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NHS Direct nurses fight plans to make them work more weekends

  • 21 Comments

Nurses working for NHS Direct have lodged a collective grievance after being told they will have to work more weekends in a bid to improve the organisation’s performance.

About 80, mostly band 6, nurses who work for the triage service on a part time basis are affected by the rota changes, Nursing Times understands.

They will require part time staff to work five weekends out of eight, the same number as full time staff. Currently the number of weekends worked by part time staff is worked out on a pro rata basis.

NHS Direct chief nurse Tricia Hamilton said the rota changes were needed to cope with an increase in demand at weekends.

She said: “We appreciate that this may not be a welcome change for some of our staff and we are doing everything we can to support them and answer any questions they may have.”

The service has recently been fined £1.1m and issued with a warning for persistently failing to meet all of the key performance indicators (KPIs) set out in its contract. At the end of March, it was failing to meet 17 of its 30 performance indicators, including time to clinical assessment for less urgent and non-urgent calls.

NHS Direct chief executive Nick Chapman told a recent board meeting that high demand at the weekends was a factor in failing to meet these indicators.

But Royal College of Nursing employment relations officer Gary Kirwan said the imposed rota changes were “damaging morale”.

He said: “Because NHS Direct are facing problems with meeting their KPIs… what they have proposed is that all part time staff will work the same weekend arrangements as full time staff.

“Many of these part time staff have got care arrangements where they would find it very difficult,” he told Nursing Times.

The dispute has gone to stage three of the grievance process, meaning members of the NHS Direct board will hold a hearing to listen to nurses concerns and recommendations.

Mr Kirwin added: “What we want to happen is instead of saying ‘we will do this’, they actually engage with staff.

  • 21 Comments

Readers' comments (21)

  • Adrian Bolt

    F***king-helski! Everyone else has to work weekends and weekends are when NHS (re) direct are going to be the most busy. Some people just don’t know when they are onto a good thing, band 6 pay for reading from a typed pro-forma, well if they don’t like it they can always get a job back in the real world.

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  • @Edwin
    The nurses know that weekends are an expected part of the working rota. It is the way in which this change has been imposed that has caused so much distress, and is a symptom of the way in which NHSD treats its staff. The reason most of the nurses are band 6 is because they *do not* read from a script, they are having use their experience and training to assess patients without being able to see them. I defy any nurse to take a random call from any area of nursing; adult, paediatric, mental health, midwifery and be able to assess the caller as well as they do. The decision support software is a way of recording the thinking and decision of the nurse, it does not do the thinking or make the decisions. It is a very, very hard job indeed. Relentless, call after call, every call recorded and scrutinised, a constant battle between a nurses' natural (and professional duty) to give each caller the time they need and the outcome that is best for them and the demands of a call centre environment with targets that are sometimes directly at odds with that. Getting time for accurate and contemporaneous documentation is a battle. You never know what happens next, there is no follow up, so precious little reward. There is no down time, no quiet time, it is constantly busy from the minute you log on till the end of your shift, never knowing whether the next call is going to be a routine bread and butter call or someone about to jump off a bridge. The majority of the shifts are antisocial, with some 'day' shifts ending at 2am.
    I left the service for a much lower paid post because of effect the stress and the hours were having on my health. In the end the band 6 was not worth that for me and I was lucky enough to get a job back in the 'real world'. I have huge respect for any nurse who survives longer than a year at NHSD - they deserve better than to be treated like this.
    However much you are paid for a job you deserve to be treated fairly, especially if you are caring for others.

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  • It is obvious that the busier times are going to be the unsocial hours and having chosen a nursing profession that negates working unsocial hours, the nurses must expect that the larger portion of their work will fall at night and weekends. You chose the job. If you dont want to work unsocial hours, find a job in a clinic

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  • After over a years service now I'm still here and still working unsociable hours and I will back what was said before in the anon comment, working at NHS Direct is very chalenging. You have to be constantly on the ball and using your critical thinking skills, with the constant worry of making a mistake or something going wrong. Working long shifts call after call, dealing with a range of subjects and some very difficult and emotional situations, it is very very stressful and with no face to face contact it takes a lot of skill to complete telephone triage. BUT I also agree, you don't go in to nursing as a career for the money or to get weekends off, you ought to know what you are getting yourself in to when you first start Uni :)

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  • In case people forgot .... Stress takes its toll on NHS Direct nurses
    30 March, 2011 | By David Williams

    Stress is by far the most common cause of long-term absence among staff at NHS Direct.


