Aligning workforce demand and patient care through smarter ambulance rostering

Welsh Ambulance Services NHS Trust serves the entire population of Wales, providing critical emergency and ambulance services across urban, rural and remote communities.

Formed in 1998 through the consolidation of regional ambulance services, the Trust now supports a population of approximately three million people through a workforce of more than 4,000 staff.

As a demand-led emergency service, ensuring the right clinicians are available in the right place at the right time is fundamental to patient safety and service delivery. The Trust recognised that workforce rostering plays a critical role in achieving this objective.

“Rostering or your roster is your single biggest determinant of patient safety on any given day.”

Following a strategic review of its operations, the Trust identified an opportunity to improve how ambulance resources were aligned to patient demand. Existing rostering arrangements had evolved over many years and no longer reflected changing service requirements or demand patterns.

The organisation needed a way to:

Given the scale of the challenge, the Trust wanted an experienced partner that could combine workforce rostering expertise, stakeholder engagement and specialist rostering technology.

The Trust partnered with Totalmobile to undertake a comprehensive workforce rostering review across multiple operational areas.

Through a highly collaborative approach, Totalmobile worked with frontline teams, operational leaders and staff representatives to evaluate demand patterns, workforce requirements and potential roster models.

Using Workforce Rostering and modelling tools, teams were able to assess different roster scenarios and understand how staffing patterns could be aligned more effectively with service demand. Totalmobile’s consultants supported local working groups across 15 operational localities, helping staff explore different options and understand the impact of proposed changes.

The project also involved extensive stakeholder engagement, including detailed consultation processes and the development of agreed rostering principles that balanced operational requirements with workforce considerations.

“We’ve managed to improve relief on the stations. We’ve managed to stop people working a lot of consecutive night shifts and give people better work-life balance.”

For Welsh Ambulance Services NHS Trust, workforce rostering is no longer viewed as a one-off project but as a critical business process that should continuously evolve alongside patient demand. The Trust expects workforce rostering reviews to become a more regular part of operational improvement and workforce planning.

As ambulance services continue to face increasing demand pressures, the organisation sees workforce rostering as one of the most important tools for ensuring resources are deployed effectively while supporting both patient care and employee wellbeing.