Our health workers suffering ‘anxiety and stress epidemic’

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They are the people we turn to when we are sick but NHS staff in the North West have highest rate of sickness in the country. Catherine Musgrove explores just why

NHS staff in the North West are suffering more ill health than anywhere else in the country, according to a new report.

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Concerns have been raised that an average sickness rate of 4.66 per cent between July to September 2016 reflects “an epidemic of stress and anxiety” due to rising pressures on emergency staff and “draconian” management policies.

The national average sickness rate was 3.98 per cent, with the lowest average 3.08 per cent recorded in North West London.

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The figure is worked out using the number of calendar days available and the number of sickness absence days for the number of staff available.

North West sickness figures have historically been the highest in the country since records September 2014, apart from February and April 2015, when the North East was the highest.

Amy Barringer, UNISON North West lead for health said: “The higher rates of staff sickness in the North West may in part reflect high levels of ill-health amongst the working age population in many of our communities. Another factor might be that local government funding cuts have been particularly severe in the North West.

“This has led to cuts in social care services, increased demands on the NHS, and a knock-on effect on the workloads and stress felt by NHS staff.

“There is an urgent need for proper investment in NHS and social care services, not least to ensure that staff on the front line are not paying the price of under investment with their own health.”

She added: “It’s important that our health workers are helped to stay healthy by their employers. For example, through providing fast track help for musco-skeletal conditions and effective wellbeing services. It is a false economy for NHS organisations not to invest in the health of their staff.”

Andrew Ford, health delegate of Unite the Union, does not believe figures in The NHS Sickness Absence Rates report showing the North West as worst are statistically significant, but says mounting pressure on NHS staff is something to be concerned about.

He said: “There is an epidemic of stress and anxiety in NHS staff because of the nature of the job.

“There’s mounting pressure on hospitals, the NHS is picking up a lot of work from social services, there’s vacancy freezes and people are having their support removed.”

He added: “Lots of trusts have punitive sickness policies. So you get people driving into to work, being sick on the hard shoulder, when they really shouldn’t be going in.

“Ambulance staff tend to have a higher percentage of sickness because they’re working long shifts in difficult situations with difficult people.

“Health visitors are facing a lot of pressure too. They’re at the sharp end of dealing with deprivation, and their case studies are meant to be set at 250, but often they’re dealing with 280, 290.”

The report findings reflect concerns about ambulance staff, as among the types of NHS organisations, ambulance trusts had the highest average sickness absence rates with an average of 5.26 per cent.

What the hospital trust says

A spokesperson for Blackpool Teaching Hospitals NHS Foundation Trust, said: “The Trust aims to support staff in a number of ways.

“The Trust was one of only eight in the country to receive the gold award in the national Sport and Physical Activity @Work Awards in recognition of the ground-breaking work done by the Trust and its ‘Better 
Tomorrow for BTH Staff’ campaign.

“Being physically active is an important part of physical and mental wellbeing, so we were very pleased to have been awarded gold status.

“The health and wellbeing of our staff is one of our main focuses of attention, so this award is an acknowledgement of the Trust’s ongoing commitment to help address the barriers which make it difficult for the diverse NHS workforce to remain physically active

“We also have a very active occupational health department which focuses on areas such as stress by offering resilience sessions to give staff the tools to help the cope better with their demanding roles.”

What the paramedics say

Neil Cosgrove, branch secretary of union Unite and a working North West Ambulance Service (NWAS) paramedic, said pressure on the health service was taking its toll on staff and and morale was not being helped by “draconian” management styles.

He said: “We’re human beings as well. With pressure on hospitals, we’re seeing ambulance crews standing around in corridors for hours with patients, and they’re not getting regular meals.

“There’s quite a few paramedics on medication themselves, and they need to take the medication with food. These things aren’t being taken into consideration.

“We get meal time windows and if crews aren’t being fed because they’re having to work through, there’s compensation.

“Crew members are getting £200 a month regularly because of this. That’s the extent of the situation.”

