NHS overtime

callow

I work in an outpatient area and we have system to cope with this. Our unit closes at 6.30pm, on the roster we have staff allocated to stay late if needed. If they have to stay it is usually only 30 minutes but on the very odd occasion it can be hours. The allocation on these is fairly distributed (we get one a week) and there are always more than one staff member.

If staff stay late then time is given back later that week or the next, we don't get overtime.

Perhaps your friend could suggest a similar system at their place of work.

FBaby

I think there is some serious over-reaction going on here. If she works for a radiography department and the hospital is not an inpatient unit, then there is no duty of care involved in case something happens any different to any other places. Patients come here for x-rays or whatever else and are not expected to collapse any more than if they were at their dentist.

Clearly, there is -OCCASIONALLY- a failing from the PTS provider to pick up patients on time. If indeed, this happens once a month, and most time we are talking about 1 hour at most, then I can't see how this can be considered a big issue. Anyone in a managerial role (and a band 7 is considered managerial) in any employment is liable to having to stay late to work occasionally. Normally, within the NHS, this will then be taken as time in lieu.

Could your friend be making a big deal for something that only happens occasionally (once a month is not often). Otherwise, if it is common practice, then whoever manages the PTS contract (probably a contract manager within the Primary Care Trust) will need to be informed as it is expected that part of the contract is that excessive lateness should be exceptional with a report to be provided to the contractors.

kazzah60

I think there is some serious over-reaction going on here. If she works for a radiography department and the hospital is not an inpatient unit, then there is no duty of care involved in case something happens any different to any other places. Patients come here for x-rays or whatever else and are not expected to collapse any more than if they were at their dentist.

you are assuming that it is purely a radiography department - it could in fact be a radiotherapy treatment centre where some VERY ill patients are sent for cancer treatments- some of which may be palliative - so patients could be taken ill at any point.

waves117

callow wrote: »

I work in an outpatient area and we have system to cope with this. Our unit closes at 6.30pm, on the roster we have staff allocated to stay late if needed. If they have to stay it is usually only 30 minutes but on the very odd occasion it can be hours. The allocation on these is fairly distributed (we get one a week) and there are always more than one staff member.

If staff stay late then time is given back later that week or the next, we don't get overtime.

Perhaps your friend could suggest a similar system at their place of work.

This is a very sensible approach especially if its written into a - dare I say it - a Risk assessment of what the procedure should be if a patient/client is not picked up by the time the department is closed.

The above system would also take care of the "lone worker" aspect with 2 people staying behind.

VfM4meplse

Dumyat wrote: »

In the NHS this is common practice. Employees are expected to fill in or make do at a minutes notice and for no pay.

So true - I've done this for years and accepted it, as have many colleagues. As a professional you do what it takes for the sake of patient care and leaving someone unattended would leave a patient open to harm, but I think your friend has the advantage of a non-management banding that should prevent exploitation.

The fact that it happens routinely suggests dreadful management - I bet if someone took the trouble to look at the whole pathway they would find dreadful inefficiencies! If your friend were to leave the patient in the care of the manager on call, it would soon precipitate action - not that I'm suggesting this to be the solution. I think the only way of dealing with this would be as a formal grievance as it's about patient safety at the end of the day. I also think it is very poor that your friend's colleagues are happy for her to be dumped on - childcare is often used an an excuse at lower bands to work to rule.

If the service manager is happy to continue to take advantage of her, I really think her best option is to move on and leave this problem behind her. If someone new was recruited into your friend's post, there is no way the JD would specify this additional role that your friend has created for herself - instead it would say something to the effect of "this JD is not exhaustive and the postholder is expected to undertake other duties commensurate to the role". The NHS Terms of Service has plenty of advice about working unsociable hours, and the remuneration involved.

Poppy9

VfM4meplse wrote: »

childcare is often used an an excuse at lower bands to work to rule.
.

But it's not an excuse. If you know your contracted hours and arrange childcare around this then it's a valid reason to leave because a private nursery or a school will not keep the children after hours because Mum or Dad have unexpectedly had to stay at work till late evening.

If you know you have to work late on X evenings then you can plan your childcare ahead but if it's ad hoc then it's tricky. Not everyone has family/friends available at short notice.

FBaby

kazzah60 wrote: »

I think there is some serious over-reaction going on here. If she works for a radiography department and the hospital is not an inpatient unit, then there is no duty of care involved in case something happens any different to any other places. Patients come here for x-rays or whatever else and are not expected to collapse any more than if they were at their dentist.

you are assuming that it is purely a radiography department - it could in fact be a radiotherapy treatment centre where some VERY ill patients are sent for cancer treatments- some of which may be palliative - so patients could be taken ill at any point.

