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Call for nurses to clock-in with hand scanners

Automated time-keeping systems that can involve nurses using hand scanners each time they arrive for a shift would help improve safety on the wards, as well as saving the NHS millions each year, according to a new report.

The study, published by the London School of Economics (LSE), estimates more than £71m could be saved annually by introducing automated time-keeping and eliminating payroll errors – money that could be spent on employing more nurses.

However, Tony Hockley, report co-author and a specialist in health policy analysis, told Nursing Times the main gain would be improved safety.

Without accurate information about who was actually on a shift or around at crucial hand-over times, he said it was impossible to truly understand staffing pressures and find solutions.

But he acknowledged the use of biometric systems such as hand scanners to “clock in and out” was controversial.

“It’s reminiscent of factory workers of the 1970s so asking professional groups to clock in and clock out is a huge cultural step,” he said.

“If it is seen as a way for managers to control staff I don’t think it can work but if it is perceived as a way of giving staff more control over their working day, freeing them up from paperwork so they can spend more time with patients and helping ensure a happier workforce then it can.”

Mr Hockley said his research showed while healthcare professionals such as nurses might be initially resistant and sceptical about automated time-keeping they were generally in favour once they’d seen it in action. Its introduction therefore required strong leadership from senior managers.

The report – NHS Staffing: Not Just A Number – focuses on the nursing workforce. It highlights widespread problems with the over-payment and under-payment of staff and also a lack of real-time data on staffing.

Tony Hockley

Tony Hockley

“In a safety-critical environment, where the absence of one member of staff for a matter of minutes can make a significant difference, knowing who is available in real time and having a verifiable record of staffing levels is of great value,” says the report.

It warns a failure to take “simple steps” such as moving towards digital workforce management systems is “putting safety and efficiency at serious risk”.

And it blames politicians for focusing on the introduction of electronic patient records rather than streamlining staffing processes that underpin the safe running of the NHS.

“If variations from the roster are not tracked and acted upon immediately it can leave wards short-staffed and payrolls in confusion,” says the report.

As part of the study, researchers looked at trusts that have introduced “paper-less” systems including Basildon and Thurrock University Hospitals Foundation Trust, which estimated it saves £160,000 a year from a time and attendance system that uses hand scanners.

The system helped ensure more efficient deployment of permanent staff and led to significant reductions in spending on temporary nursing staff.

The £71.5m saving from the introduction of similar measures across the NHS would be on top of much bigger savings from e-rostering, now used by nearly all nursing teams, says the report.

But it stresses such innovations must go hand in hand with active analysis and workforce planning.

In the wake of the Francis report trusts are now being asked to provide monthly staffing reports.

However, Mr Hockley said this could mean increased paperwork for over-stretched nurses and the data gathered may not be much use.

“By the time data is aggregated over a month there’s no way of knowing what’s really happening or whether it’s a robust reflection of ward pressures,” he said. On the other hand automated systems could provide “minute by minute” information on staffing levels.


What do you think?

We’re going to be discussing this research and its possible implications on twitter at 1pm Wednesday 19 February. To join in, search for #NTtwitchat and use this hashtag in all your tweets.


Readers' comments (40)

  • OK, after my knee jerk reaction (quite negative) I can see that it could be a good thing. In my workplace, we clock in & out, so a focus on doing it so that you get paid properly is a big incentive plus it enables a good audit trail for who has worked what etc...
    It will be interesting to see how the NHS folk cope this idea. I cant see it would be that big a deal anyway??

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  • Load of rubbish-Next

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  • Load of rubbish-Next

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  • you mean nurses don't clock in? how old fashioned just another sign of how archaic, unfit for any sort of purpose and unsafe the NHS is.

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  • I have not analyse this properly as yet, but first reaction is happy for it, as I should get more pay every time I clock out late. I am always on time at start of shift and so are all my fellow nurses on the ward, however we are most times later.

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  • So, doctors will be clocking in/out as well then?!

    Or is it just the nurses that are being targeted as the ones at fault again..

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  • Anonymous | 19-Feb-2014 8:45 am

    not necessarily. your case will be analysed to see why you are repeatedly clocking out late. the idea is to make the services more efficient by cutting costs and stopping workers from fiddling the system, not incurring further ones!

