Health staff have been asked by their bosses to “seriously consider” volunteering for weekend and other additional work over the next two weeks in order to alleviate bank holiday overcrowding hospitals.
The request has been made in a letter from HSE senior management warning of a “substantial impact” on hospitals “with onward implications for the rest of the healthcare system” if wider services are not provided over the coming weekends.
“Hospital group chief executives and chief officers have been authorised to engage directly with a number of grades of staff with a view to providing services over the coming bank holiday weekend to reduce the risk patients experience in emergency departments through delays after triage or in waiting for admission,” according to the letter, seen by The Irish Times.
“As you know, the solutions to these delays are not confined to emergency departments but involve a system-wide response to maximise patient flow within hospitals as well as between hospitals and the community,” says HSE chief executive Bernard Gloster, chief clinical officer Dr Colm Henry and chief operations officer Damien McCallion.
“We would ask that if you are contacted directly, you would seriously consider volunteering to either change your current working pattern for the two-week period ahead to allow some aspect of weekend working or to work by way of additional arrangements which would of course be remunerated in accordance with the terms of your individual contracts.”
Thousands of clinical and support staff who normally work a five-day week are expected to be asked to work over the June bank holiday weekend to avoid a repeat of the “dreadful position” hospitals were in after this month’s bank holiday.
Speaking in Galway, Mr Gloster said hospital managements around the country would be starting to ask staff over the coming 24 hours to alter their work arrangements that weekend to allow service provision to be closer to weekday levels.
He was addressing delegates representing some 33,000 workers at the Fórsa trade union’s health division conference on Thursday,
The request, Mr Gloster said, would be to work on a voluntary basis with those making themselves available receiving either overtime payments or days in lieu in accordance with the terms of their contracts.
In the longer term, Mr Gloster said a move to seven-day rosters for a whole range of HSE staff outside of the ranks of doctors and nurses was essential if capacity issues were to be addressed and services improved. It would, he said, be a key issue in the forthcoming public sector pay talks.
“The reality is we have exceptionally talented, very good people working across the Irish health service but the majority of our working practices and processes by which people move through the system are Monday to Friday and at the weekends it’s essentially medical on-call care and nursing care in our hospitals and in our community services and GP out of hours.
“We need to put a whole range of services around them at weekends to keep people moving through the system. That won’t make it perfect, but it would certainly reduce some of the significant pressures that the public are experiencing.”
Mr Gloster said clinical staff not currently rostered to work weekends normally and the administrative staff required to allow them function at full capacity would all be asked to contribute.
It is believed occupational therapists, physiotherapists and radiographers would be among those affected.
Last January, after a new record of 931 patients waiting for admission to hospital was set, HSE staff were ask to work weekends to help relieve overcrowding. The voluntary initiative is credited with helping the health service quickly overcome the worst effects of the severe flu wave then circulating.
Since he become chief executive in March, Mr Gloster has stressed the need for more seven-day working in the health service. Speaking at the Oireachtas health committee this week, he acknowledged this will require longer-term changes to be negotiated as part of pay agreement but said he hoped staff would agree to see more weekend working on a voluntary basis in the short term.
In his address to delegates Mr Gloster acknowledged that for the moment “all I can say is ‘please’ ”, but he said formalising new arrangements would be a key priority for the HSE in this year’s public sector negotiations.
“In the next round of public sector pay talks, from my perspective as the head of the HSE, that distribution of service across the week is as important, if not more important, than anything to do ... with numbers.”
Asked if he had spoken to the Department of Public Expenditure and Reform (DPER) about the potential implications for the talks of attempting such significant changes to rosters, he said he had spoken to both his own department’s senior officials and to the Minister for Health, Stephen Donnelly, and that all were in agreement about the need for change.
“But to be fair to DPER, I think no department more than them would want to see the public services stretching their effectiveness and efficacy over seven days of the week from five days of the week. So I think they’d consider that a very good thing.”
Responding to the proposals, Ashley Connolly, Fórsa’s head of health and welfare, said there had already been a succession of requests this year to work additional or different hours and that the union had no issue with that as long as people had a choice. Beyond that, she said, the union would engage on any proposed reforms.
For the June bank holiday, there is no expectation in the HSE of large numbers of staff volunteering for weekend work but senior managers are hoping key staff responsible for discharging patients and community care will be available in order to ease the threat of overcrowding.
“In winter there was fear and alarm which is absent now. And also, it is recognised, people have holiday breaks to take,” a source told The Irish Times.
A spokesperson for the Irish Hospital Consultants Association, meanwhile said it welcome Mr Gloster’s “recognition that the significant capacity and resourcing challenges facing our hospitals must be immediately addressed and echo his comments that a whole-of-service approach is required to do this.”