Clinical Enabling Support - Benefits

Clinical Enabling Support - Benefits

Clinical Enabling Support (CES) has benefits because of what it is designed to do. It protects clinical capacity by reducing avoidable disability-related barriers around clinical work.

Where clinical capacity is protected, the benefits are not confined to one person or one part of the system. Patients benefit from safer, more consistent and more sustainable care. The clinical unit benefits from more reliable clinical capacity and fewer avoidable disruptions. The employer and the NHS benefit because trained clinical skill is used more efficiently and is less likely to be lost through overload, sickness absence, burnout or resignation. The clinician benefits because they are better able to work safely, sustainably and in a way that allows their clinical strengths to be used.

These are not separate or competing benefits. They are the natural consequences of enabling a clinician to use their clinical skills effectively.

CES should therefore not be assessed only as an added cost. It should also be assessed against the losses that may follow if clinical capacity is allowed to be wasted or damaged. Those losses may include reduced efficiency, longer working hours, increased fatigue, sickness absence, burnout, errors, complaints, grievance processes, litigation, locum use, recruitment difficulty and the loss of a trained clinician from the service.

Looked at in this way, the cost of not providing CES may be far greater than the cost of providing it. The question is not simply whether support has a price. The question is what clinical, organisational and financial cost follows if avoidable barriers are left in place.

Back to: Clinician Enabling Support (CES): Definition and Purpose

1. Benefits for patients

Patients benefit when clinicians are able to work safely, calmly and sustainably.

CES may improve continuity of care by helping clinicians remain in post and work effectively. It may reduce delays caused by overload, sickness absence, burnout, missed follow-up actions or repeated handovers.

Patients may also benefit from calmer consultations, clearer communication, fewer errors linked to fatigue or interruption, and a more reliable service.

In practical terms, CES may support:

• better continuity of care;
• fewer delays and missed actions;
• safer and more consistent decision-making;
• clearer communication;
• reduced risk of error from fatigue or overload;
• a calmer and more humane clinical atmosphere.

2. Benefits for the clinical unit

The clinical unit benefits when work flows more reliably and clinical capacity is less easily lost.

CES may reduce the need for colleagues, supervisors or administrative staff to repeatedly chase, rescue, clarify or reorganise work that has become delayed or fragmented. It may also reduce disruption caused by sickness absence, burnout, unfinished tasks or avoidable crisis management.

In some settings, CES may reduce workload for the wider team. This is because questions and tasks can be gathered, clarified and presented to the doctor in a more coherent form. Instead of several members of staff asking separate questions at different times, the CES worker may be able to collect the relevant information, identify what decision is needed, and return a clearer answer to the team.

This does not mean that CES removes the need for normal teamwork. It means that the flow of work may become less fragmented. The doctor may be interrupted less often, the team may receive answers more quickly, and other staff may spend less time chasing, re-asking or working around delayed responses.

In practical terms, CES may support:

• more reliable clinical output;
• fewer delayed or lost tasks;
• clearer communication within the team;
• quicker and more focused responses from the doctor;
• fewer repeated interruptions and avoidable crises;
• less informal “rescue work” by colleagues;
• reduced need for staff to chase the same issue repeatedly;
• smoother supervision, training and workflow;
• better use of scarce clinical time;
• improved morale and stability within the unit.

3. Benefits for the employer and the NHS

The employer and wider NHS benefit when trained clinicians are able to work safely, efficiently and sustainably.

CES may reduce avoidable loss of clinical capacity through sickness absence, burnout, reduced hours, resignation or movement out of NHS work. It may also reduce the organisational burden created by repeated disputes about workload, adjustments, performance, absence or disability-related difficulty.

CES may also make better economic use of clinical time. Doctors are highly trained and relatively expensive staff. Where a significant part of their time is consumed by administrative, organisational or preparatory work that could be safely supported by a differently paid member of staff, the service may be using clinical time inefficiently.

This is not only a disability issue. It is a wider workforce-design issue. However, it becomes particularly important where the administrative burden also creates a disability-related disadvantage.

If CES allows a doctor to spend more of their available capacity on clinical work, while appropriate support staff organise, prepare or structure the surrounding tasks, the result may be higher effective clinical output at lower overall cost. This is especially likely where the alternative is lost clinical time, longer working hours, sickness absence, burnout, locum cover, recruitment cost or loss of a trained clinician.

In practical terms, CES may support:

• reduced sickness absence;
• reduced staff turnover and loss of trained clinicians;
• better use of expensive clinical training and experience;
• higher effective clinical output where clinical time is protected from work that can be safely prepared or supported by appropriately paid staff;
• reduced reliance on locums, recruitment or repeated induction of replacement staff;
• lower risk of grievances, disputes, complaints or discrimination claims;
• better patient satisfaction through more reliable and consistent care;
• improved staff relations and morale;
• improved disability inclusion and Workforce Disability Equality Standard outcomes;
• better organisational understanding of Equality Act duties and reasonable adjustments;
• a more sustainable and efficient clinical workforce.

CES should therefore not be viewed only as a cost to the employer. It may reduce the much greater organisational cost of allowing clinical capacity to be lost through avoidable overload, poor adjustment or preventable deterioration in working relationships.

4. Benefits for the individual clinician

The benefits for the individual clinician include the obvious day-to-day benefits, but also more serious long-term benefits.

CES may help the clinician work with less overload, less unpaid catch-up work, fewer repeated task restarts, and less anxiety about missed or unfinished work. It may also allow the clinician to do a better job by preserving the capacity needed for clinical reasoning, communication and decision-making.

However, the benefits are not only about feeling better at work. For some clinicians, CES may be the difference between sustaining a career and becoming burnt out, unwell, deskilled, or forced out of work they have trained for over many years.

In practical terms, CES may support:

• reduced overload and fatigue;
• fewer unpaid extra hours;
• less anxiety about missed, delayed or unfinished tasks;
• better use of the clinician’s strengths;
• greater confidence and professional satisfaction;
• safer and more sustainable clinical practice;
• reduced risk of burnout or sickness absence;
• reduced risk of losing a career because of avoidable workplace barriers;
• improved ability to remain in, progress within, or return to clinical work.

CES therefore matters not only because it may make work easier. It may help prevent the loss of a valued professional career.

Summary

CES benefits patients, clinical units, employers and clinicians because it protects clinical capacity.

It should not be assessed only as an individual support measure or as an added cost. It should also be assessed against the consequences of not providing it: wasted clinical skill, avoidable overload, reduced efficiency, sickness absence, burnout, disputes, recruitment difficulty and loss of trained clinicians.

Properly designed, CES may allow clinical work to be done more safely, more sustainably and with better use of the skills doctors have spent many years developing.