Health service management to pursue greater staff flexibility

Health service management will ask staff to provide greater flexibility in working arrangements as part of proposed reforms linked to the new public service pay agreement.

Management also want staff to facilitate some services being made available over a full day. Where necessary they would also like to see redeployment arrangements – introduced during the Covid-19 pandemic – continue “as service requires”. This would be done in order to match demand for services across hospital sites and geographic locations.

Draft proposals, marked confidential, tabled by health service management would also involve staff co-operation with key elements of the Sláintecare reform programme including with projects aimed at shifting the delivery of care to community settings and the introduction of new approaches to chronic disease management and to the care of older people. The proposals say that these measures may require provision of services at other places of work on a regular or intermittent basis.

In parallel with the Government’s new agreement with State employees, which provides for a 1 per cent pay rise this year and next year and access to a potential further 1 per cent under new sectoral bargaining mechanisms, management across the public service were to draw up specific reform plans.

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The draft proposals drawn up by the Health Service Executive and Department of Health have been given to trade unions. But it is understood the unions have yet to respond formally.

The HSE said that the proposals are "for discussion and consultation with our staff who, working under enormous pressure, have shown great flexibility in their response to the pandemic. We hope to work with staff to build on some of the changes we have seen over the past year."

The document, drawn up by health service management, would also request staff support the implementation of new community healthcare networks.

The proposals would also involve full co-operation with the opening of new acute forensic psychiatric facility in north Dublin. This will replace the existing Central Mental Hospital – and with the rollout of new strategic plan for psychiatric services – will be in keeping with reform plans for the sector.

The proposals would also involve co-operation, with introduction of public- only contracts for hospital consultants as set out under the Sláintecare programme.

The draft management document also says it wants to see measures to “enable greater flexibility within working hours and working arrangements across the health service workforce to allow for greater productivity and efficient delivery of services”.

‘Flexible patterns’

The document calls for services to be delivered “in a manner that maximises efficiency, productivity and flexibility in use of resources including focus on 7/7 working”.

Management proposals also seek staff co-operation “with provision of diagnostic services over full duration of day as required, up to 24/7 as deemed necessary”.

The draft document says management want to see “maximisation of the concept of task sharing/transfer introduced in respect of doctors/nurses”.

It suggests that staff working flexible patterns would “ allow management to maximise resources in a way that delivers efficiency and ultimately better patient outcomes”.

It says that “obsolete practices” should be eliminated. The document also says that staff “will enable an increase in the capacity to manage the number of emergency cases”.

It also says “staff will enable the delivery of services at times that suit service users, reduction in waiting lists and enhanced patient flow”.

The document also says management wants to “accelerate digitisation of the health service for staff and patients to improve efficiency of healthcare delivery”. There would be a requirement for continued adherence in respect of all productivity measures associated with the implementation of the enhanced nurse/midwife contract, consistent with provisions of Sláintecare and similar measures would be required in respect of the mental health sector.