16. Priority care for front-line? (resolution)

Inner North East London Branch

That this meeting of RCN Congress believes that health care professionals should be given priority access to health care services.

On this page:

Play this video

Progress report

Council Committee: MRC
Committee decision: Covered by existing work
Council member/other member/stakeholder involvement: Anne Griffiths
Staff contact: kim.sunley@rcn.org.uk

This work is being taken forward through the NHS staff council sub-group the Partnership for Occupational Safety and Health in Healthcare (POSHH) of which the RCN is co-chair. A sub-group has been set up to develop the recommendations of the Boorman review around reducing and managing absence, fast tracking and rehabilitation.

The RCN is currently representing the staff side of the social partnership forum on a DH convened task and finish group on wellbeing. The group will make recommendations on NHS occupational health provision in England and we are using this opportunity to promote fast tracking. The recommendations will form a stakeholder engagement process on OH provision during December.

Guidelines on the prevention of ill health, support and rehabilitation of sick employees are also being developed with RCN input via the NHS staff council. The guidelines continue to promote fast tracking and will give examples of good practice. Subject to agreement the guidelines will be published in early 2011.

The RCN in Scotland published its manifesto, Nursing Scotland's Future, which has called for the implementation of the Boorman review’s recommendations in Scotland including the recommendation for fast tracking.

The RCN is also working with activists to promote fast tracking and Boorman recommendations, holding masterclasses and workshops. 

Debate report

Andrew Wight opened the resolution stating that the health of health care professionals is paramount. With £5m being the cost per NHS organisation for sickness absence, it is important that every health care professional returns to work as soon as possible. He called for staff health and wellbeing needs to be placed alongside quality at the heart of the NHS.

Graham Revie, Greater Glasgow branch member, spoke of the recent bombardment of negative press around sickness absence in the health service and asked "is our employer looking after us?". Graham described a successful NHS pilot in Scotland that has been effective in reducing staff absence, and called for it to be mainstreamed.

Mike Smith, Outer South West London branch member, said that too many staff are off work longer than needed and improvements need to be made in the workplace. He suggested that more money be invested in occupational therapy.

Cirain Hurley, RCN Perioperative Forum member, reflected the views of most of the other speakers who strongly supported the resolution, by saying that it is best for everybody, not just individuals, if health care professionals are given priority access to health care services.

Kathleen Walker, a Portsmouth branch student, said that she looks forward to working in an NHS where priority is given to those with the greatest clinical needs whatever their profession and asked, doesn’t everybody require priority?

The proposer closed the debate stating that health care professionals need to be fit and healthy in order to deliver high quality service to patients,

The resolution was passed with 79% of the vote.

For: 346  (79%)
Against: 92  (21%)
Abstain: 0

Background

Early intervention to treat and rehabilitate workers who develop health conditions is at the heart of government initiatives to improve the health of the working age population. Early intervention, in the form of prompt treatment and effective rehabilitation back to work, has been shown to reduce the likelihood of individuals developing chronic illnesses which can lead to long term absence from work, ill health retirement and permanent unemployment. This has an impact on the individual, their family, and society as a whole including costs on public finances.

In the NHS the importance of early intervention is recognised in Annex Z of the NHS Agenda for change agreement. The UK-wide agreement recommends staff are provided, at the earliest opportunity, with direct access to appropriate dedicated resources such as physiotherapy and cognitive behavioural therapy.

A number of NHS organisations have comprehensive occupational health services and already provide access to speedy in-house treatment and rehabilitation – primarily in the form of physiotherapy or counselling, with some providing cognitive behavioural therapy. However, a freedom of information request by the Liberal Democrats in October 2009 revealed that NHS trusts spent £1.5 million on private treatment for 3, 337 staff between 2006 and 2009.

The case for early intervention or ‘fast tracking’ NHS staff was detailed in the Boorman review of the Health and Wellbeing of the NHS workforce in England (2009). While recognising that early intervention programmes could be perceived as queue jumping, Boorman argues that interventions based on clinical need generate financial and patient care benefits and benefits for patient care by increasing the availability of trained and skilled staff. The review calls on the NHS to do more to prevent the work related and lifestyle causes of ill health amongst NHS workers.

In Scotland evaluation of an NHS pilot scheme – OHSxtra – to reduce staff absence through rapid access to services such as physiotherapy, occupational therapy and mental health support alongside access to occupational health nurses and physicians was found to be cost effective and successful in rehabilitating staff back to work.

A recent Managing sickness absence Welsh Audit Office report identified examples of fast tracking, where injured staff fill physiotherapy appointments cancelled by members of the public. The report highlighted a lack of formal agreement of fast tracking NHS staff ahead of members of the public without consideration of clinical need.

In Northern Ireland the RCN is working in partnership with the DHSSPS to address a range of issues related to the health of health professionals within the context of a broader review of regulatory systems and processes, including occupational health provision.

The RCN was involved in negotiations on Annex Z of the Agenda for change agreement and was a key stakeholder on the Boorman review. The RCN is also represented on the Health, Work and Wellbeing National Stakeholder Council and, in partnership with the Department for Work and Pensions, has developed a learning zone on health, work and wellbeing.

References and further reading
The NHS Staff Council (2010) Agenda for change: NHS terms and conditions of service handbook. Amendment number 16, London: NHS Employers.
www.nhsemployers.org/SiteCollectionDocuments/AfC_tc_of_service_handbook_fb.pdf

Black C (2008) Working for a healthier tomorrow: Dame Carol Black’s review of the health of Britain’s working age population, London: Stationery Office. www.workingforhealth.gov.uk/Carol-Blacks-Review/

Waddell G, Burton A and Kendall N (2008) Vocational rehabilitation: what works, for whom, and when? London, Stationery Office.

Boorman S (2009) NHS health and well-being review: final report, Leeds: NHS Health and Wellbeing Review.
www.nhshealthandwellbeing.org/FinalReport.html

Royal College of Nursing (2009) Helping patients back to work? Here’s some help for you.
www.rcn.org.uk/development/communities/rcn_forum_communities/nurse_practitioner/news_stories/helping_patients_back_to_work_heres_some_help_for_you