HSE moves forward with more evening and weekend healthcare after landmark deal with unions
Plans to increase the healthcare provided to patients in the evenings and weekends will be sent to senior health managers on Monday, following a landmark agreement between the
Health Service Executive
and unions.
Under the new system, senior consultants and other staff including social workers, therapists and administrative staff, will be rostered to work five over seven days.
The number of staff working evenings will also increase, as the health service seeks to move away from the typical Monday to Friday, 9-to-5 working week.
Discharging of patients is expected to improve, along with more clinics, surgeries and diagnostic testing carried out over a longer week.
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The agreement is a significant step to tackle chronic issues in the health service, such as the number of patients on trolleys and waiting lists.
Senior health officials have consistently signalled weekend and evening work is vital to 'maximising physical capacity' of the health service, and to meet the growing demands in the sector.
A memo circulated to staff said the way in which services will be expanded in each hospital will depend on local needs, and may involve a stepped increase, moving first to working five over six days.
However, the memo identifies key priorities, which include provision of care over seven days, greater access to diagnostics services and equipment and the availability of more senior staff in the evenings and at weekends.
The standard opening hours of injury clinics and monitoring of consultant availability on Sundays are also highlighted as priorities in the memo.
The majority of staff affected by the changes are those working across a wide range of administrative, diagnostic and other support roles, and are members of Fórsa and Siptu.
According to the memo, staff hired after December 16th 2008 – a large proportion of the total – would be obliged to co-operate with the changes. However, the intention is that volunteers will be sought.
The document suggests six- or seven-day rostering along with evening working may suit some individuals looking to be free for family obligations or other reasons during what would traditionally have been their working hours.
The latest agreement comes two years after the introduction of the new public-only consultant contract, which sought to increase the number of senior decision makers on-site at evenings and weekends.
The introduction of the contract faced significant backlash from doctors' unions at the time, but the majority of consultants have since signed up.
In light of the new changes, members of the country's two consultants' representative organisations will also asked to work more hours, though their existing contracts will not be altered.
The process will be reviewed in October to assess the outcomes and effectiveness of the measures.
Unions have previously raised concerns about staffing levels if hours of operation are extended, arguing that existing shortages in many areas will be exacerbated if the same number of workers are rostered over significantly more hours. They also point to the need for additional infrastructure, including beds.
Practical concerns have also been raised about how two staff might be rostered to cover one role across a 12-hour operational period in particular situations.
The memo being distributed today, however, says any changes should be dependent on the maintenance of patient and staff safety.
In a statement, HSE chief executive, Bernard Gloster welcomed the agreement.
'We want to thank the unions for their engagement. This has been a priority of the Minister Jennifer Carroll McNeill and the HSE, and we now look forward to implementing it, focusing on the two priorities of patient flow (ED) and the commencement of outpatient clinics outside routine hours.'
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