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News Update No. 25 : 25th July 2016

INMO Emergency Department Members

Implementation Of Emergency Department Agreement  - Workplace Relations Commission - Fourth Review

Monday, 25th July 2016

Dear Colleagues,

As required, under the ED Agreement, the Workplace Relations Commission (WRC) carried out its fourth review earlier today.

The review involves the WRC chairing a meeting, between the INMO/HSE/ Department of Health, to consider the ongoing implementation of the agreement and to deal with any problem areas.

The INMO delegation was led by our President, Ms. Martina Harkin-Kelly, together with a number of ED representatives, from around the country, with officials from the INMO including myself.  The management side delegation was led by Ms. Rosarii Mannion, HSE National Director of Human Resources, together with officials from the HSE and the Department of Health.

1.    In opening the meeting the INMO made the following points:

1.1    That while the level of ED overcrowding had significantly decreased, in May/June, it had, regrettably, increased in the first three weeks of July leading to a 12% increase on the same period in 2015.

1.2    The INMO also pointed out that there continued to be totally unacceptable delays in the filling of the posts, established within the agreement, including:

  • the internal filling of seven CNM1 posts - this remains outstanding in some departments;
  • the filling of a CNM2 post, for admitted patients, in a number of departments across the country; and
  • the appointment of an Assistant Director of Nursing post, with total focus on patient flow, in all departments.

The INMO highlighted the fact that a number of local managements were continuing to state that they were awaiting action, from the National Recruitment Service (NRS), and this was causing delays.  At today’s meeting the INMO firmly stated that this was totally unacceptable, in complete contravention of the agreement and demanded that management, at national level, act to ensure the filling of all posts immediately.

1.3    The INMO also highlighted the continuing failure, of some managements at local level, to fill vacant Staff Nurse/CNM2 posts, within Emergency Departments.  This was despite the fact that all departments continued to be under significant pressure due to ever increasing demand.

1.4    In a small number of locations the INMO also highlighted the fact that some local managements continue to ignore the existence of a national Escalation Policy.  Instead they continue to apply their own policy in contravention of the agreement and that this must cease immediately.

1.5    The failure of a number of hospitals to notify the Joint Chairs (Tony O’Brien, HSE/Liam Doran, INMO) every time they move into Full Capacity Protocol (FCP) and to specify what actions they are taking to de-escalate and address the overcrowding situation throughout the hospital.

1.6    The need to circulate the Security Audit Reports, of all Emergency Departments, and to make them available to our members locally complete with the actions to be taken by hospital management to improve security for frontline staff.

2.    In response to these points the HSE stated the following:

2.1    They remained absolutely committed to implementing every strand of the agreement in the shortest possible timeframe.

2.2    This includes their absolute commitment to fill all vacant posts. All local / group managements have been notified, by senior national management, that they must move to fill these posts, immediately, and that the funding for same will be provided.

2.3    They acknowledged that hospitals must notify the joint chairs, with regard to Full Capacity Protocol, and they will ensure this happens going forward.

2.4    In relation to the increased levels of patients on trolleys, in recent weeks, the management side indicated they felt this was caused by a number of factors including:  

  • the changeover in Non-Consultant Hospital Doctors;
  • the fact that the numbers of persons presenting, to Emergency Departments, continues to be up by 6% year on year; and  
  • the problems arising from increased numbers of delayed discharges due to the temporary curtailment of funding for homecare packages.  This had now been addressed and homecare packages were now available again to all persons requiring same.

3.    Discussions / Actions

3.1    Under the chairmanship of the WRC a lengthy discussion then took place, with regard to all of the foregoing issues.

3.2    It was acknowledged that ED nursing staff are increasingly frustrated at the delay in implementing the agreement.  A number INMO representatives present, at this morning’s meeting, stressed that members were frustrated and the delay in implementing all measures would, ultimately, lead to a recommencement of industrial action due to workload and clinical care concerns.

3.3    In order to address all outstanding issues, against the background of management stressing their absolute commitment to implement the agreement, the following was then agreed:

  • a small three person group (one nominee each from the INMO/Department of Health/HSE) would be established immediately;
  • this three person group would commence hospital visits/review, this week, with a view to ensuring that all posts, both new and existing vacancies, are filled, immediately, and any blockages in relation to same removed;
  • this three person group will also ensure that all hospital managements understand they must offer current fourth year undergraduate permanent posts upon graduation - this will aid existing staffing shortages/recruitment difficulties; and
  • this group will report, in the first instance, to the next meeting of the Implementation Group which is scheduled for 16th August 2016.

3.4    In response to these proposals, which were accepted by the INMO, the Organisation stated that failure to implement, in full, the agreement would, inevitably lead to industrial action, in Emergency Departments, in September/October.  Against this background the Workplace Relations Commission proposed that it will undertake a fifth review, of the agreement, at 10.30 a.m. on Friday, 2nd September 2016.

3.5    In addition to this special initiative, aimed at prioritising all staffing issues, it was agreed the local meetings, at hospital and group level, will continue to oversee the implementation of the agreement and, in particular, the full 24/7 operation of the Escalation Policy.  Local Emergency Department representatives will continue to be involved in all of these local engagements.

Thank you for your attention to this note.  A further update will issue, in approximately two/three weeks, following feedback from the first round of hospital visits by the three person group established today.

Yours sincerely

General Secretary 

Members Updates
News Update No. 23 : 16th April 2016
Workplace Relations Commission (WRC) held its second review
News Update No. 21 : 16th March 2016
WRC Review of Implementation of ED Agreement
News Update No. 20 : 15th March 2016
ED Talks at Work Relations Commission
News Update No. 19 : 10th March 2016
Following ED Meeting 9th March 2016
News Update No. 18 : 25th February 2016
WRC Convenes Review Of ED Agreement
News Update No. 17 : 5th February 2016
INMO Emergency Department Members - ED Members Accept Revised WRC Proposals
News Update No. 16 : 19th January 2016
Report on National Meeting - ED Representatives. 19.01.16
News Update No. 15 : 15th January 2015
INMO Emergency Department Members
News Update No. 14 : 13th January 2015
National meeting, of ED representatives Tuesday, 19th January 2016
News Update No. 13 : 11th January 2015
INMO Executive Council Defers Planned Industrial Action
News Update No. 12 : 9th January 2015
News Update No. 11 : 9th January 2015
Workplace Relations Commission Invite INMO/HSE To Participate In Further Discuss...
News Update No. 10 : 7th January 2015
Outcomes - National ED Meeting 7th Jan '16
News Update No. : 5th January 2015
Ballot Result And Next Steps
News Update No. 8: 24th December 2015
Recruitment / Retention Measures - Claim for Incremental Credit for new Graduat...
News Update No. 7: 22nd December 2015
Advertisement for Nursing Posts, New Escalation Policy
News Update No. 6: 18th December 15
ED Dispute - Settlement Proposals.
News Update No. 5: 15th December 15
Strike Action Deferred.
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Irish Nurses & Midwives Organisation (Cumann Altrai agus Ban Cabhrach na hEireann). The Whitworth Building, North Brunswick Street, Dublin 7. T:0016640600 E:inmo@inmo.ie