During the last week of March, a small group of Senior managers from HR, Ops, Clinical and EOC, met with us to look at addressing the top 3 stressors staff raised in our #PBTH survey: Late finishes, individual performance management (inc PDRs about performance rather than development), sickness management.
Staff who took part in our #PBTH survey told us these issues caused them high levels of stress, caused them to take time off sick, and made them consider leaving.
It has been agreed that crews will be able to swap over onscene, on Trust premises, and at acutes, when the new Operational Instruction is launched – to help reduce late finishes by handing over non time critical patients to another crew, if the call cycle will take them over their finish time. The crews sent to assist will be out of service (with the exception of R1 calls), to ensure they are not diverted. This was agreed, and will go to the Board for noting, although it will not start until the operational instruction is released, which will be after the Board meeting.
There are 3 proposals that we put forwards, that will go to the Board to consider:
1. ’Intelligent Xray’ – If the travel time back to base, once clear from an incident, would result in a late finish then the crew will be able to book out of service as ‘intelligent x-ray.’ This will result in them only being available for a confirmed Red 1 if they are the nearest resource.
2. During the last 30 minutes of a shift crews will respond to R1 calls and Hot 1 back ups only, as they can not complete a call within 30 minutes. The job cycle means any other job given will cause them a significant late finish.
3. During the last 60 minutes of a shift crews will only respond to R1, R2, and Hot 1.
Rob Ashford and myself will present the operational instruction we produced to the Board on 30th April. We have asked if there is scope for an extraordinary meeting prior to that, given this is a long term issue, and staff have very clearly evidenced the need for this to be addressed.
There was joint support that this issue needs to be addressed, and the benefits are clear in helping to alleviate pressure on staff, reduce sickness, help retention and make us more sustainable as an employer of choice.
Accepting and implementing the above will clearly have a significant impact on reducing late finishes, which is the top reason staff gave as making them consider leaving, and causing them high levels of stress, and taking time off sick.
‘Green in 15’ has been withdrawn with immediate effect – and will be replaced in time with an average for each acute that only the lower 5% of staff will be approached over. The clear guidance around this is being developed in April/May with UNISON, as it’s important staff are supported and any reasons for delays at hospital are understood.
30 second mobilisation has been withdrawn with immediate effect – there are so many variables and it’s clear this is simply not achievable in many areas.
OOS codes will be put in for crews to use for completion of:
- Clinical debrief
PDRs – It was agreed the current PDRs are not fit for purpose, and they have been immediately withdrawn. Work is being undertaken to rewrite the PDRs to be more supportive and incorporate genuine development and not measure staff against arbitrary targets that are not achievable. This work will be completed in April/May.
A more supportive policy has been agreed, which has some changes including:
Rapid access to treatment
Not counting sickness that occurs over halfway through a shift
The new disability policy has been referenced
We are also continuing to work on areas of concern including:
Discounting sickness for maternity,
Discounting sickness following industrial injury and illness contracted at work
The need to be more supportive in the application of sickness management
Guidance and training for managers.
There is clear guidance being developed in April, to ensure the policy is being interpreted consistently.
Training for managers will also start in April/May, which UNISON will also be involved in developing as well as jointly taking part in the training sessions.
The training will incorporate the new disability policy which is already live. Targeted training will also be given to chairs of capability panels.
There is still some way to go to develop a more supportive sickness policy and procedure.
Other measures agreed:
As we run the 111 service in Norfolk, it was agreed we could explore a trial to look at managing the R2 calls within 111 by a clinician to ensure they require an Ambulance response.
Lone working policy trial
Dave Fountain, LD for B&H has agreed to trial the lone worker policy we put forwards at the January SPF, which is based on the WMAS lone worker policy, and is very supportive of staff. This policy gives staff the option to decline to work alone, if they do not normally do so. 11% of staff taking part in our #PBTH survey told us they were considering leaving because of this issue and enforced lone working.
Pre retirement/post retirement working
Guidance is being worked on to ensure staff know their rights and are supported to stay in the Trust pre retirement, or return to the Trust post retirement.
Terminal illness policy
This was written several years ago, and was initiated by Ann Langdon, although it was never included in the HR policies. The policy was updated during the week and will be relaunched very soon.
Other issues we are working on as the result of the evidence staff have given us from the #PBTH survey:
Annual leave, Meal break policy, JE training (EOC)
The implementation of agreements from the week of meetings will also be key to making sure the spirit of staff support is continued, and we put staff back at the Heart of our Ambulance Trust.
UNISON Branch Secretary
East of England Ambulance Branch 20106