Feedback received through this activity informs the following collective response on behalf of UNISON members affected by this proposal.

Transcription

1 Pennine Acute Harmonisation of Nursing and Midwifery Shift Patterns Proposal UNISON Consultation Response 5 th November ) UNISON Consultation Method Over 1,200 of the affected staff are UNISON members. Since the launch of the above proposal UNISON has had contact with as many members as possible through the following activity:- - Attendance at all staff briefings at every site 23 rd 25 th Sept (2014). - UNISON steward, officer, organiser visits to every affected ward. - Attendance at ward meetings by invitation. - Meetings with groups of members inside and outside of workplace discussions with affected / concerned members consultation survey responses on behalf of 348 members / staff - Comments / responded forwarded from members via . Feedback received through this activity informs the following collective response on behalf of UNISON members affected by this proposal. 2) UNISON Position UNISON does not object to the principle of standardisation of shift patterns. In particular UNISON recognises the requirement upon the Trust to enforce the working time directive and to reduce spend on agency staff. UNISON also recognises that the current proposal is a significant improvement on the original proposal of 3 years ago and does go some way to address some of UNISON s initial concerns. However, having consulted widely with UNISON members and considered the proposal at length it is difficult to envisage the implementation of a single universal shift pattern without a significant detrimental impact on a large number of staff and an additional detrimental (and potentially discriminatory) impact upon those with carer responsibilities and / or restrictions or conditions associated with health, disability, and / or age. It is UNISON s view that the current proposal would adversely impact staff morale and wellbeing to such an extent that staff absence and turnover would increase with a corresponding negative impact on Trust finances and patient care. For these reasons UNISON is unable to endorse or support the current proposal. 1

2 UNISON remains willing to work constructively with the Trust to develop and consult upon a more standardised approach to shift patterns. However the intention would be to reach agreement on a standard set of shift patterns for wards to select from, rather than one universal shift pattern. Other additional concerns would need to be addressed before an agreement could be reached. If the Trust is unwilling to extend the current process of consultation with a view to reaching agreement on alternative proposals then UNISON will have no choice but to oppose implementation and consult with our members on next steps and possible further action. UNISON s 10 points for further consultation are outlined under section 6 on pages 13/14. 3) UNISON Survey Results 85 Survey Responses were received. These were a mixture of individual and collective responses and represent the views of 348 members / staff. The overall view presented by the survey responses is consistent with the feedback received during ward visits, at staff meetings, and in comments forwarded by members via ) Support for Standardisation Of responses received:- 67% Don t support standardisation. 32% Don t object to standardisation in principle but have some concerns re this proposal. 1% Support the proposal and look forward to implementation (on the proviso that staff not be required to work nights or cover other wards demonstrating a misunderstanding of the proposal) 3.2) Impact on Patient Care 89% believe that the current proposal would have a negative impact upon patient care The most common reasons given were:- - Staff Morale, stress and anxiety due to lack of work / life balance and inability to accommodate carer responsibilities 2

3 - Staff fatigue from length of shifts / requirement to rotate between day and night in same week / requirement to work additional shift every 5-8 weeks / inability to take breaks. - Long breaks on nights results in fewer staff on wards or inability to take breaks - Handover during patient visiting times 1% believe that the proposal would have a positive impact upon patient care The two reasons given were:- - Longer handover - Continuity of care 10% either believe that the proposal would not impact upon patient care or did not respond to the question. 3.3) Work Life Balance 80% believe that the proposal would have a negative impact on work life balance. The most common reasons given were:- - Child care responsibilities. o 07.30hrs too early for schools / nursery drop. o 15.30hrs too late for collection. o 08.00hrs night shift end to late to return home and prepare children for schools / nursery drop. o Difficulties with rotating between days and night depending on carer arrangements - Adult care responsibilities. - Additional Shift every 5 8 weeks. - Requirement for day / night rotation. 1% believe that the proposal would have a positive impact on work life balance. The reason given was that staff would get home earlier and not be as tired 19% either believe that the proposal would not impact upon work life balance or did not respond to the question. 3.4) Availability to cover all shifts / hours of the proposals 3