Never heard of such centre opened only from 9 to 5 with only technicians present.

vixmix

Oh so many issues...

Custom & Practice - I think that the very fact she has a history of multiple complaints would put any argument for custom & practice out of the window, she has clearly not been accepting of this as part of her terms & conditions.

Agenda for Change is very specific as to hours of work being 37.5 hours per week - all hours beyond this to be paid at a rate of time and a half.

Supervision of a patient on a Prescription only medicine? Requires a familiarisation course and certification.

Incident reporting in our Trust are buried constantly, no surprise that there has been no outcome there.

It is possible that the Ambulance Trust operates PTS Services during office hours - there may not be any out of hours vehicles and any that exist may be committed to their own patient load. It may be that the patients are waiting to be moved by A&E Services who will put the patient at the very bottom of the priority as there are no time constraints to moving routine patients (beyond the one that the Ambulance Trust has already failed by not moving them before the department shut. IE it doesn't matter if the patient is picked up 5 mins late or 5 hours late - it all counts as late - how's that for patient care?)

I think the union has failed her totally. She should escalate her complaint to the full time official for opinion and also consider other unions and canvas for opinion there too - it is easy to change union if her current one is ineffective. I was Unison and changed to Unite for this very reason.

I imagine that her department manager is thwarting any efforts to change as this would require having to impact the budget to get a solution - not to mention the fact that a solution may indeed by very difficult to achieve. Management won't even pay her the overtime she is entitled to!

She needs to raise this an official grievance under the Hospital/Trust grievance procedure. Follow it to the letter! Likely she will be ignored at the lower levels she has already complained to but continually escalating her complaint will eventually reach board level and potentially even at ACAS level. She needs to approach this with ALL concerns - ie lone worker; lack of training to care for patients alone; not being paid overtime for hours worked beyond 37.5 h/p/w; patient safety, etc.

To back up her claims she will need to request from the Trust a copy of the risk assessment for patient being left in a department (there should be one...), overtime working policy and the lone worker policy. Ask if there is a policy or guidance on who should be supervising patients outwith their ward whilst attending outpatients appointments and also whether patients who live at home require supervision at all (they don't have it at home...) this should be written in policy. There may even by a policy on being at work for over a certain period of time (mealtimes) - there will certainly be one about patients being in the hospital over a certain amount of time.

Possible courses of action:
1. As above full official grievance with backing from union
2. Go off sick - stress - state in writing why (not having serious concerns listened to is a reasonable cause of stress) - It's amazing how managers will listen to you as soon as they need to get you back to work...
3. Go home and refuse to carry out unauthorised overtime - which may lead to disciplinary action, however, given the myriad of paperwork which she has previously submitted expressing her concerns and unwillingness to continue and the fact the Trust has refused to deal with it - I doubt any action would stick.

Welcome to the wonderful world of NHS Trust mismanagement. Far too many staff are carrying out tasks above and beyond their contract because they work in the face of their patients and it would be very difficult to refuse and walk away from people in need.

Cooper18

Many thanks to all, for the huge efforts you have put into contributing to this thread. This place never fails to amaze me for how far people will go to advise total strangers!

A few other pointers. Firstly, she most definitely HAS suggested that a nominated person stay late and would be happy to take her turn if it happened. I believe the response to that was that there aren't enough of them to share the load if 2 need to stay - I think there are only 3 of them to begin with.

Some of these folks are most definitely sick, with the potential to get worse very quickly. They are inpatients in other hospitals for a reason after all, but transported to her for the specialist skills her department provides.

The nature of the studies involved means that patients won't be finished until the middle of the afternoon, so getting them out early cant happen.

I'll definitely be suggesting she returns to the union, perhaps with me in tow, and also will be suggesting she takes her issues higher up in her trust.

I know this might not seem like a huge issue (the staying late bit) but as many of you have said in the NHS we do things above and beyond day and daily. We miss lunch, start early, work late - but for the majority of times I do this because I CHOOSE to. I know my friend does the same. But in this scenario she feels she is being FORCED to stay, and this is what is taking its toll on her.

sammyjammy

Cooper18 wrote: »

A few other pointers. Firstly, she most definitely HAS suggested that a nominated person stay late and would be happy to take her turn if it happened. I believe the response to that was that there aren't enough of them to share the load if 2 need to stay - I think there are only 3 of them to begin with.

This is just nonsense though isn't it? If there are only three and its unacceptable for them to share the load how can they think its acceptable for her to do it.

It just means they would have a rota where they are responsible three times out of two. I imagine that the other two people have partners who can share responsibility for collecting a child, its just an excuse.