Three surgeries, four dentists, five nurses, and a book that assumes everyone is in
A practice with three surgeries has more clinicians than rooms. A principal on four days, an associate on five, a second associate on Thursday and Friday only, a hygienist on Tuesday and Thursday: four people sharing three surgeries by the day. Every surgery that runs needs a nurse chairside, one nurse runs the decontamination room, and the fifth alternates between decon and cover. Reception is two people from a quarter past eight, with one of them on the late until seven on Tuesday. The practice manager holds the whole thing together and is usually also the person who answers the phone at lunch.
The appointment book assumes everyone is in. That is where the rota fails: Surgery 2 is booked solid on Thursday and its nurse is on a course, so the associate works with the decon nurse and decon stops; the hygienist’s Tuesday moves for a month and the book is still full; a receptionist calls in sick at eight and the other one opens the door alone. The hours of nurses and reception live in a diary, and the month end is a calculator and an argument about a Saturday.
Below is how a practice of twelve looks in InShift: the surgeries as shift types with the pair in one cell, the week as a table of who is in which room, the hours per person for payroll, and the practice manager approving a holiday from the phone.