Agenda for Change
Milburn MeetingA recent meeting with Alan Milburn confirmed his determination to see Agenda for Change implemented as soon as possible. He still hopes early implementers starting by the year end and full implementation by spring 2004. If early implementers do not have the full support of the staff side they will not be accepted. Early implementation depends on the speed of negotiations and on the speed with which the unions can make a decision on acceptance or rejection. He also made clear that they have no plan B. Rejection of what the unions agree among themselves and with the DoH would leave us all in the position where all the interim "agreements" such as PRB status for all "Health professional" staff would fall. The implications for the future of the NHS would also be substantial. Whether we should have got ourselves in this position is another matter but that is where we are.
A recent meeting with Alan Milburn confirmed his determination to see Agenda for Change implemented as soon as possible. He still hopes early implementers starting by the year end and full implementation by spring 2004. If early implementers do not have the full support of the staff side they will not be accepted. Early implementation depends on the speed of negotiations and on the speed with which the unions can make a decision on acceptance or rejection. He also made clear that they have no plan B. Rejection of what the unions agree among themselves and with the DoH would leave us all in the position where all the interim "agreements" such as PRB status for all "Health professional" staff would fall. The implications for the future of the NHS would also be substantial. Whether we should have got ourselves in this position is another matter but that is where we are.
Central Negotiating GroupA special meeting of the Central Negotiating Group for Agenda for Change, recently took place to look at the vexed question of out of hours working. It sought to cover formal shift working, on Call and the various hybrids schemes. The position to date was a payment to be made based on agreed flexibility, there was some prospect of this being seen as indirectly discriminatory. On the other hand existing arrangements are based largely on payment for unsociability. MSF proposed an arrangement which, after discussion, seemed to be a consensual view that we should look at a system based upon both a flexibility payment and payment for unsociability. This will require a lot of working through to identify the consequences for all staff groups but could remove a major blocking point for many Amicus-MSF members. This scheme would be separate from overtime arrangements and just address hours within the standard working week.
A special meeting of the Central Negotiating Group for Agenda for Change, recently took place to look at the vexed question of out of hours working. It sought to cover formal shift working, on Call and the various hybrids schemes.
The position to date was a payment to be made based on agreed flexibility, there was some prospect of this being seen as indirectly discriminatory. On the other hand existing arrangements are based largely on payment for unsociability.
MSF proposed an arrangement which, after discussion, seemed to be a consensual view that we should look at a system based upon both a flexibility payment and payment for unsociability. This will require a lot of working through to identify the consequences for all staff groups but could remove a major blocking point for many Amicus-MSF members. This scheme would be separate from overtime arrangements and just address hours within the standard working week.
Working Time Directive
Members will be aware that the Working Time Directive is being extended to all doctors in training. The 48 hour limit from 2009 with reductions between now and then. In addition, by 2004, the 11 consecutive hours break must be operated. This would require an additional 40% staffing of consultants and others if no other action were taken. It would also mean that 24 hour cover was not possible in many smaller hospitals nor specialist 24 hour cover in many large hospitals. There are broadly two solutions. The first is to enhance the skills of many non consultant/doctor roles to replace them and the second is reconfiguration to focus work requiring regular 24 hour cover in larger units. It is very likely that both will be required and the former is already being developed and explored providing many opportunities for enhanced roles for Amicus-MSF members. In the long run reconfiguration will have to come as we are already seeing in Pathology. In addition to the WTD amendment, the MSF complaint to the European Commission has been upheld and the DTI will have to tighten up the existing Working Time Regulations. The main effect will be to require the employer to see that all breaks are taken and that compensatory rest is taken close to when it is generated. This will make virtually all existing on call systems illegal in some cases because an 11 hour break is not available or because compensatory time has to be taken before the next shift thus disrupting regular work periods. Shift arrangements with proper breaks before and after a night shift will be the only realistic option. Long overtime hours still worked by some staff will also have to cease. We should be looking at a working week not significantly longer than the contractual week. The best guide at present is about 38.5 hours to provide a 24 hour 7 day service. Providing 24/7 cover should remain voluntary but if there are insufficient volunteers to enable a system to work Trusts may have no option but to make it compulsory. This could then clash with Improving Working Life but employers would have little alternative. So we are anxious to maintain a system in which all those who can participate do so.
