Redeployment and COVID-19

This advice guide has information on your rights and your employer's responsibilities if you have been redeployed due to COVID-19. If you are being asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance.

If the move is non COVID-19 related, please see our guide on redeployment: being moved from your normal area.

If you are being redeployment as part of a formal redundancy or reorganisation process, see our redundancy and reorganisation guide.

The coronavirus (COVID-19) pandemic may require health and social care professionals to be flexible in what they do. It may entail working in unfamiliar surroundings or working in clinical areas outside of your usual practice for the benefit of patients, individuals and the population as a whole.

During COVID-19, staff may be required to cover other areas both within and outside their substantive organisation. New models of care delivery may be required in the short or medium term to ensure workforce sustainability and maintain high-quality patient care.

Staff may be redeployed for a number of reasons including:

• The increase in demand for some services because of a surge in the number of patients with and recovering from COVID-19. 
• To support areas where staff are off sick.
• To support certain areas as elective and routine services return, and to potentially support a back log of work. See NHS England's roadmap to safely bring back routine operations.

Redeployment may mean covering wards or clinics or providing support in other areas, for example general practice nurses required to work in different practice settings or even NHS staff covering independent health and care sectors

There must be an appropriate governance structure during the period of deviation with clear plans to ensure the safety of these temporary models of care, alongside a strategy for returning to standard care delivery.

Further information

For guidance specific to ICU, see the Faculty of Intensive Care Medicine Bridging guidance for Critical Care during restoration of NHS services. 

The Critical Care National Network Nurse Leads Forum (CC3N) has some further information specific to redeployment and induction in critical care.

The United Kingdom Critical Care Nursing Alliance (UKCCNA) Position Statement: Nurse Staffing during COVID-19 has been released for surge 2 in Jan 2021

RCN news: 

15 Jan 2021: RCN warns of increasing risk to patient safety as hospital capacity reaches critical level.

11 December 2020: Shortage of critical care nurses means redeployed staff are needed to ensure patient safety, says RCN.

England

• NHS England: Management – confirmed coronavirus (COVID-19)
• NHS England - Joint statement on developing immediate critical care nursing capacity
• NHS England - Discharge

Wales

• Welsh government COVID-19 workforce risk assessment tool
• Welsh government guidance - Keep Wales safe at work

Scotland

• Health Protection Scotland

Northern Ireland

• Guidance for HSC staff, healthcare workers and care providers

If you are being redeployed to a different area or workplace, use this ten point checklist to help you:

• assess your situation
• consider if your employer has met their responsibilities
• decide whether any further support is needed.

1. Your personal circumstances and risk

When redeploying staff, we expect employers to undertake appropriate occupational health risk assessment based on the individuals own health and wellbeing. The risk assessments must be relevant to areas of practice and patients, including consideration of PPE requirements. It is important to see our occupational health section below for more information on risks and underlying health conditions.

Employers also need to consider an individual’s unique experiences and skills before considering where to redeploy them.

2. Your contract and pay

It is important to check that your contract allows you to be moved. Also check any relevant local policies. If your contract does not allow you to be moved, discuss this with your manager and contact us on 0345 772 6100 for further advice.

If you contract does allow the move, you should not experience any detriment in relation to your pay or  your terms and conditions of employment.  

3. PPE requirements

You must be provided with the appropriate personal protective equipment (PPE). Where necessary, you should also receive fit testing and appropriate training, including safe donning and doffing.

4. Security systems and IT

You will need an induction to the relevant security systems, passcodes and a name badge might be required. You will also need an induction to the telephone and alarm systems, along with incident reporting IR1/Datix system and record keeping procedures (see below).

5. Your working time

Your employer must comply with your contract of employment and local policies in addition to meeting the requirements of the Working Time Regulations.

They must also ensure that appropriate arrangements for recording and accruing overtime and TOIL are in place, and any related payments are made. Read more about overtime and TOIL on our COVID-19 faqs.

6. Your role, responsibilities and team

The specific duties and responsibilities of the role along with your level of competence should be discussed from the outset. You should also know who your line manager will be and who you will be working with.

As part of your induction to the new role you should be given information about the team around you and each team members competencies. It is reasonable to make enquiries about other redeployed staff and their competencies. Any areas of concern should be escalated and reported to senior managers.