4 24% indicated specific shifts and / or hours within the proposal that they could not work. Of those:- - 8% would need to start or leave a particular shift early - 16% would be unable to work long days - 37% would be unable to work days - 39% would be unable to work nights The majority of reasons given related to carer responsibilities although an inability to work long days was generally attributed to concerns / restrictions relating to health and / or age. Some of those who indicated an inability to work nights also cited concerns / restrictions relating to health and / or age. 4) Key Issues for UNISON Members 4.1) Flexible working 24% of survey respondents indicated an inability to work certain hours / shifts with many citing carer responsibilities or disability, health or age related conditions or restrictions. From discussions with staff and management UNISON is extremely concerned that large number of affected staff (and management) still fail to appreciate the proposals expectation that staff are available to rotate between day / night shifts. UNISON is confident that if credible dummy rosters were circulated, or when real rosters are implemented, the number of new flexible working requests will rise considerably. However there is insufficient clarity re how flexible working requests will be handled and to what degree they can be accommodated. The standard response of operational requirements is no comfort to those whose future employment at the Trust is dependent upon a degree of flexibility from the employer in regards to current proposals. UNISON remains concerned that a failure / inability to accommodate flexible working requests could in certain circumstances amount to discrimination. These concerns are outlined in further detail under sections 5.2 / ) Shift times As outlined in the survey responses and confirmed by hundreds more UNISON members through 1-1 conversations and meetings UNISON members are concerned that:- 4

5 hrs too early for schools / nursery drop hrs too late for collection hrs night shift end to late to return home and prepare children for schools / nursery drop. - Shift times not necessarily suitable for those who rely on public transport. Many staff have indicated to UNISON that unless these times are changed and / or more flexibility introduced they would need to consider their future with the Trust. Many staff point to the success of current arrangements in providing excellent patient care whilst accommodating the needs of staff and therefore retaining an experienced and motivated workforce. UNISON is concerned that an inability to provide shift times that accommodate outside commitments and responsibilities will have a significant detrimental impact on staff morale, health and wellbeing, sickness absence, retention and ultimately patient care 4.3) Requirement to rotate between shifts / days and nights This is a significant issue for very many staff who point to current arrangements of rostering for permanent nights and days and question the merit of rotation. Of survey responses received numbers who identify themselves as unable to work days are almost equal in numbers to those who identify themselves as unable to work nights, suggesting that permanent day / night arrangements could continue to function effectively within a more standardised approach. UNISON is extremely concerned by studies that establish the link between shift work involving circadian disruptions (eg day / night rotation) with a higher incidence of serious health conditions including:- Cancer Diabetes Cognitive Function Concerns regarding day / night rotation include the inability to manage carer responsibilities, work life balance, and fatigue, all of which would have a significant detrimental impact on staff morale, health and wellbeing, sickness absence, retention and ultimately patient care. 5

6 UNISON seeks a commitment from the Trust to accommodate permanent day and permanent night working where ever possible and for the Trust to keep a record of which staff would prefer permanent days or permanent nights and take all possible measures, including the movement of staff between wards where agreed and appropriate, to facilitate those preferences. Numbers of staff required to rotate against their preference should be monitored with a view to ongoing reductions. 4.4) Additional shifts The requirement for 37.5 hr full time staff to accrue unworked hours until an additional full shift can be rostered every 5-8 weeks is a significant source of anger, concern and anxiety. Members point to the impact on work life balance and significant additional costs in terms of transport and childcare. UNISON is additionally concerned having had sight of some pilot e-rosters where some staff were allocated shifts leaving them up to 12 hours under whilst others received shifts totalling 10 hours over their contractual 37.5 hour week. The Trust appears to rely on section 10.2 of Agenda for Change terms and conditions handbook which states that The standard hours may be worked over any reference period, e.g. 150 hours over four weeks... However this example is not incorporated into PA contracts of employment which state Your hours of work will be 37½ per week (exclusive of meal breaks)... Any authorized hours worked above 37½ in a given week will attract overtime rates It is UNISON s understanding that the employer does not have the right under current contracts of employment to roster staff for weekly work of less or more than their weekly contractual hours and UNISON will be taking further advice in this regards and advise our members accordingly. However, irrespective of whether the proposal is consistent with current contracts or not, the disruption to staff is likely to result in a significant detrimental impact on staff morale, health and wellbeing, sickness absence, retention and ultimately patient care. 4.5) Nights Survey responses and other discussions with night staff show that many staff chose to work nights to fit shifts around carer responsibilities. The night shift hours proposed are not consistent with child care responsibilities as they finish too late to accommodate the school / nursery run. Many current night workers have indicated that they would find it difficult and stressful to juggle home and work commitments 6

