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# roster tensions
Explainer: Why are HSE bosses calling for a ‘permanent’ seven-day roster for hospital staff?
The HSE has said it wants to avoid a “substantial impact” of overcrowding on hospitals.

IN RECENT DAYS, healthcare workers have been pleaded with by HSE bosses to volunteer to work weekends ahead of the June bank holiday. 

HSE chief exeuctive Bernard Gloster said this week that staff were being asked to volunteer for the weekend shift in return for overtime payments or days in lieu. 

Gloster has also outlined he is seeking to introduce a “permanent” new seven-day working roster for hospital staff. 

The HSE has said it wants to avoid a “substantial impact” of overcrowding on hospitals.

These requests have been met with varying reactions from those working in the healthcare sector, with representives saying some workers, such as consultants, already work on an on-call basis, seven-days a week. 

So, let’s take a quick look at what has been happening over the past week. 

Oireachtas Committee

Many healthcare staff, such as nurses, work on a roster covering a seven-day week already. However, some other hospital staff work on a Monday to Friday basis. 

The Business Post reported on Wednesday that Gloster told the Oireachtas Health Committee that he is to writing to all hospital staff to request they volunteer for a seven-day working roster to reduce overcrowding to reduce overcrowding in Emergency Departmnents for the June bank holiday weekend. 

It reported that the aim is to allow hospitals to discharge patients over the weekends at the same rate as they are during the regular working week. It reported that the absensce of sufficient senior decision makers, such as consultants, means that patient discharges can be delayed over the weekends, adding to overcrowding. 

“I’ll let you know after the June bank holiday weekend how it actually worked because the request is going out to them today. But that’s just testing it. My plan is to permanently change it,” he told the Committee. 

The Business Post reported that Gloster is planning to seek the introduction of the permanent seven-day working rosters for hospital staff in the new public sector pay talks which are expected to begin in the summer. 

Gloster told the Oireachtas committee that he did not want to “demonise” hospital consultants because they needed support staff.

“When I talk about seven over seven-day working, if a queue of consultants lined up to work next Saturday and Sunday, they’re very limited unless I can give them what they need around them to make their decisions,” he said.

NO REPRO FEE 008 HSE Sharing the Vision Sasko Lazarov / HSE CEO Bernard Gloster Sasko Lazarov / /

Gloster’s comments came after consultants said earlier this month that they already work rosters that cover the full seven-day week. 

In a statement on 8 May, Professor Matthew Sadlier, the Irish Medical Organisation’s chairperson of the Consultant Committee, said doctors, including consultants, are already providing seven-day services through on-call rosters to deal with urgent patient need. 

“With over 900 vacant or temporary filled consultant posts, we simply do not have enough consultants to provide routine services over five days, let alone seven days,” Saldier said. 

The IMO said the root issues affecting the Irish healthcare system lies in the fact that there are too few beds, too few doctors and too few healthcare professionals to deliver the care required by patients.

“Hospitals rely on multi-disciplinary teams in order to ensure the patient journey is as safe as possible. Any break in the chain has a ripple effect which disrupts the entire process, so it stands to reason that doctors need the right level of support at any times they are working,” Saldier said.

“It is not simply a matter of coming in on a Saturday and discharging patients; patients can only be discharged when there are safe and appropriate pathways for them to transfer to,” he added. 

Bank holiday work

Gloster has written to healthcare staff pleading with them to volunteer for weekend work ahead of the June bank holiday. 

“We appreciate this is a significant request, but evidence informs us that if we do not start to provide a wider range of services over the weekend periods, we will see substantial impact in our hospitals with onward implications for the rest of the healthcare system which extend beyond the bank holiday weekend period,” the letter said. 

704 patients were admitted to hospital without a bed on Tuesday, 2 May following the bank holiday weekend, according to the Irish Nurses and Midwives Organisatrion (INMO).

Speaking to delegates representing 33,000 workers at the Fórsa trade union’s health division conference in Galway yesterday, Gloster said: “For the moment all I can say is ‘please’.”

He said staff were being asked to volunteer for the weekend shift in return for overtime payments or days in lieu, reported. 

808File Photo Forsa Sam Boal / Sam Boal / /

The letter to staff, also signed by Chief Clinical Officer Dr Colm Henry and Chief Operations Officer Damien McCallion, said hospital bosses “have been authorised to engage directly with a number of grades of staff with a view of providing services ove the coming bank holiday weekend to reduce the risk patients experience in emergency departments through delays after triage or in waiting for admission”.

Going back to the longer-term plan for the permanent seven-day working week, reported that Gloster said a move to the full-week roster for a whole range of HSE staff outside the doctor and nurse ranks is essential if capacity issues were to be addressed and services improved. 

“The reality is we have exceptionally talented, very good people working across the Irish health service, but the majority of our working practices and processes, by which people move through the system, are Monday to Friday, and at the weekends it’s essentially medical on-call care and nursing care in our hospitals and in our community services and GP out-of-hours,” he told the conference yesterday.

“We need to put a whole range of services around them at weekends to keep people moving through the system.”

Similar to the comments made by Sadlier about consultants providing weekend on-call services, reported that trade union Siptu’s sector organiser John McCamley said radiographers provided a seven-day service in every location.

“There is a lack of understanding at the top of the HSE about what we do. Radiographers provide a comprehensive out-of-hours service and most of it is on-site, so there are no delays,” he said. 

‘Timely engagement’

Today, the head of Fórsa’s health and welfare division, Ashley Connolly, said the management at the HSE need to provide “timely engagement” in relation to members working on a voluntary basis and a possible seven-day roster. 

“We need to see the real detail if we are to have a sustainable plan. We need to see what the proposals entail,” Connolly told RTÉ’s Morning Ireland

She said the sooner management present them with detail they can allay their members’ fears. 

Connolly said Fórsa will not be found wanting in terms of engagement but “members have a genuine fear when you hear seven over seven”.

She told Morning Ireland that the level of detail required hasn’t been provided to trade unions about requests to work the June bank holiday weekend. 

Connolly said that whenever a call is made for members to provide additional services, services have “not been found wanting”.

“They have always been willing to do so on a voluntary basis,” she said. 

Connolly also claimed that members have not been provided with any firm proposals in terms of pay. She added the trade union is “available to have those discussions”. 

9189 Talks Leah Farrell / INMO general secretary Phil Ní Sheaghdha Leah Farrell / /

Elsewhere, responding to comments by the HSE in relation to seve-day rosters ahead of the bank holiday weekend, the INMO’s general secretary Phil Ní Sheaghdha said that the hospital system “is a 24/7 service and nursing and midwifery working patterns already reflect this – people get sick and need hospital care morning, noon and night no matter what day of the week it is”.

“It is clear from the INMO TrolleyWatch figures, that the number of patients being admitted without a bed are always worse post-bank holiday weekends as the bed numbers available over the weekend remain largely static,” Ní Sheaghdha said. 

“We must look seven-day rosters as a practical way to tackle this problem – all necessary dialogue with the health sector unions, including the INMO, should start immediately to ensure all rosters and remuneration are fair and observant of agreements for shift workers.”

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