You may need more information about:

• essential contacts (for example who is on call)
• senior staff on shift
• supervision and support arrangements.

7. Your work area

You will need to have an induction to the clinical area which should cover:

• policies and procedures (see below)
• the infection status of the clinical setting
• access to and appropriate use of any equipment that might be needed in your role
• moving and handling (access to equipment, procedures)
• location of toilets and staff room/lockers/drinking water
• working times, rota and break allocation.

8. Access to policies and procedures

This should be discussed and copies must be readily and easily available. For example, you may wish to check the:

• record keeping policies
• medical teams & referral process including escalation
• medicine safety procedures (including any limitations e.g. IV drugs)
• emergency procedures (for example evacuation and fire safety, violent incident, resuscitation, needlestick/exposure incident)
• infection control procedures.

9. Indemnity cover

Employers must ensure that the appropriate indemnity arrangements are in place for all staff who are required to move to a new work area. Read more about this in our indemnity section below.

10. Career development opportunities and returning to your role

Opportunities
Although temporary redeployment can be unsettling, there could be opportunities to working in a different environment. Both you and your employer should maximise these learning opportunities by setting some key objectives during your redeployment. Consider how you might use the experience and reflect on it for your revalidation.

Your return
When you return to your original place of work you may need a period of reorientation. Employers should consider a further risk assessment to include additional education and training needs, and any support, clinical supervision, or counselling requirements which are available to support  you in your return to your previous role and duties.
 
If you are delayed returning to your substantive role, discuss this with your manager and if you have concerns, call us for advice on 0345 772 6100.

If you are asked to move to a new work area or are temporarily moved to work for a different employer because of the COVID-19 pandemic, you should not experience any detriment in relation to your pay, or terms and conditions of employment.

If you work in the NHS, a joint working group of the NHS Staff Council Executive has published two FAQs on pay protection relating to COVID-19. The questions cover pay for those who are temporarily redeployed for short periods to help service and patient needs.

See our redeployment checklist above for more information on your rights during redeployment and call us on 0345 772 6100 if your pay has been reduced due to COVID-19 and temporary deployment.

Your employers’ responsibilities

Your employer is responsible and accountable for ensuring staff have the necessary skills and knowledge to take on work. They should consider staff limitations and competencies carefully when delegating tasks or temporarily moving staff. This is relevant for all members across the health and social care workforce, including those in training (for example Student nurses, trainee Nursing Associates and Nurse Apprentices).  

Your responsibilities

Registrants are accountable to the NMC Code, and where appropriate the NMC's Standards for competence for midwives. If you are a registered nurse, you must practice in line with the NMC Code at all times and use professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in your professional standards. It may be helpful to read Supporting Nurses and Midwives across the UK and Nursing Associates in the event of a COVID-19 epidemic joint letter. Along with the NMC's guidance on regulation during Covid-19.

Remember, you must speak out if the move may undermine your ability to follow the NMC Code.

Accountability and delegation

Accountability and delegation principles apply to all members of the nursing team. Read more about accountability and delegation in practice. Our accountability and delegation case studies provide helpful examples of how the decision making process and the principles of accountability and delegation apply in various health and care settings.

Unregistered Nursing Support Workers, (NSWs)

NSWs, must also speak up if they feel they do not have the relevant skills and training to adequately carry out safe and competent practice. Read more about accountability and delegation and see our section on Nursing Support Workers (NSWs) and Nursing Associates (NAs) below.

If you do not feel competent

Firstly, look at our redeployment checklist above to see if further support is needed from your employer. Speak to your manager and if the issues cannot be resolved, follow this up in writing using our model letter. Please also see our section on refusal below, along with our advice guide on refusal to treat.

You must speak out if the move may undermine your ability to follow the NMC Code. If you need further support, document your issues and contact RCN Direct on 0345 772 6100.

Any NHS organisation employing redeployed staff to support the COVID-19 pandemic has the benefit of the NHS indemnity schemes. The NHS indemnity cover applies to all NHS employed staff and those providing their services to the NHS as locums, bank staff and other self-employed roles. Read more about this, along with helpful faqs on NHS Resolution.

For those outside the NHS, the Department of Health and Social Care (DHSC) has made it clear that the employer will provide indemnity cover to anybody working in redeployed or backfilling roles. In the unlikely event that there is a gap in that cover for the pandemic response, the new state-backed Coronavirus indemnity scheme will cover their work.

