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News Update No. 28 : 25.10.2016

ED Update:  Report From Sixth Review Of ED Agreement By The Workplace Relations Commission  


Tuesday, 25th October 2016

Dear Members

As previously advised the Workplace Relations Commission (WRC), undertook its sixth review, of the implementation of the ED Agreement, last Friday, 21st October 2016.

The HSE management team was led by Mr. Liam Woods, Director of Acute Hospitals, HSE, with other officials from the HSE and the Department of Health.  The INMO delegation included local representatives, IROs, Ms. Phil Ni Sheaghdha, Director of Industrial Relations and myself.

The following is a summary of the outcome of this review.

1.    Overcrowding - Trolley / Ward Watch Figures

The latest figures, with regard to the numbers of admitted patients on trolleys, in Emergency Departments, confirm that the problem remains critical with a 1% increase, in the first 14 days of October this year, compared to last year.

In response to this trend the INMO delegation sought details on what special/additional measures management intended to bring forward to deal with this continuing crisis.

In response to this the management side confirmed that €40 million, as part of the winter initiative, has been allocated, starting immediately, with a particular focus upon:

  • additional transitional care beds;
  • additional home care/home help packages; and
  • additional Community Intervention Teams;

to aid with delayed discharges and maintaining people in their own home.

In response the INMO demanded that resources must be allocated immediately to all Emergency Departments to allow them employ additional nursing staff through every means available.

2.    Use of Full Capacity Protocol

The INMO delegation then raised the continuing failure of a number of hospitals, despite a requirement to do so, to declare they are in Full Capacity Protocol (FCP) and that they have started “de-escalation” measures.

The INMO provided examples of a number of hospitals which, on a recurring basis, were confirming they had additional beds/trolleys on wards as well as admitted patients in the ED.

The management response was to accept that failure to notify was a breach, of the Escalation Policy, within the Agreement.  This also confirmed that all hospital managements would be reminded they must advise the Joint Chairs (including myself), through the SDU, that they are in full capacity and what measures they are taking, i.e. cancelling elective procedures/extra ward rounds, to alleviate the situation.

3.    Weekly Hospital / Group Meetings

The INMO also highlighted the failure, of some managements, to adhere to the requirement, within the agreement, to meet, at hospital/group level, on a weekly basis to monitor implementation and, specifically, to deal with any frontline difficulties.

We highlighted a number of locations where senior management, or Clinical Directors, were not regularly attending meetings and demanded that this must be addressed and the agreements’ requirements met, in full, by management.

In response the management team confirmed that all senior hospital managements, and Clinical Directors, together with senior group management, would be reminded of their obligations, under the agreement.  It was accepted that the weekly meetings should continue unless, by agreement, they are adjusted i.e. Group level meetings to take place every two weeks.

4.    ED Staffing
In relation to this matter which remains critical, the following was noted:

  • the HSE will commence, as previously agreed,  a dedicated recruitment campaign, beginning with a national advertisement, to seek to fill all vacant Staff Nurse posts in Emergency Departments across the country.  The full provisions of the terms of the ED agreement will be afforded to new recruits to the ED;
  • the issue of having a separate recruitment campaign, to provide a permanent cadre of nursing staff to look after admitted patients, within EDs, will be prioritised.

The INMO will raise this at a meeting with the Minister for Health in the next week/10 days:

  • it will be recalled that this is a specific recommendation of the ED Expert Group which issued in September;
  • the management side confirmed that the eight additional ANP posts, also identified by the ED Expert Group, are currently being processed, for permanency and the work is underway to agree how to fill the 70 additional ANP posts stipulated by this Expert Group; and
  • the establishment of the Taskforce on ED Nurse Staffing, as also recommended by the Expert Group, is underway and this group should be established within the next month and issue an interim report within six months.


At this review the INMO delegation repeatedly highlighted that the level of overcrowding, despite all initiatives, remains intolerable, unsafe for patients, and can only be addressed by further radical measures which must include a significant volume of additional nursing staff.

The WRC noted all the points raised and that the HSE was to revert, directly to the INMO, on a number of issues.  It also confirmed that it would convene a further meeting, to review the implementation of the agreement, at 2.30 p.m. on Monday, 12th December 2016.

In the interim members are again requested to remain absolutely committed to the full implementation of the agreement and, specifically, to participate in all local meetings, with management, to highlight failures, immediately, when they take place.

Please contact your local Industrial Relations Officer (IRO) if you have any queries/ concerns on this priority issue.

Thank you for your attention to this note.

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.
Site Map
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