TEAM BONUSES:
Rewarding staff for a job well done
By Olumide Cole, MRPharmS
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The Government has identified a role for team bonuses as a form of performance-related pay in the health service. This is a brief description of a pilot scheme that started in April at a Sunderland trust
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Mr Cole is staff editor on Hospital
Pharmacist
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Could team bonuses become the norm? At the recent Guild
of Healthcare Pharmacists annual conference, Hazel Blears, Minister for
Health, identified the payment of team bonuses as a way of rewarding pharmacy
staff for "a job well done". Such bonuses can also promote the retention
of staff. Team bonuses are favoured over individual bonuses as the latter
can have a divisive effect among members of staff.
An example of a team bonus scheme in operation is
provided by the pharmacy service at City Hospitals Sunderland NHS Trust.
Each member of staff in the department, regardless of grade or job type,
will receive a bonus of £600 if targets relating to the pharmacy service
are achieved. Staff who are employed as new starters or who leave during
the pilot will receive their personal bonus on a pro rata basis,
and similar considerations apply to part-time staff.
There is also an additional £60,000 bonus that will
be made available to the department for environmental improvements. The
pharmacy department intends to use the money for improvements in ventilation,
lighting and furniture.
The City Hospitals Sunderland NHS Trust treats about
87,000 inpatients per year and has an annual drug budget of £6.5m. Staff
in the pharmacy department include 29 pharmacists, 52 pharmacy technicians
and 27 support staff (pharmacy assistants and clerical staff). These staff
are responsible for issuing 550,000 dispensed items each year.
The hospital's pharmacy department aims to promote
the safe, effective and economic use of medicines at ward level. To this
end, the targets that have been set for the department are patient-focused
and are based on the performance measures of quality, efficiency and effectiveness.
The team bonus scheme is being piloted on eight wards (four elderly and
four orthopaedic).
Each of the measures has a target attached to it,
except for effectiveness, which has two targets (see Table 1 below). The
department receives the full reward by meeting all four targets. Achievement
of some of the targets will result in pro rata bonuses (that is,
achieving three targets [75 per cent] means that staff will receive only
£450, and a corresponding environmental improvement allowance of
£45,000). Success in meeting each target is determined on a pass
or fail basis.
In order to ensure that resources are not being
diverted from other aspects of the pharmacy service in an attempt to meet
these targets, it was determined that existing performance indicators
such as stock turnovers, outpatient dispensary waiting times, sickness
absence, vacancies and overtime payments must at least match those of
2001/02.
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Table 1: Targets for pharmacy
service under the bonus scheme
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Target 1 (Quality)
To reduce the time interval between a clinician’s decision
to discharge a patient and the provision of discharge medication
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Aim To free medical and surgical
beds for additional admissions
Measure of success To achieve a minimum of 75 per cent
of discharge medication supply within four hours of the decision
to discharge patients on all pilot wards
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Target 2 (Efficiency)
To re-use patients’ own drugs and reduce the amount of
drugs destroyed; to save resources by not re-issuing medicines
that patients already have; and to improve safety by stopping
inappropriate medication
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Aim To reduce waste and minimise
the need to supply medicines in the hospital
Measure of success To recover an average of 50 per
cent by value of patient’s own drugs for use during their
stay as inpatients
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Target 3 (Effectiveness)
To ensure that all patients have a specific reminder card
which includes information on why their medicines are being
prescribed, as well as the dose regime and major side effects
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Aim To inform the patient and achieve
concordance with the dose regime
Measure of success To ensure that 90 per cent of discharged
patients (excluding those who require intermediate care) receive
a patient reminder card
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Target 4 (Effectiveness)
To reduce the number of prescribing and administration errors
on prescriptions
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Aim To improve the whole medicines
management process
Measure of success To ensure that 80 per cent of prescriptions
have a validated medication history
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Acknowledgement
Details of the scheme were provided by David Miller, chief pharmacist,
City Hospitals Sunderland NHS Trust.
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