Case Study
December 2016
It’s your ESR
Establishment Control using ESR
A case study by Derby Teaching Hospitals NHS Foundation Trust
Background
Derby Teaching Hospitals NHS Foundation Trust has an annual budget of £500 million and
is one of the largest employers in the region with more than 8,000 staff. It provides both
acute hospital and community based health services, serving a population of over 600,000
people in and around Southern Derbyshire.
The Trust runs two hospitals: the Royal Derby Hospital, which incorporates the Derbyshire
Children’s Hospital, is a busy acute teaching hospital and London Road is the Trust’s
Community Hospital.
The Trust treats a million patients each year and more than 6,000 babies are born in its
maternity unit annually, an average of 17 births every day. 72,000 elective operations take
place every year in the hospital’s suite of 35 modern operating theatres, an average of more
than 280 operations per day.
The Project
The main aim of the project was to enable accurate reporting on establishment from ESR.
This meant that we would need to ensure all staff establishment data was entered into ESR
so that we could identify notional vacancy gaps and over-establishments. This was driven by
a requirement to accurately report staffing utilisation at business unit level in Trust Board
Reports.
Before work on updating the current ESR data commenced, our Finance team worked with
our ESR team to develop a joint process for new starters including creating new positions in
ESR when necessary. The Finance team would complete a New Position form for the ESR
team, identifying the position details (Including Job Title, Band, Cost Centre & subjective
code and Staff Group), along with the funded establishment against the position. The ESR
Team would then create any new positions identified in ESR, and record the funded
establishment. Once this process was in place, we began to update the existing position
data in ESR.
The NHS Electronic Staff Record Programme is delivered in partnership with IBM
© NHS Electronic Staff Record 2016
Case Study
December 2016
It’s your ESR
Firstly the ESR team ran the Position Analysis report, identifying all current positions in ESR.
The Finance team used this to match each position in ESR against the details held in the
General Ledger. ESR differs to the General Ledger in that there can be several similar
positions in a single Cost Centre, all of the same band, but which Finance would just identify
as a single budget line/Subjective Code. In order to minimise data maintenance it was locally
determined that the establishment would be recorded against a single position in that
organisation, rather than against each position. This would mean that some positions
showed as over established and some under established, but when reporting at the
organisational (Cost Centre) level or by band, the total establishment matched the ledger at
that level.
For example – All the ESR positions below are in the same Organisation, but from a Finance
perspective, the Ledger simply has one line for Consultant with an establishment of 69.84.
By recording the 69.84 in ESR against only one position, all the other positions show as
under-established, but when aggregated at Organisation (Cost Centre) level, it can be seen
there is an under-establishment of 17.44
The reason there are so many ESR positions in this Cost Centre, is due to the fact they are
all on differing Pay-scales (Due to Level of Seniority – as can be seen by the Grade column
below).
The NHS Electronic Staff Record Programme is delivered in partnership with IBM
© NHS Electronic Staff Record 2016
Case Study
December 2016
It’s your ESR
Once the Finance team had completed this work, the data was returned to the ESR team,
who then entered each of the identified establishments against the ESR positions.
When ESR had been updated, we agreed and embedded a new process:
 When any budgetary change is made by the Finance team, which changes an
established position, they access ESR and amend the establishment to maintain a
match with the General Ledger.
 A monthly control report is run which the Finance team use to ensure the ESR details
reconcile with the General Ledger details.
As well as enabling accurate reporting, having the establishment recorded against each
position means ESR advises if the entry being made takes a position over its established
total -see the screenshot below.
This then leads to a question as to whether this over-establishment is expected.
Due to the process that our Trust has implemented, recording establishment against
selected positions (rather than all) we do receive the above message for most amendments
made in the system, so our workaround is to ignore them. The messages would be of benefit
however, if recording the establishment against individual posts.
Key Benefits
The main benefit of embedding the ESR Establishment Control process is the ease at which
reports can be run, clearly identifying over and under establishments.
The NHS Electronic Staff Record Programme is delivered in partnership with IBM
© NHS Electronic Staff Record 2016
Case Study
December 2016
It’s your ESR
Example Oracle Business Intelligence Report:
Recommendation 12 of the Carter Report stated that: “NHS Improvement should
develop the Model Hospital and the underlying metrics, to identify what good looks like,
so that there is one source of data, benchmarks and good practice.”
One of the Key items identified for trusts was: “Trust boards ensuring that the Electronic
Staff Record (ESR) is reconciled to the financial ledger on a weekly basis, with a
minimum reconciliation of 95% from October 2016”.
Having the Establishment Control process in place in ESR enables us to meet this
requirement, and our quarterly validation checks between the finance ledger and ESR
ensures that the establishment remains in line. Monthly meetings with Finance Managers
ensure Cost Improvement Programme’s (CPI) and any changes to establishment are
mapped accordingly.
This has enabled us to submit more accurate returns, and in particular has been beneficial
for providing the monthly Monitor staff information, and providing detailed staff and vacancy
information for the Sustainability and Transformation Plans (STPs) has given us a clearer
understanding when reviewing staff details in relation to the Carter metrics.
The NHS Electronic Staff Record Programme is delivered in partnership with IBM
© NHS Electronic Staff Record 2016
Case Study
December 2016
It’s your ESR
Close working between our ESR and Finance teams over a number of years has given us a
much better understanding of the true level of vacancy in the organisation. There are still
“differences” between the two systems with regards to Maternity leave and other absences,
and also with the treatment of CIP/vacancy factor in the Ledger the difference now is that we
understand these areas.
“The joint working has also allowed ESR Occupation Codes to be fed into the General
Ledger to make the reporting of cost and WTE by staff types easier in the many returns now
required by the Trusts regulators.” – Scott Jarvis, Director of Operational Finance.
Lessons Learned
The implementation of an Establishment Control process does take time, and does require a
very close working between your Finance and ESR teams.
It is vital that the maintenance of the establishment data in ESR is kept up-to-date with
changes made in the General Ledger. If they are not, this will lead to a further reconciliation
exercise being required to realign the two data sets.
Further Information
If you want more information about the Establishment Control project at Derby Teaching
Hospitals, please contact Greg Chambers, Workforce Systems Manager – 01332 258141,
[email protected] or Chris Broadhurst, Head of Finance Systems - 01332 789531,
[email protected] directly.
For information about ESR Establishment Control functionality and best practice please
contact your NHS ESR Functional Advisor or Account Manager or access the HR Best
Practice guide on Kbase. Log in and click the following link:
https://www.electronicstaffrecord.nhs.uk/kbase/afile/223/6215/
The NHS Electronic Staff Record Programme is delivered in partnership with IBM
© NHS Electronic Staff Record 2016