This case study features in the NHS Innovation Accelerator’s year three research report, Understanding how and why the NHS adopts innovation.
Lantum is a cloud-based tool built to help NHS providers fill empty shifts in their clinical rotas. Lantum has a secure online environment where users can advertise shifts which their own clinical staff can book at any time via any device, including smartphone app. The tool integrates with clinical staff calendars to efficiently match available clinicians with open shifts. By implementing Lantum, significantly more shifts can be filled by providers’ own clinical staff banks.
Additionally, Lantum gives staffing managers access to a wider pool of fully vetted clinicians outside of their own staff banks. This enables staffing managers to bypass agencies, to reduce costs and boost fill rates. Lantum also incorporates additional features including automatic payment capability (which allows a provider to agree timesheets and pay clinicians online) and administrative tools such as automatic pension forms, invoicing and compliance document storage.
A GP Practice Manager joined a local NHS practice from a commercial background in early 2014. He faced the continual time-consuming challenge of needing to find locum GPs to fill shifts. He had found Lantum (or Network Locum, as it was previously called) online, and then met them in person on their stand at a practice managers conference. He quickly saw the benefits Lantum offered:
- Improved practice efficiency
- Speed and ease with which jobs could be posted
- More direct control in matching applicants to available shifts
As a small practice with relatively few decision makers, the Practice Manager had the autonomy and freedom to be able to quickly adopt and utilise Lantum.
Roll out across a GP Federation
During 2014/15, GP practices increasingly began to group together to form Federations, partly in response to the Five Year Forward View. In Sutton, the Medical Director for the GP Federation had previously been a Medical Director for an out-of-hours GP service, where he had personally experienced long-standing recruitment and retention issues, alongside the constant challenge of trying to staff shifts.
When planning to set up the Sutton GP Federation, the Medical Director, along with the Chief Operating Officer, were concerned that staff planning would continue to be a challenge.
The idea of having an ‘Uber-like’ system to deal with staffing rotas was a very attractive proposition, and they both saw the opportunity to incorporate a Lantum-style offer into their early plans for setting up the Federation of 25 GP Practices.
The aforementioned Practice Manager sat on the GP Federation Board, and was able to both share his experience of implementing Lantum and highlight its benefits. Lantum was then adopted across the GP Federation.
Key role of the adopting individual: The role of the Practice Manager within the original single GP practice and the role of the Medical Director in the GP Federation was arguably the most important enabler in this case study.
User-centric design solving a pressing problem: Initially, adoption occurred primarily through individual GP practices. A major feature enabling this process was that the system has been designed with a clear understanding of the end-users needs. Doctors and rota managers were closely involved in the development of the system from its beginning, and it has been developed, tested and modified in the light of feedback from users in a flexible way so as to provide greater functionality that offers a range of added benefits to users.
Costing structure: The costing structure established by Lantum has facilitated its uptake within GP Federations. GP Federations pay a reduced fee for GPs that are supplied from within the Federation’s geography. This allows the Federation to keep costs as low as possible by, in the first instance, seeking to preferentially select GPs who are in their group of practices.
Structural NHS change – from GP practice to GP Federation: The uptake of Lantum across the GP Federation was facilitated by the national policy drive to encourage groups of GP practices to work together in federations to optimise efficiency. Workforce was one such area where there was a pressing need to explore ways of using people’s time more efficiently. Lantum’s entry into the market was timely in aligning with this need. In this example, implementation within a local practice meant that the original adopter could then become a champion for it across the Federation.
In the first 12 months of using the system, the Federation was able to make an additional 18,000 appointments and see 14,500 additional patients. Whilst also attributable to other factors, the GP Federation Medical Director was clear that their use of Lantum played a key role in this
After approximately 18 months usage of Lantum, the GP Federation Medical Director reported 98-99% GP shifts were regularly filled. This was not something he had witnessed previously in the out-of-hours service, and was attributed to Lantum.
In Sutton GP Federation, the Medical Director quickly saw that there were many benefits, and little or no downside, to implementing Lantum for GP rotas. He is also convinced that widening usage to include receptionists and practice nurses will bring even greater benefits, and has fed this back to the company. The company has now expanded Lantum to include rotas for practice nurses, practice receptionists and administrative staff.
1. Cynthia Abankwa, GP Federation Chief Operating Officer
2. Melissa Morris, CEO and Founder of Lantum, NIA Fellow
3. Julia Prudhoe, Project Manager, Health Innovation Network, South London AHSN
4. Dr Farhan Rabbani, GP Federation Medical Director
5. Practice Manager, GP Practice, Sutton GP Federation