Members will be aware that the Working Time Directive is being extended to all doctors in training. The 48 hour limit from 2009 with reductions between now and then. In addition, by 2004, the 11 consecutive hours break must be operated. This would require an additional 40% staffing of consultants and others if no other action were taken. It would also mean that 24 hour cover was not possible in many smaller hospitals nor specialist 24 hour cover in many large hospitals. There are broadly two solutions. The first is to enhance the skills of many non consultant/doctor roles to replace them and the second is reconfiguration to focus work requiring regular 24 hour cover in larger units. It is very likely that both will be required and the former is already being developed and explored providing many opportunities for enhanced roles for Amicus-MSF members. In the long run reconfiguration will have to come as we are already seeing in Pathology.
In addition to the WTD amendment, the MSF complaint to the European Commission has been upheld and the DTI will have to tighten up the existing Working Time Regulations. The main effect will be to require the employer to see that all breaks are taken and that compensatory rest is taken close to when it is generated. This will make virtually all existing on call systems illegal in some cases because an 11 hour break is not available or because compensatory time has to be taken before the next shift thus disrupting regular work periods. Shift arrangements with proper breaks before and after a night shift will be the only realistic option. Long overtime hours still worked by some staff will also have to cease. We should be looking at a working week not significantly longer than the contractual week. The best guide at present is about 38.5 hours to provide a 24 hour 7 day service.
Providing 24/7 cover should remain voluntary but if there are insufficient volunteers to enable a system to work Trusts may have no option but to make it compulsory. This could then clash with Improving Working Life but employers would have little alternative. So we are anxious to maintain a system in which all those who can participate do so.
Pay Review Body Site Visits
The Pay Review Body is visiting the following sites to gather evidence as part of this year's Report: Leicester University Hospitals NHS Trust 27th May Mental Health Services Salford NHS Trust 31st May Newcastle General Hospital 31st May Lanarkshire Acute Hospitals NHS Trust 7th June Southampton PCT 12th June City & Hackney PCT 17th June Lowestoft PCT 17th June Broadmoor Special Hospital 19th June Powys Healthcare NHS Trust 24th June Yorkshire Wolds & Coast PCT 1st July Gwent Healthcare NHS Trust 5th July Alder Hey, Liverpool 8th July St Mary's NHS Trust, Paddington 10th July North Staffordshire Healthcare NHS Trust 15th July Fife PCT 15th July Bath & North East Somerset PCT 19th July Please ensure that Amicus MSF participates where groups are covered by a PRB by contacting local Trust management or the Staff Side for details of any arrangements. Please raise the following issues: the erosion of clinical grading the iniquity of Discretionary Points the poor arrangements for staff working in community who use their cars the failure by the NHS in many areas to connect all clinicians to the web by the Government's target date of 1st April 2002.
The Pay Review Body is visiting the following sites to gather evidence as part of this year's Report:
Please ensure that Amicus MSF participates where groups are covered by a PRB by contacting local Trust management or the Staff Side for details of any arrangements. Please raise the following issues:
Dignity At Work Bill
Bullying has been identified as one of the major causes of stress in the NHS. If you or a colleague have suffered from bullying or harassment and believe that the resolution of the problem or the failure to deal with it properly by management have lessons for others, then please share your experience so the legislation can be better designed and supported:
Campaign Against Bullying at Work Working Environment Unit, Amicus, 40 Bermondsey Street, London SE1 3UD e-mail weu@amicus-m.org
Have you experienced bullying at work? Do you know something about it?
Trade unions and individuals have been campaigning for an end to workplace bullying. We demand dignity at work, and rights to redress in the tribunals for those who are bullied.
Wednesday 29th May 2002 Committee Room 4B House of Lords 4pm to 6pm Use the St Stephen's entrance and ask for the room booked in the name of Baroness Gibson and Amicus/Campaign against Bullying at Work
Needle Stick Injuries
Amicus MSF wishes to develop guidance in this area. Initially we want to determine the extent of the problem and what occupations such injuries affect. Whilst it is obvious that some occupations are vulnerable, please remember that a large percentage of injuries occur to individuals who did not initially use the needle. Please could you write and indicate whether your occupation is prone to such injuries, citing if possible any research in this area and indicating whether you would be willing to participate in an electronic discussion group to produce Amicus MSF guidelines and best practice. Please also forward any local policies that you may have.
Please reply to Colin Adkins at Colin.Adkins@amicus-m.org