In the search for higher productivity and quality organisations develop a litany of policies. However if these polices do not include anything that specifically regulate working hours and breaks, confusion may result.

A set of floor time polices usually sets out a managements conceptions of efficiency and organisation. Although it is understandable for a practice to try and accommodate the needs of the workforce. If there are a number of interrelating rules if can be difficult to assess their validity where they are seen in isolation from the rest of the practice.

Given the complexities of staffs attitudes, office politics and interactions with policies, this key can be the hardest.

Level 1

At level one breaks are at workers discretion. At face value this is understandable, especially for patients facing staff. Patient queries may appear in both volume and complexity at any time so staff take their breaks as and when needed. This results with some staff never getting breaks and others taking successive breaks. Management make no attempt to monitor or regulate start/stop times. Staff will often start to close the practice earlier than needed to ensure staff finish on time. This results in lost work time as staff wind down earlier than they should.

• Start to have a short meeting at the start of each working day. This is a 3 minute meeting that is as informal as possible. All staff that are here at the start of the working day should attend. The meeting can either be a quick check in, to any information that is pertinent to the day. It can even just a rousing cheer to motivate the staff. Although this may sound simple or silly, the results can be surprising.
• If possible, have a similar meeting after lunch.
• Set up another event that signifies the end of the working day this will aide pulling the working day together.

If there is any resistance from some of the more cynical staff, they should be spoken to privately. Ask them for them help to create enthusiasm and avoiding verbal sabotage. after a while habits will start to form and the desired results will be achieved.

It is important that the meetings must not be more than 5 minutes in length. If not the meeting will be counter productive. The meetings are not formal, and should be held as near to the where the staff work. The groups should be relatively small. If the practice is large have a number of groups but rotate some members to avoid ‘them and us’ narratives.

Level 2

At level 2, depending on the culture, a practice can either quickly slip back to level 1 or improvements accelerate to level 3.

• Everyone arrives and leaves on time. If some staff are consistently late arriving or early leaving, this is contagious and if left will suck a practice back to level 1.
• Use meetings to create commitments to daily timings this is facilitated by line managers and backed the leadership.
• For any chance of adherence of daily timings, staff must be in agreement with the timings. A practice wide campaign should also be employed to aide the process.
• Use friendly, gentle counsilling to persude habitual latecomers and early-leavers to follow regulations,

Level 3

Lateness, extended lunch breaks etc are mostly resolved. Often staff will leave meetings with no particular rush to get started at work. Hence time is wasted through a sluggish returns to work.

• Tiding and cleaning that staff may engage after a meeting should be done at the end of the working day. This is because task that take 10 minutes after a meeting are often much quicker at the end of the working day when staff are trying to leave on time.
• Use of task cards, allocated to specific positions./ PC. When this is used in conjunction with a staff rota, staff have a clear idea what they are doing and when. Staff will even prepare for work in advance.
• Create a place where any non routine task are advertised. This allows staff to see and prepare of this affects other work or ask who is completing the work. Which ever method to achieve this is used it must be easy to access/ unmissable.
• Encourage staff to prepare for the next working day at the end of a shift.

Level 4

At level 4 staff are ready to start work at the start of their shift before the morning meeting. To advance to level 4 the practice should also be achieving level 4 for Key 7 Anti-monitoring. . Staff will only be stopping for designated breaks.

TO PROGRESS TO LEVEL 5 ALL OTHER 19 KEYS MUST PROGRESS TO LEVEL 5

Level 5

All staff at all levels are ready to work at the start of the working day. All closing up, preparation for the next days work is done at the end of the shift.

A Level 5 practice runs on a strict schedule staff start on time so the needs of the practice are met and staff leave on time so that needs of the staff are met.