Mid Staffordshire Failures
The failures of management and staff at Mid-Stafforshire NHS Foundation Trust brings shame on all concerned and forces all NHS staff with a conscience to reflect on what on earth was going on? What does this mean for us here, are we doing anything similar?
The ability of that Trust to create fear amongst staff who dared challenge the state of things is something that no Trust would want to emulate, its not one that UNISON would tolerate.
The importance of strong Trade Union and Professional Organisations within the health service has been critical since its creation in 1948.
Feedback to Trusts from service users and staff needs to be heard, if there are problems with hearing then the resource of organised Trade Unions, with their political and collective voice can be brought to bare.
In recent times we have locally disputed staffing and resource allocations, stating clearly that problems were being created. This Trust recognised our right to do so and responded in a collaborative way and that process is ongoing.
The financial problems that will adversley affect large parts of the NHS over the next few years will challenge the patience, negotiating skills and resolve of managment and staffside in a way we have not seen since the 1980s.
If the public decide to return a goverment that wants to create division, slash services, confront Trade Unions and undermind the NHS then so be it.
The trade unions have been around a long time and are not going anywhere, we continue and respond as appropriate to whatever national or local developments/cuts/surpluses requirements are made .
UNISON's starting point in any negotiations is protecting the patient and the staff who care for them from adverse unsafe practice be that straight forward openly honest cuts or more likely be wrapped up in fancy language around 'innovation' or service review or any other jargon that is used to justify a bad move.
The massive investment and expansion in the NHS over the past years must not be undermind by illthought out short terms cuts. Some re-prioritation and questions about what is core is a debate UNISON will engage in.
Challenging times ahead no doubt but a strong Trade Union is not a threat to management, its the voice of reason.
The Branch Officers and Stewards will be considering this report and sharing our thoughts through the JSC with management.
Karen Jennings UNISON Head of Health issued a press statement today, press on the link to read the full statement.
Copies of both Inquiry volumes are below.
The ability of that Trust to create fear amongst staff who dared challenge the state of things is something that no Trust would want to emulate, its not one that UNISON would tolerate.
The importance of strong Trade Union and Professional Organisations within the health service has been critical since its creation in 1948.
Feedback to Trusts from service users and staff needs to be heard, if there are problems with hearing then the resource of organised Trade Unions, with their political and collective voice can be brought to bare.
In recent times we have locally disputed staffing and resource allocations, stating clearly that problems were being created. This Trust recognised our right to do so and responded in a collaborative way and that process is ongoing.
The financial problems that will adversley affect large parts of the NHS over the next few years will challenge the patience, negotiating skills and resolve of managment and staffside in a way we have not seen since the 1980s.
If the public decide to return a goverment that wants to create division, slash services, confront Trade Unions and undermind the NHS then so be it.
The trade unions have been around a long time and are not going anywhere, we continue and respond as appropriate to whatever national or local developments/cuts/surpluses requirements are made .
UNISON's starting point in any negotiations is protecting the patient and the staff who care for them from adverse unsafe practice be that straight forward openly honest cuts or more likely be wrapped up in fancy language around 'innovation' or service review or any other jargon that is used to justify a bad move.
The massive investment and expansion in the NHS over the past years must not be undermind by illthought out short terms cuts. Some re-prioritation and questions about what is core is a debate UNISON will engage in.
Challenging times ahead no doubt but a strong Trade Union is not a threat to management, its the voice of reason.
The Branch Officers and Stewards will be considering this report and sharing our thoughts through the JSC with management.
Karen Jennings UNISON Head of Health issued a press statement today, press on the link to read the full statement.
Copies of both Inquiry volumes are below.
| staff_vol_1.pdf |
| staff_vol_2.pdf |
Management insight ?
4.3.10
One in 10 NHS staff believe the poor care seen at Mid Staffordshire Foundation Trust may be experienced by patients at their own trust, an HSJ poll suggests. The Health Service Journal, a weekly magazine read by the great and the good of the NHS across the country confirms that the gap between management and patient experience is so vast that something is seriously wrong in the system.
One in 10 NHS staff believe the poor care seen at Mid Staffordshire Foundation Trust may be experienced by patients at their own trust, an HSJ poll suggests. The Health Service Journal, a weekly magazine read by the great and the good of the NHS across the country confirms that the gap between management and patient experience is so vast that something is seriously wrong in the system.