7 under these circumstances and may be forced to leave PA if permanent night shifts at current hours are not maintained. Many members have reported inadequate security particularly around car parking at nights. This leaves staff feeling vulnerable and many have indicated that they are unwilling to work nights for this reason. There is a significant degree of concern and anger over the proposal for 2 x 45 minute unpaid breaks at night. Concern because on a two staff ward patients will be left for a total of 3.00hrs with just one member of staff colleague. Anger because staff suspect that the Trust does not anticipate staff taking their break entitlement and that this element of the proposal is constructed to increase unpaid work and ensure a 30 minute handover at the expense of night staff. Many staff point to the iniquity between 1hr 30mins unpaid within a 12 hour night shift as opposed to 1hr unpaid within a 13 hour long day. Whilst the Trust has previously cited research to support this approach, no such research has been provided or referenced. UNISON therefore proposes that one of the 45 minute breaks is paid to increase a night shift to hours paid. 4.6) Long day In addition to anger and concerns for long day staff to work an additional shift every 5-8 weeks, many staff who currently choose not to work long days are very concerned by the proposed requirement for 50% day shifts to be long days. For some staff these hours are inconsistent with carer responsibilities. Others have health or age related restrictions or conditions and some report that a 12 hour shift would leave them dangerously fatigued and are concerned at the potential impact on patient care. UNISON is seeking assurances that staff will not be required to work long day shifts against their preference or medical advice. Many members have also questioned the fairness of the e-rostering system that apparently counts a request to change a long shift as 2 requests as opposed to 1 for other shifts. Members also highlight the difficulties in organising cover for long shift absences. UNISON understands the need to enforce the working time directive requirement for a minimum 11 hour break between shifts which restricts the opportunity to further extend long day shifts. UNISON therefore proposes that one of the proposed 30 minute breaks should be paid on all long day shifts to increase a long day to 12.5 hours paid. 7

8 Without an increase to 12.5 hours paid long shift with the corresponding ability to work a 37.5 hr week it is nonsensical for the Trust to expect staff to be motivated to move to or maintain long shift working as preferred by the Trust. 4.7) Breaks European Working Time Directive compliance is a key theme that runs through the proposal. Those same regulations and subsequent case law establishes a very clear distinction between working time and a rest period. The two are mutually exclusive. A worker who therefore enforces their right to a rest period cannot be expected to work or be available for work during that rest period. UNISON does not believe that the proposal includes adequate provision to enable staff on many wards to take their breaks. This would be demonstrated if the Trust were able and willing to provide accurate dummy rostas for each site as requested by UNISON. UNISON again requests that accurate dummy rosters be provided to illustrate the failings of this proposal and provide for an extended and meaningful period of further consultation. UNISON believes that any move from current hours should be accompanied by a strict policy and process in regards to the rostering of breaks, rostered cover for those breaks, and the accrual of time owing where staff have been unable to take those breaks due to the failure of the Trust to provide adequate cover. UNISON also seeks an urgent improvement of staff facilities to ensure staff are able to take their entitled breaks in comfort away from the ward, including at nights. 4.8) Part time hours The Trust has offered no assurance to those who currently work part time hours on shorter shifts over a 5 day period. The Trust claims to be unaware of the extent of such working practices and therefore unaware of the potential discriminatory impact of such a proposal in terms of the disproportionate detrimental impact on female carers. Ignorance however is not a defence to the likely discriminatory impact of effectively withdrawing part time shift hours. UNISON proposes the limited introduction of a short shift of around 5.5 hours with one 30 minute unpaid break to provide a shift option for those who can only remain employed with part time hours spread over 5 days and to mitigate the potentially discriminatory impact of these proposals against part time workers / carers. 8

