-hour shifts, provide appropriate rest, prevent consecutive weekends and allow full leave entitlements — without losing essential theatre and ICU coverage.
Redesigned the shifts: created alternative day and night patterns to replace 24-hour calls.
Built in safer sequences: introduced mandatory rest and limited working runs to a maximum of 11 consecutive days.
Tested headcount scenarios: produced draft rosters with zero to four additional doctors and measured each scenario against workforce rules, leave and normal service availability.
Removing 24-hour shifts was possible at the existing headcount, but the model could not also provide appropriate rest, avoid consecutive weekends and accommodate full leave. Adding one doctor allowed full leave but still did not satisfy the rest and weekend requirements. Two additional doctors were the minimum required to meet all three workforce conditions.
The scenarios showed the service trade-off clearly. With two additional doctors, all roster requirements could be met while retaining 90% of normal service. Three additional doctors increased this to 94%, and four increased it to 98%. The evidence supported a business case for increased staffing by connecting each headcount option to a defined level of safe roster operation and clinical service capacity.
The model separated the staffing required to satisfy workforce rules from the additional capacity needed to restore normal service.
Modelled staffing scenarios
| Additional doctors | Remove 24-hour shifts | Rest & no consecutive weekends | Full leave | Normal service available |
|---|---|---|---|---|
| 0 | Yes | No | No | Not applicable |
| 1 | Yes | No | Yes | Not applicable |
| 2 | Yes | Yes | Yes | 90% |
| 3 | Yes | Yes | Yes | 94% |
| 4 | Yes | Yes | Yes | 98% |
Key finding
Two additional doctors were the minimum needed to satisfy the full roster-rule and leave requirements; further staffing progressively restored normal theatre and ICU service capacity.
What changed for the organisation once the platform was live.
24-hour shifts removed
in every feasible modelled scenario
+2 doctors
minimum to meet all workforce rules
90%
normal service at minimum compliant staffing
98%
normal service with four additional doctors
Full leave
entitlements maintained
No consecutive weekends
designed into feasible models
Theatre and ICU coverage
protected across scenarios
Evidence-based business case
for increased staffing
We will walk you through how this engagement was delivered and what the equivalent first phase would look like for your organisation.
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