ED Update: Report From Sixth Review Of ED Agreement By The Workplace Relations Commission
Tuesday, 25th October 2016
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:
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 INMO will raise this at a meeting with the Minister for Health in the next week/10 days:
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.