9 4.9) Flexible workforce - move between wards specialism s / spread thinly The Trust has indicated that a reduction in spend on agency and bank staff is one of the anticipated benefits of this proposal. Whilst it has not been confirmed by the Trust as such, UNISON assumes that the standard start and finish times means staff will be moved between wards to provide cover for staffing shortages. Staff fear the consequences of being moved into areas and specialisms for which they are untrained, inexperienced and unfamiliar. Staff also fear that in reducing bank and agency spend without a corresponding increase in the substantive workforce, staff will be spread more thinly making breaks even less likely with a negative impact on staff health and wellbeing, sickness absence, retention and patient care. UNISON seeks the development of safeguards and guidance to ensure that staff are not required to provide cover to other areas within sufficient training, skills and experience and guarantees that minimum safe staffing levels can be maintained in every area of the Trust when staff are moved to cover shortages. 4.10) Unsocial hours enhancement / pay protection Staff who currently work late / long days are angered by the proposal to end that shift at 2030hrs thereby in most cases losing 30 minutes per shift of enhanced pay for unsocial hours worked. Over a year this can amount to a loss of thousands of pounds for some members who will face significant financial hardship as a consequence. UNISON asks that the Trust provide detail of anticipated cost of pay protection resulting from this proposed change. 4.11) Handover Of all the survey responses received and the many hundreds of conversations with members and staff regarding these proposals, only 4 staff have indicated support for a standard 30 minute handover. Staff are clearly unconvinced as to the merit of such a rigid handover regime. However the proposed requirement for a 30 minute handover is one of the cornerstones of inflexibility within this proposal that results in shifts and hours that are so unsuited to so many. UNISON therefore proposes that this requirement be reviewed and wards be entitled to select from a range of potential handover arrangements to suit the circumstances of that ward and staffing arrangements. From this could flow a range of different shift times more suited to different wards and staff. 9

10 Many staff who have indicated a view that patient care will be adversely impacted by these proposals point to the hrs timing that coincides with the busiest period for ward staff to deal effectively and respectfully with the legitimate questions and concerns of visitors. The Handover period would also have a significant impact upon staff in terms of car parking arrangements. It is nonsensical for the Trust to continue to argue that there is sufficient staff car parking arrangements to cope with standard handover period when all staff from 3 shifts will be present on site for the same hour (30mins handover plus time to arrive and leave shift). Following further information requests from UNISON the Trust has confirmed staff car parking spaces of 1878 NMGH, 1416 ROH, 1050 FGH, 425 RI. The Trust has so far failed to confirm how many staff could be expected to be at each of those sites between the hours of and UNISON again requests that this information be provided and suggests that if the Trust is unable to calculate how many staff will be present at those times then the current proposal is not sufficiently planned or understood to enable implementation at this time. 5) Other Key UNISON Concerns In addition to the key concerns raised by UNISON members outlined above UNISON has a number of concerns that we would want to address via an extended period of consultation. These include:- 5.1) Deficiencies in consultation process. There has been little meaningful engagement from the employer during the consultation process. The staff briefings held 23 rd 25 th Sept and subsequent ward based staff meetings the Trust has failed to ensure an adequate level of understanding of the proposals amongst many affected staff or management. In particular many staff appear unaware of the expectation that they will be required to rotate between shifts including long days and night shifts or that unused contracted hours will accrue until an additional full shift can be rostered. UNISON brought these concerns to the attention of the Trust on 23 rd Oct and requested that the consultation period be extended to allow for a further round of management / staff briefings to ensure an adequate level of understanding of the proposals. To date UNISON has not received a response to that concern and no such meetings have been scheduled. Following UNISON s request of 29 th September for Dummy rosters for all wards to assist staff to understand the proposals, 4 dummy rosters were eventually received by UNISON on 22 nd October. Those Dummy Rosta s were not consistent with the 10

