Wednesday, 14th December 2016
This is an update to advise you that the sixth review, by the Workplace Relations Commission (WRC) of the ED Agreement, between the INMO/Department of Health/HSE, took place last Monday afternoon in the WRC Head Office in Dublin.
The meeting was attended by a number of local representatives, from Tullamore Mayo, Cavan, Waterford and some of the Dublin Emergency Departments (ED), together with officials of the organisation. The management side involved senior officials from both the HSE and the Department of Health.
The following is a brief summary of the meeting.
1. EMERGENCY DEPARTMENT STAFFING
Under this heading, and in the context of implementing the agreement from last February, the INMO raised a number of issues including;
1.1. Filling of all current Staff Nurse vacancies
It was noted that the HSE has commenced, via public advertisement, a national recruitment campaign, for staff nurse posts in all ED’s, two weeks ago.
In this context the latest figures from the HSE confirms that there were up to 140 staff nurse vacancies, out of a total workforce of 1,300 (approx.), with a number of these vacancies currently filled, in an inconsistent manner, through agency employment.
The HSE committed to progressing this recruitment campaign and to keep us advised of developments and timeline.
2. EMERGENCY DEPARTMENT EXPERT GROUP REPORT
2.1 Recruitment of permanent nursing staff dedicated to look after admitted patients in Emergency Departments.
The INMO raised this pivotal recommendation, from the ED Expert Group report last August, which called for the appointment of additional staff nurses, to be based in ED’s, with a specific, dedicated, brief/responsibility to look after admitted patients.
- The purpose of this recommendation is, obviously, to lift from ED nursing staff the twin role of caring for emergency department presentations and, providing inpatient ward services/supports.
The management side’s response, on this issue, was very disappointing other than acknowledging they accepted the recommendation in the report. However they were not in a position, at the meeting, to confirm a timeline, for implementation, the numbers, per hospital, of additional staff who would be employed and when these additional, permanent, staff would be in situ.
In the context of this discussion, and at the request of the Chair of the process from the WRC, the management side committed to provide further clarity, on this issue, by later today (Wednesday).
In relation to this issue the INMO delegation clearly stated that the failure to progress this issue is further evidence, if it were needed, of the need for special staffing/recruitment/retention initiatives to be brought forward immediately. We also indicated that, depending on the ballot result, which is to be known tomorrow, we would be highlighting the failure of management to progress this recommendation, which was made last August, as tangible evidence of the failure to respect and respond to the needs of nurses in the frontline.
2.2 Advance Nurse Practitioners - Emergency Departments
The Expert Group also recommended that, as an initial step, priority action should be taken leading to the appointment of a minimum of 148 ANP’s (6 per emergency department) in all departments across the country.
The Expert Group report noted that there were currently 78 ANP’s, within ED departments, but this figure should be increased, immediately, to assist the quality of patient care, patient flow and, in addition, recruitment/retention within emergency department nursing services.
Once again, on this issue, the management side were unable to supply the required clarity and this is also to be a subject of a further update by later today.
2.3 At this stage, in the meeting, the INMO raised the issue of the need, recommended by the Cavan Report, to have Registered Children’s Nurses present, on a 24/7 basis, in all emergency departments. The management side acknowledged that this was an agreed policy and that a further advertisement would be required, seeking to recruit these Children’s Nurses, and this would be progressed immediately.
3. NONCOMPLIANCE WITH ESCALATION POLICY
The INMO then raised the issue of noncompliance, by a number of hospitals, with the various steps in the HSE’s own Escalation Policy, which form part of the INMO/DOH/HSE ED Agreement. The INMO had specifically requested the involvement of the Special Delivery Unit (SDU) In respect of meeting the Hospitals in question and if they are unavailable, then an agreed alternative mechanism to ensure compliance must be agreed between the parties to the agreement i.e. INMO and HSE.
In response to this the management side confirmed that this issue was acknowledged and they would revert to the INMO by the end of this week in respect of the specific locations cited by the organisation.
4. SECURITY REPORTS
The management side confirmed, following a query from the INMO, that all security audits, of ED’s were now complete.
It was agreed that the management side would make them available to INMO representatives, at the local hospital meetings taking place under the ED Agreement, where this had not already taken place.
In that context all members are advised to request copies, of the security report, and to immediately review same and demand implementation of all recommendations in the interests of staff health and safety.
5. ADVANCED SKILLS FRAMEWORK
It was confirmed that discussions, on this matter, were at an advanced stage between the INMO and the management side.
In that context the INMO confirmed that the next step would be for management to indicate what payment mechanism it was proposing in line with the commitments on this issue as part of the national ED agreement.
Members should be advised that the INMO made it clear that INMO members will not undertake any additional enhanced roles in ED departments without an agreement involving additional payment as set out in the ED agreement.
(Please Note - This is separate to the agreement in respect of the four tasks: IV Cannulation, Out of Hours Emergency Phlebotomy, First dose intravenous anti-biotics and Nurse facilitated discharge, which is agreed and incorporates restoration of premium pay 6-8 pm)
It was agreed that a further, specific, meeting, on this issue, would take place in mid-January.
6. NEXT WRC REVIEW
In view of the continuing very serious workplace issues which exist, within all ED’s, it was agreed, in addition to ongoing contact, that the WRC would undertake its next review, of the ED Agreement, at 10.30am on Friday 20th January 2017.
7. LOCAL HOSPITALS/GROUP MEETINGS
All members are again reminded that this must, in conjunction with their relevant IRO, continue to engage, on a weekly/fortnightly basis, with local hospital/group management with regard to the ongoing implementation of the ED Agreement.
Notwithstanding the ongoing pressure we must continue to utilise the potential, of this agreement. This obliges management to meet with us, on a regular basis, and confirm what steps they are taking to address the staffing and health and safety issues that continue to confront nurses, in ED’s, at this time.
Thank you for your attention to this note.