News Update No. 30 : 20.01.17

Emergency Department Agreement -Review By Workplace Relations Commission

Friday, 20 January 2017

Dear Members

The Workplace Relations Commission (WRC) undertook a further review, of the implementation of the ED Agreement, involving the INMO/Department of Health/HSE, this morning (Friday, 20th January 2017), with a meeting between the parties.

The INMO was represented, at this meeting, by both local representatives and officials.  

The following is a brief summary of developments at today’s meeting:

1.    The INMO, at the commencement of the review, reminded all parties that the level of overcrowding, in Emergency Departments, had reached record levels, in the last four/six weeks, with a peak of 612 patients, on trolleys, in one of the first days of this year.

This had placed intolerable pressures on ED staff with no additional staffing resource being supplied to deal with very ill patients.

2.    In that context the INMO sought clarification, in relation to management’s position, on the following critical issues:

(i)    ED Staffing - Need for Immediate Measures
The meeting noted that the first meeting of the Emergency Department Taskforce, to review and issue recommendations on ED staffing levels, took place earlier this week.  It was confirmed that the INMO has already objected to the suggestion that the Taskforce will take 12 months to produce its report.

At today’s review the INMO sought an immediate staffing initiative, from management, to recognise the current workload, on nursing staff, and the acknowledged fact that attendances, at ED, had increased by over 5% in the past 12 months.

In response to this management said they would have to examine whether it would be possible for the Taskforce to issue an interim report, to assist with current difficulties.  It was indicated that they were not in apposition to put forward any special staffing initiatives at the meeting.

(ii)    Staffing for Admitted Patients in ED
As part of the original agreement an Expert Group reported, last August, and made specific recommendations regarding the need for additional, permanent, staff to look after admitted patients in EDs.

When this matter was raised today, by the INMO, the management side said that there was no funding available, for the additional staff, which would be well in excess of 100 additional nurses, and that no action was planned on this report at this time.

The INMO responded by saying that this was totally unacceptable, offensive to both patients and staff and an overt breach of the original ED Agreement from last January.

(iii)    Nursing Vacancies in ED
In relation to the issue of vacant nursing posts, the management side made the following points:

(iv)    Posts Arising from the Agreement
At today’s meeting the management side did confirm their agreement to the following:

(v)    RSCN Posts - ED
The management side also agreed, following a demand from the INMO, that a new national competition would be commenced seeking Registered Sick Children’s Nurses, for all Emergency Departments, to comply with best practice and recommendations of previous reports.

3.    Security Review

The management side agreed to ensure that security reports, with regard to all individual Emergency Departments, are circulated, locally, and they will begin acting upon all recommendations relevant to each site.

4.    Management / INMO Meetings (Local/Group Level)

The INMO sought reaffirmation, as provided for in the agreement, that senior management, including Group CEOs and Clinical Directors, will attend the relevant hospital/Group meetings provided for under the agreement.

5.    Advanced Skills Initiative
It was confirmed that discussions are at an advanced stage, between the INMO/HSE/Department of Health, on finalising an Advanced Skills document for consideration by the parties.


In view of the very unsatisfactory response, from management, in relation to the critical staffing issues, identified above, the WRC, at the INMO’s request, adjourned today’s meeting and it will reconvene in two weeks’ time on Friday, 3rd February 2017, at 10.30 a.m.

In the interim the lack of progress, on this staffing issue, will be raised, as part of the national discussions, now commenced, on Staffing/Recruitment/Retention generally, within nursing and midwifery, and an assessment will be made on what progress emerges.

In relation to the specific issue of ED staffing it is possible that, if management continues to refuse to implement the expert group recommendations, we will refer the matter, for an emergency Labour Court hearing, asserting breach of the agreement.

All members will be kept advised, of all developments, and thank you for your attention to this note.

Yours sincerely

Liam Doran
General Secretary 

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