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  • Big brother is watching you!!!

    This proposal will be OK if every minute of overtime is paid. Somehow, I doubt it will be. It will just be used to undermine nurses if they dare to be late starting a shift, and completely ignore overtime worked.

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  • Here we go again another load of money spent on technology which will be dumped after a few months because it does not work and shows up too much that cant be addressed because it will cost too much and show how hard nurses are really working and what we are really putting up with. Nothing against innovation but lets think about why this is being suggested

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  • Anonymous | 19-Feb-2014 2:05 pm

    the whole idea is eliminate all but essential overtime for an emergency so that payment isn't being claimed without good reason. it gives better control of finances as each case can be considered individually on its merits. if somebody is consistently working overtime their motives need to be questioned.

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  • It should be for all staff not just nurses, and will they be paying overtime for those of us who get off late regularly due to workload? I don't think so. Also will be clock on and off our breaks! And get paid when we miss them? Another silly fad.

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  • Nurses already clock in/out in the private sector. If anything, clocking in/out can be used to properly record time owing in lieu or, even better, paid overtime.

    It will also accurately record staffing levels and illustrate the divide between managers leaving early and nurses staying late.

    Big Brother paranoia in the NHS only illustrates an attitude that some staff regard themselves as "untouchable".

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  • Well all I can say is. If 'they' (managment or Government), do that then 'they' will be amazed at just how many extra hours nurses donate to the health service without payment. However, no doubt we will be criticised for it being our inefficiency that makes us work extra hours not that we are dedicated, overworked and understaffed.

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  • tinkerbell

    'Its introduction therefore required strong leadership from senior managers'

    some of whom are possibly the worst offenders of coming late and going early. Good, no objection to clocking in and out but let's make sure everybody is playing by the same rules.

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  • it worked well in our favour as it meant we were paid for the hours we worked and if we went over the official number of hours in a working week or fortnight we could take time off when the ward was quiet and well staffed any time we wished.

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  • we had 'credit' style ID cards with chip and PIN and magnetic bands which were registered with equipment like you have at ticket barriers on the tube or railway stations which also prevented unauthorised persons entering the hospital through the staff entrancce and zone which was a good security measure as well and confined others to the visitor areas where entries and exits could be better controlled. this card also gave access to the automatic valet service to withdraw laundered uniforms and to pay in all the hospital cafés and restaurants. could be cheaper and more effective than each having a handheld scanner. they also gave computer access to patient records and for ordering pharmacy and ward other ward supplies from the stores. it was also a useful tool for the accounts department for salaries and billing any staff services such as private phone calls, access to staff club, memberships and other benefits.

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  • Will I have a scanner in my car for the days I am working away from my base or will it look like I end up owing time by the time I add in two hours travelling

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  • We have a hand scanner type clock in system. No matter what time you clock in or out you are not paid extra time unless your manager authorises it. It has created another few hours a week on the computer for ward managers who have to check all the 'exceptions' and either acknowledge or authorise shift times etc etc. Nightmare and you are more likely to be underpaid as often the electronic clockins don't register.

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  • So for those nurses who have to turn up early for their shift (15-30 mins in some areas) to allow adequate handover and stay beyond the end of their shift a similar period, quite apart from the 1 - 1 1/2 hours on units that cannot close till the last patient has gone home, e.g. chemotherapy and day surgery units, waiting for treatment to finish, relatives or hospital transport to arrive.
    Missed lunch and coffee breaks etc
    Nurses keep the NHS running with unpaid overtime, the places I have known that have introduced scenes like this have pretty rapidly withdrawn them as they have found that the employers have been breaching employment law on rest time, shift breaks etc
    I have already exceeded my paid time in 3 days, with 2 yet to work this week. I will not be paid for it and it is unlikely I will get time back for it either.

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  • On the one hand I like this idea. At my workplace we often have healthcare assistants (and even regular bank nurses) come in late, sometimes when handover is nearly finished. But would we get paid overtime if we had to stay behind to finish paperwork? If the ward suddenly became disturbed?

    And what about other NHS staff -would doctors and OTs be subject to this clocking system too, or is it just us nurses that are hounded again and again?

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