11 proposal for long days to constitute 50% of day shifts, did not include additional accrued shifts as a consequence of hours deficits, and did not include any illustration of flexible working requests. The dummy rosta s provided therefore gave an inaccurate and misleading illustration of the proposals and UNISON requests that accurate dummy rosters now be provided along with an extension to the consultation period to enable unions and staff to consider and respond to those rosters. During staff briefings staff were assured by management that all new starters are now employed on a long day contract. This offered some reassurance to staff that new staff would all work long days thereby reducing the likelihood / expectation that current staff would be expected to work long days against their preference. Following further information requests from UNISON the Trust has confirmed that only 15 staff are currently employed on a long day contract and around 100 expected by January Furthermore from the information provided by the Trust it appears that new staff are not actually employed on a different contract from current staff, but simply informed in their letter of offer of a general expectation that long days be worked. A letter of offer does not in itself constitute a contractually binding agreement and if the contracts under which new staff are employed are the same as existing contracts then a false and misleading impression has been given to staff during this consultation process and this should be clarified to staff by the employer ASAP and in good time prior to the close of consultation to enable staff to respond. 5.2) General Equality Duty / Failure to provide a robust Equality Impact Assessment. As a Public Body Pennine Acute NHS Trust has a General Equality Duty as outlined in the Equality Act This duty requires the Trust to have due regard to the need to eliminate discrimination, promote equality of opportunity, remove or minimise disadvantage, and take steps to meet the needs of people with protected characteristics. Protected characteristics are defined by the Act as age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation. Proposals to alter the working pattern of a workforce that is over 93% female threatens to have a disproportionate detrimental impact upon carers which could constitute indirect sex discrimination. Furthermore the requirement to rotate between shifts and work 13 hour days and 12 hour nights could have a disproportionate detrimental impact upon older and / or disabled staff which could also constitute indirect discrimination on the grounds of age and / or disability. The purpose of a robust Equality Impact Assessment is to provide the necessary information to enable an assessment as to whether a proposed change would disadvantage a particular group or groups of staff. The Trust s Service Equality Impact Assessment dated Sept 2014 fell short of providing sufficient information. 11

12 Following an additional information request from UNISON, the Trust confirmed on 22 nd October that the information contained in the September Equality Impact Assessment was based upon the entire nursing and midwifery workforce of 3,984 and not the 2,378 staff affected by these proposals. The Trust also confirmed that they are unaware of the extent of current flexible working agreements or arrangements and that they were unable or unwilling to provide details of current part time working contracts / hours. The Trust did confirm that aside from flexible working arrangements / agreements, 913 staff currently work on wards with an early shift finish time of 15.15hrs or earlier. Moving these staff to finish times of 15.30hrs would have a significant detrimental impact on carers for whom 15.30hrs is too late to collect children from nursery / school. Similarly moving staff to an earlier shift start time 07.30hrs would have a significant detrimental impact upon carers for whom anytime before 0730hrs is too early to drop children off at nursery, school, childcares etc. Also, moving night shift staff to a later finish time of 0800hrs would have a detrimental impact upon carers for whom 0800hrs is too late to return home in time to care for children and drop them at school or nursery before / for 09.00hrs. Those who currently work part time hours to suit carer responsibilities could also be further disadvantaged by these proposals which do not include any shorter shifts to accommodate current part time workers. Carers would also be disadvantaged by a shift pattern that resulted in a requirement to work an additional shift every 5-8 weeks as this could incur additional child care costs. A requirement for staff who do not currently rotate between shifts to now rotate could also have a significant impact on those with carer responsibilities. It is clear that the proposals are likely to have a significant disproportionate detrimental impact upon certain groups of staff including those with the protected characteristics of sex, age, and disability. However, the equality impact information provided has been insufficient to enable a full assessment of the disadvantage that will be caused. UNISON therefore believes that the Trust has failed to meet their obligations in regards to the General Equality Duty as outlined in the Equality Act 2010 and again asked that the consultation period be extended to enable time for the Trust to provide the required information and consider alternative proposals to eliminate or reduce the potential impact / disadvantage for certain groups of staff 5.3) Flexible Working / Discrimination UNISON remains concerned by the Trust s stated intention to review flexible working patterns with staff. Particularly as management informed staff at the September briefings that the current consultation period would extinguish all current flexible working agreements. 12