Staff should be provided with the necessary PPE relevant to the area they are being asked to work in and in line with the current public health guidelines.

Where a risk assessment indicates the wearing of FFP3/P2 masks, a fit test should be carried out for every new model worn. Staff should be given appropriate training in using and discarding this (known as donning and doffing). Please see our PPE guidance for more information.

The movement of staff should be restricted as far as possible to prevent the potential transmission of infection. Where staff need to move for workforce needs, or to support reinstatement of elective services, a risk assessment should be undertaken to identify any risks to patients or staff in the receiving area as well as the HCW themselves. This may include the presence of COVID-19 symptoms or other infection, and competence/education needs of the individual staff member.

Anyone who develops symptoms after redeployment should immediately inform their employer, ensure they are tested and self-isolate.

In relation to symptoms of COVID-19 specifically, the absence of symptoms is not a barrier to redeployment. Members should refer to their relevant national guidance and local organisational polices on testing and self-isolation and discuss any concerns with their manager. This advice applies to all care settings.

For further advice, please see Public Health England's guidance: COVID-19: management of exposed staff and patients in health and social care settings.

NMC code

There is a general expectation within the NMC Code that nursing staff should support redeployment in emergency situations, performing as competently and safely as they can and providing the appropriate safeguards, including relevant personal protective equipment (PPE), are in place.

It may be helpful to read Supporting Nurses and Midwives across the UK and Nursing Associates in the event of a COVID-19 epidemic joint letter.

NMC regulation

The NMC and other health care regulators have recognised that Covid-19 presents an extraordinary situation and challenging issues for health and care and those who work within it. They have published a statement on how they will regulate with the context of the current situation taken into account. See the NMC's website for more information 

Remember, you must speak out if the move may undermine your ability to follow the NMC Code

Further Information

RCN guidance on accountability and delegation
RCN advice on refusal to treat
RCN advice on duty of care 

An employer is required by law to protect their employees from harm. Assessing risk is just one part of the overall process used to control risks in your workplace.

The risk assessment itself must reflect the established evidence and be based on the individual’s own health and wellbeing. See Public Health England's (PHE) report COVID-19: review of disparities in risks and outcomes for more information identifies a number of risk factors that any risk assessment will need to consider including;

• ethnicity - read more below
• age, gender and location
• underlying health conditions and other factors such as BMI
• pregnancy  - read more below
• individual staff members’ domestic living arrangements (for example if they are living with someone who is particularly vulnerable or have additional caring responsibilities) mean they need to be able to take further precautions.

Ethnicity, race or national origin

Ethnicity needs to be explicitly considered. Black, Asian and Minority (BAME) staff face an increased risk of both contracting COVID-19 and dying from the disease as noted in COVID-19: review of disparities in risks and outcomes. PHE describe the ethnic groups most at risk of becoming critically unwell as a result of COVID-19. These include those from Bangladeshi, Black Caribbean and other black communities Read more about our position and your employers responsibilities for BAME staff.  

Staff with underlying health needs

If individuals have a disability or an underlying medical condition, for example immunodeficiency, which means they may face a risk to their health or wellbeing if they move to an unfamiliar or new working environment, they should inform their line manager or an appropriate person and/or seek advice from their local occupational health service before agreeing to move. A risk assessment would be needed before any further decision is made.

If you work in the NHS, see NHS employers guidance on risk assessments for staff.

If you have concerns, discuss these with your manager and if the situation is not resolved, contact RCN Direct on 0345 772 6100.

Pregnant women

The Royal College of Obstetricians and Gynaecologists (RCOG) has issued updated guidance on pregnancy and COVID-19, including occupational health advice for employers and pregnant women.

The RCN expects employers and occupational health to carry out or review a pregnancy risk assessment and put systems in place to protect the health care worker and find suitable alternative work, including home working or redeployment in line with health and safety standards.

Read more about pregnant workers on our COVID-19 FAQ.

Information from the Royal College of Midwives can be found here and along with their advice for pregnant healthcare workers.

If you have concerns, contact RCN Direct on 0345 772 6100.

