INMO Emergency Department Members
Implementation Of Emergency Department Agreement - Workplace Relations Commission - Fourth Review
Monday, 25th July 2016
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 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:
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:
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.