NWAS said it has a range of health and wellbeing initiatives for staff, and shifts are not going uncovered due to sickness, but critics believe more could be done.

Mr Cosgrove added: “You shouldn’t be coming into work if you’re sick – you’re no use to the patients or your colleagues, but NWAS has adopted a draconian style of management over sickness absences.

“There are trigger points in our policy, whereby if you’re off sick for so many hours, it will trigger an informal meeting about it, which is recorded on your file, then if you’re off longer it will trigger stage two, which is a formal meeting, and it goes right up to dismissals.

“NWAS want to reduce the trigger point from 118 hours of absence to 90. When the majority of staff work on 11.5 hour shifts, this can be eight shifts, and that’s not a lot.”

Neil also raised concerns about a “discriminatory” new policy of automatically restricting overtime for 28 days for people who have been off sick, which he says was brought in last year without consulting staff.

He said: “It means that a lot of shifts are going unmanned, and more pressure is being put on the people who are working.

“People are coming into work when they really shouldn’t, because they don’t want to invoke the 28 day overtime restriction.”

An NWAS spokesman said: “NWAS works jointly with staff representatives to agree its policies and procedures and has a jointly agreed procedure to manage absences amongst its staff.

“The Trust is currently reviewing the Sickness Absence Procedure and has suggested some alterations which include proposals to ensure consistency, simplify procedures and reduce the trigger points to a level which represents five per cent absence.  Given high sickness rates across UK ambulance services in general this is not an unreasonable level at which to trigger a discussion with a member of staff regarding their attendance. 

“It is disappointing that NWAS Trade Unions are seeking to share information regarding proposals which are still under confidential discussion with them in partnership.

“The Trust is seeking to ensure consistent and effective management of sickness absence which is being supported through a range of health and wellbeing initiatives including new initiatives to support mental health.

“The decision to restrict overtime for staff with high absence when they return to work is also done in the interest of staff health and wellbeing. It recognises that the role of a frontline emergency worker can be pressurised and the Trust has a responsibility to ensure that staff are being supported back into the workplace without the additional pressure of working overtime shifts.  This aims to support staff to maintain good attendance following their return.

“Overall levels of sickness absence are not resulting in shifts being uncovered and the Trust is able to maintain high levels of staffing whilst continuing to support staff on their return from absence.”

NWAS said staff members injured while at work do not have these injuries counted against their trigger points, and there is nothing to suggest this will change.

Mr Cosgrove argues staff who are injured in this way, or have maternity-related illnesses, are still discriminated against as they are prevented from overtime for 28 days.

Ambulance service set to save millions by going electric

North West Ambulance Service (NWAS) is set to save millions by introducing electric vehicles into its fleet.

The Trust will be one of the first in the country to use the electrically-powered rapid response vehicles (RRVs), and as well as being more environmentally-friendly, it is expected the move could save up to £2.5 million in fuel costs over the four year lease period.

Neil Maher, assistant director service delivery support for NWAS, said: “The Trust relies heavily on rapid response vehicles to be able to attend patients as quickly as possible.

“The introduction of these electrically powered cars will not only provide huge cost savings for the Trust, it will also have a huge impact on our carbon footprint, reducing the carbon contribution from our RRVs from 1379.28 tonnes to 100.8 tonnes, a reduction of 73 per cent.”

Maintenance and lease costs are also reduced with the introduction of the new RRV model, with an overall expected annual saving of over £4,300 per vehicle.

NWAS currently has 174 rapid response vehicles throughout the North West and will initially be introducing four electrically powered vehicles as a trial. The Trust will look to replace all RRVs with the new electric models gradually in the coming years once the life-span of the current vehicles comes to an end.

The four vehicles, initially being trialled in Bury and Rochdale, will be an updated version of the BMW i3 model.They are currently being used by police and fire Services across the UK, and are equipped with a system that can extend the mileage range using a small petrol engine that can generate electricity for the battery.

A number of charging points across are expected to be introduced across Trust buildings by early April.