Further information

NHS Employers guidance on supporting vulnerable staff
NHS Health and Wellbeing guidance
Health and Safety Executive HSE guidance on risk management

In most cases your employer can redeploy you to other areas, but it is important that you check your contract and local policies and to note that temporary deployment is generally a voluntary choice, staff should not be forced to move. You may be able to refuse if you have reasonable grounds, for example because a medical condition cannot be supported or if you are pregnant and the necessary measures cannot be put in place.

You are also within your rights to refuse to do something if you are not competent to do so, but you cannot refuse to learn how to do something if it is a requirement for patient care or safety.

If you are being asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance. Please contact us if the situation is not resolved.

Before refusing

Read our refusal to treat guidance below and speak to your line manager about your concerns. If this does not resolve the situation, contact us on 0345 772 6100 for further advice. 

Further information

• Refusal to treat guide
• Raising concerns guide
• NMC Code
• NMC’s Joint statement on expanding the nursing workforce in the Covid-19 outbreak.

It is natural to feel anxious when moving work areas, returning from home working or returning to your substantive posts. You may also lose that immediate connection and peer support of the team that you have worked very closely with on a COVID-19 ward or ITU. 

It's important to look after your mental health and seek support if you are experiencing difficulties. Visit our COVID-19 and your mental wellbeing page for further information. Your employer should also have a range of proactive measures in place to protect and support mental wellbeing.

Further information

NHS employers guidance on mental health and wellbeing

NHS Pathways

Lone workers being temporarily moved to another area need to be advised who their immediate line manager will be during the redeployment and be introduced to the wider team. Ideally their substantive line manager needs to be part of this discussion.

If staff are asked to work on their own, it is important to consider how they will be able to keep their manager and colleagues up to date with their movements, how they will access support and whether they need a mobile phone and/or lone worker alarm.

See our redeployment checklist above along with our lone worker checklist in our publication Personal safety when working alone: guidance for members working in health and social care.

If you are a student nurse and you are being redeployed to a different area or workplace, use our redeployment checklist to help you:

• assess your situation
• consider if your employer/university has met their responsibilities and duty of care to you
• decide whether any further support is needed.

If you have concerns about your deployment, speak to your placement coordinator and university and read our COVID-19 advice for students and trainee nursing associates. If you need further support, contact us on 0345 772 6100 for advice. 

Please note, this advice is only applicable to England.

Your role

The nursing associate role bridges the gap between the health care support worker and the registered nurse.  NAs will contribute to the delivery of integrated care which remains led and managed by the registered nurse.  More information can be found on the Care Quality Commission (2019) briefing document for providers for the nurse associate role.

Being asked/trained to deliver care beyond your scope of practice

Nursing associates are deemed competent and confident within their scope of practice at the point of registration with the NMC. If you are being asked to undertake any clinical interventions that are outside the scope of your practice knowledge, experience and skills you need to refer to the NMC guidance and local policy to support decision making on how best to procced. 

If you are being asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance.

There are a number of resources that describe the role and remit of NAs:
The NMC Code
Health Education England Nursing Associate resources
Employers guide to Nursing associates (NHS Employers, 2019)
An improvement resources for the deployment if nursing associates in secondary care (National Quality Board, 2019) 
Standards of proficiency for nursing associates (Nursing and Midwifery Council. 2018) (NMC)
Standards of proficiency for registered nurses (Nursing and Midwifery council, 2018)
Briefing to providers: Nursing associates (Care Quality commission, 2019) (CQC)
Advisory guidance: Administration of Medicines by Nursing Associates (Health Education England, 2018

Organisations must have effective procedures in place to allow nursing staff and their representatives to raise any concerns in relation to equipment, policies and processes for managing COVID-19 at the earliest opportunity.

Nursing staff should feel able to raise their concerns without detriment and should receive timely feedback on their concerns.

If you are being asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance. If you have any other concerns about your redeployment, speak to your line manager and see our raising concerns guidance. You might also find the following information useful:

PPE and COVID-19
Refusal to treat guide
NMC Code.

If the issue is still not resolved, please call us on 0345 772 6100.

If there are any issues with returning to your substantive post at the end of your redeployment period, discuss this with your manager and ask for the reasons in writing.

If you have any concerns about this, contact us on 0345 772 6100 for further advice.

If you are facing redeployment as part of a formal redundancy or reorganisation process, please see our advice guide on redundancy and reorganisation our 121-meeting checklist.