Long day and night shifts are to be made compulsory for ward-based nurses at a Colchester General Hospital in a move that bosses have said will help to fill staffing gaps on rotas and save money.
The hospital wants to transfer ward-based nurses, midwives, assistant practitioners and healthcare assistants onto 12-hour shifts patterns, beginning at 7am or 8am in the day, and at 7.30pm at night.
“Any cost reduction will be realised via the removal of vacant posts from the establishment”
Chief nurse letter to Colchester Hospital University NHS Trust staff
For full-time employees this would mean three shifts per week for three weeks, plus one week of four shifts.
Colchester Hospital University NHS Foundation Trust, which runs the hospital, reviewed its rosters and found that “a huge number” of different shift patterns were in place, making it difficult to find cover for short-staffed wards.
This meant the trust was often forced to use more expensive bank and agency staff, according to consultation documents seen by Nursing Times.
In addition, nurses already on longer shifts were sometimes having to work beyond their planned hours to make up for the staffing shortfalls – which the trust found had resulted in some working up to 14.5 hours.
“Staff should be able to choose whether to do longer shifts or not, rather than being required to do them”
The move to standardised, longer shifts – which is expected to affect inpatient wards, accident and emergency, and assessment units – will “help us to resolve these issues, along with improving our continuity of care for patients,” said director of nursing Catherine Morgan in a letter sent to staff in January.
No redundancies are planned as part of the changes and “any cost reduction will be realised via the removal of vacant posts from the establishment,” said the documents.
However, in its assessment of the impact of the changes, the trust noted that older staff with health needs or those with childcare considerations were likely to be adversely affected by the changes.
Staff with flexible working arrangements in place are having to re-apply to the trust for permission to be excluded from the move to 12-hour shifts.
“There is also very limited evidence to support that 12-hour shift patterns are more cost effective than eight-hour patterns”
Following a consultation on the plans in February, the trust acknowledged there were also concerns about drug rounds taking place at the end of long night shifts. As a result, it now plans to include the drugs round at the start of morning shifts, the majority of which will begin at 7am.
The proposals, which are now being developed to include some further changes, are due to be brought in over the coming months.
But a union said that, while it acknowledged and supported the majority of staff who wanted to move to 12-hour shifts, it objected to others being forced into the new working pattern.
“Our argument is that staff should be able to choose whether to do longer shifts or not, rather than being required to do them,” Unison’s staff representative Isaac Ferneyhough told Nursing Times.
“Research has shown that working 12-hour shift patterns significantly reduces the quality of care to patients, he said.
“There is also very limited evidence to support that 12-hour shift patterns are more cost effective than eight-hour patterns and careful analysis needs to be made regarding patient outcomes, quality of service and longevity of quality care with an ageing workforce,” he added.
“We have been very clear that we are not introducing a trust-wide compulsory move to 12-hour shifts”
He warned that staff may find it difficult to take their full break times during longer hours and that the changes would only be suitable for fitter employees.
“Effectively the trust will be designing for a smaller pool of staff. We are concerned that this will mean that those less able will be displaced. This may lead to a shortage of skilled staff due to early retirement, for example,” he said.
In a statement provided to Nursing Times, the trust’s director of nursing said it had been consulting with staff over the changes and was working with those who did not want to switch to longer shifts.
“We have been consulting with our staff over the past few months on a proposal to standardise shift start and finishing times and the introduction of 12-hour shifts.
“We have been very clear to staff and trade unions that we are not introducing a trust-wide compulsory move to 12-hour shifts,” said chief nurse Catherine Morgan.
She added that the trust acknowledged 12-hour shifts were popular with some staff but not practical for others.