    Papers for the trust’s latest board meeting show that stress and anxiety accounted for 19 of the trust’s 85 recorded long-term sickness cases as of 28 February.

    The second most prevalent cause was musculo-skeletal conditions, with nine cases, and the third was surgery, with eight.

    However, the total of 85 was a reduction on January’s figure of 100, and the 122 cases recorded in December 2010.

    “The churn of long-term sickness cases remains high”, the board papers note.

    The documents add that 39 cases of long-term sickness absence were resolved during February. Of these, seven “resigned or were dismissed,” and 32 returned to work. However, 26 new cases were reported last month.

    A key performance indicator for the trust is to reduce the long-term sickness rate to under 50 by 31 March

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  • as a full-time member of staff - I have agreed to work as per contract - 5 shifts out of 8 weekends, every 4 weeks. The situation that has now arisen is that all staff irrespective of hours worked will now do the same. EG someone working 3/7 days per week, ie 12 shifts every 4 weeks; will now work 5 of those shifts on the week end. This does not take into consideration any other unsocial hours that the person works during the week ie after 2000hrs. so technically the person can do all unsocial hours not through choice nor flexibility.

    No one disputes the difference in jobs and the issues that arise from each role a nurse has to play in some ones life - but respecting that diffferent roles bring different types of stress and politics to the individual should be observed

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  • as a full-time member of staff - I have agreed to work as per contract - 5 shifts out of 8 weekends, every 4 weeks. The situation that has now arisen is that all staff irrespective of hours worked will now do the same. EG someone working 3/7 days per week, ie 12 shifts every 4 weeks; will now work 5 of those shifts on the week end. This does not take into consideration any other unsocial hours that the person works during the week ie after 2000hrs. so technically the person can do all unsocial hours not through choice nor flexibility.

    No one disputes the difference in jobs and the issues that arise from each role a nurse has to play in some ones life - but respecting that diffferent roles bring different types of stress and politics to the individual should be observed

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  • Adrian Bolt

    @Anonymous | 12-May-2011 1:33 am

    Fair enough but GP's don't work at Weekends so it seems logical that NHS Direct's busiest time will be at the weekend so that is when the bulk of the staff are needed. There are compensations to having time off during the week.

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  • Anonymous | 12-May-2011 1:33 am
    Well said.
    Edwin you're spouting hot air, again.

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  • Edwin - How disrespectful and rude of you to level foul language to people you do not know, and about someone you clearly do not understand! I am a nurse at NHS Direct, and I work here due to a disability that prevents me from 'working in the real world'as you put it. I work 30 hours per week all my shifts start after 4pm, I take one call after another, and I can tell you, the work is very stressful. You never know what type of call you are going to get, and sometimes I have to made life or death decisions, I do not earn as much as a doctor, and I am constantly scrutinised and always fearful of making the wrong decision on the spur of the moment in case someone listens to my call, who has the benefit of hindsite, and pulls your call to pieces.

    Only last year I was forced to sign a new contract [otherwise I would be terminating my contract] I have worked with my new contract. And, because wrong decisions were made, and too many people work office hours during the week [In other words whoever decided on the new rosters got it wrong] Now I, who remember does all my shifts when the service is busiest, are having to give up more of my home life time, because as a nurse at NHSD you are seemingly, not entitled to a private life! I do not object to working my fair share of weekends. What I do object to is working more than my fair share, and what is particularly annoying is because someone got it wrong. There was no discussion, they just changed our shifts, giving very little notice or consideration to those of us affected. I hope those responsible at NHSD are reading this. Because this is no way to treat staff. It is no wonder that there are high levels of sickness due to stress related illness!

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