13 UNISON is also concerned by the Trust s claim to be unaware of the extent of current flexible working agreements / arrangement and questions how the Trust can fully assess the potential impact of the proposals without a full and detailed understanding of current flexible working agreements / arrangements. Where a formal agreement has been reached with a member of staff through the Trust s flexible working policy (EDH050) that agreement is permanent unless specifically agreed otherwise. Page 6 of the policy states that 6.3 Any changes made to the agreed arrangements should be subject to normal consultation between the manager and employee. This position is further reinforced for those staff who s flexible working request and agreements would also qualify under the Work and Families Act 2006 / Flexible Working Regulations 2006 (ie 26 weeks notice and carer or considering becoming a carer). Where such an individual contractual agreement exists it cannot be lawfully unilaterally withdrawn by the employer as part of a collective consultation process. Such an act would constitute breach of contract and potential indirect discrimination on the grounds of sex (if carer for a child) or associative disability / age discrimination (if carer for someone who is disabled or elderly). UNISON has made a number of representations to the Trust on this issue. The Trust s statement that there will not be a unilaterally withdrawal of current flexible working agreements is not consistent with management s insistence that staff submit new requests for flexible working agreements even where an existing and contractually binding agreement is in place. You will be aware that UNISON has issued advice to members to assist them to protect any current contractual agreement. UNISON will vigorously defend the rights of any member who s contract is breached by the employer. UNISON requests a breakdown of how many flexible working requests have been submitted, timescales for their consideration, and the proportion of those requests that have been agreed in full, agreed with amendment, or rejected. If this information is not yet available please provide information on when it will be available and provided. If the Trust is unwilling to provide UNISON with this information the same request will be re-submitted under the Freedom of Information Act. 6) Alternative proposal 10 points for further consultation UNISON members reject standardisation and support the status quo. However UNISON understands the rights and restrictions of the Working Time Directive and in particular the requirement for an 11 hour break between shifts. It is clear however that ensuring an 11 hour break between shifts, a 30 minute handover, and shift start of 730am cannot suit every ward, service and staff member. UNISON maintains that the current proposal would adversely impact staff morale and wellbeing to such an extent that staff absence and turnover would increase with a corresponding negative impact on Trust finances and patient care. 13

14 UNISON therefore proposes that the current process of consultation be extended to enable further time to consider:- 6.1) The development of a set of 4 or 5 standard shifts from which wards can select. Allowing some wards to select an earlier start to shifts times would ensure an earlier finish for short day and Night shift to accommodate some patterns of carer responsibilities. Whereas a later start to shifts on other wards would ensure a later start for early and long days to accommodate other patterns of carer responsibilities. Wards should select best fit and the Trust facilitate movement of staff between wards by agreement where it enables staff to work their preferred shift pattern. 30 minute handover and certainty over start and finish times maintained but scope to accommodate flexible working requests would be greatly increased and car parking pressures reduced as handover times will be different on different wards. 6.2) A commitment to permanent day working and night working wherever possible and practical measures to ensure that numbers of staff required to rotate between night / day against their preference is monitored, kept to an absolute minimum, and reduced on an ongoing basis. 6.3) Practical measures to ensure staff can work a 37.5 hour week, including consideration of paid breaks if no alternative solution can be identified. 6.4) A review of flexible working requests submitted to date and assessment of flexibility required to mitigate potential staff disruption and discrimination resulting from a change to current practice. 6.5) Introduction of Breaks Policy to ensure that breaks are rostered, adequate cover provided and time owing recorded where no break could be taken due to Trust s failure to provide adequate cover. 6.6) Review of Staff break facilities including rest areas and catering provision for all shifts. 6.7) Introduction of shorter part time shift during normal schools hours to accommodate current part time workers with carer responsibilities. 6.8) Measures to ensure that staff not be required to work long days where it would have a detrimental impact upon their health and wellbeing. 6.9) Agreed safeguards and guidelines regarding movement of staff between wards (and sites). 6.10) Commitment to ensure that any savings are spent on increasing staffing levels. 14