Mid-Staffordshire Inquiry
The Francis report's 18 recommendations
Recommendation 1:The trust must make its visible first priority the delivery of a high class standard of care to all its patients by putting their needs first. It should not provide a service in areas where it cannot achieve such a standard.
Recommendation 2: The secretary of state for health should consider whether he ought to request that Monitor - under the provisions of the Health Act 2009 - exercise its power of de-authorisation over Mid Staffordshire Foundation Trust. In the event of his deciding that continuation of foundation trust status is appropriate, the secretary of state should keep that decision under review.
Recommendation 3: The trust, together with the primary care trust, should promote the development of links with other NHS trusts and foundation trusts to enhance its ability to deliver up-to-date and high class standards of service provision and professional leadership.
Recommendation 4: The trust, in conjunction with the royal colleges, the deanery and the nursing school at Staffordshire University, should review its training programmes for all staff to ensure that high quality professional training and development is provided at all levels to and that high quality service is recognised and valued.
Recommendation 5: The board should institute a programme of improving the arrangements for audit in all clinical departments and make participation in audit processes in accordance with contemporary standards of practice a requirement for all relevant staff. The board should review audit processes and outcomes on a regular basis.
Recommendation 6: The board should review the trust’s arrangements for the management of complaints and incident reporting in the light of the findings of this report and ensure that it:
Recommendation 8: The board should give priority to ensuring that any member of staff who raises an honestly held concern about the standard or safety of the provision of services to patients is supported and protected from any adverse consequences, and should foster a culture of openness and insight.
Recommendation 9: In the light of the findings of this report, the secretary of state and Monitor should review the arrangements for the training, appointment, support and accountability of executive and non-executive directors of NHS trusts and NHS foundation trusts, with a view to creating and enforcing uniform professional standards for such posts by means of standards formulated and overseen by an independent body given powers of disciplinary sanction.
Recommendation 10: The board should review the management and leadership of the nursing staff to ensure that the principles described are complied with.
Recommendation 11: The board should review the management structure to ensure that clinical staff and their views are fully represented at all levels of the trust and that they are aware of concerns raised by clinicians on matters relating to the standard and safety of the service provided to patients.
Recommendation 12: The trust should review its record-keeping procedures in consultation with the clinical and nursing staff and regularly audit the standards of performance.
Recommendation 13: All wards admitting elderly, acutely ill patients in significant numbers should have multidisciplinary meetings, with consultant medical input, on a weekly basis. The level of specialist elderly care medical input should also be reviewed, and all nursing staff (including healthcare assistants) should have training in the diagnosis and management of acute confusion.
Recommendation 14: The trust should ensure that its nurses work to a published set of principles, focusing on safe patient care.
Recommendation 15: In view of the uncertainties surrounding the use of comparative mortality statistics in assessing hospital performance and the understanding of the term ‘excess’ deaths, an independent working group should be set up by the Department of Health to examine and report on the methodologies in use. It should make recommendations as to how such mortality statistics should be collected, analysed and published, both to promote public confidence and understanding of the process, and to assist hospitals in using such statistics as a prompt to examine particular areas of patient care.
Recommendation 16: The Department of Health should consider instigating an independent examination of the operation of commissioning, supervisory and regulatory bodies in relation to their monitoring role at Stafford hospital with the objective of learning lessons about how failing hospitals are identified.
Recommendation 17: The trust and the primary care trust should consider steps to enhance the rebuilding of public confidence in the trust.
Recommendation 18: All NHS trusts and foundation trusts responsible for the provision of hospital services should review their standards, governance and performance in the light of this report.
The Francis report's 18 recommendations
Recommendation 1:The trust must make its visible first priority the delivery of a high class standard of care to all its patients by putting their needs first. It should not provide a service in areas where it cannot achieve such a standard.
Recommendation 2: The secretary of state for health should consider whether he ought to request that Monitor - under the provisions of the Health Act 2009 - exercise its power of de-authorisation over Mid Staffordshire Foundation Trust. In the event of his deciding that continuation of foundation trust status is appropriate, the secretary of state should keep that decision under review.
Recommendation 3: The trust, together with the primary care trust, should promote the development of links with other NHS trusts and foundation trusts to enhance its ability to deliver up-to-date and high class standards of service provision and professional leadership.
Recommendation 4: The trust, in conjunction with the royal colleges, the deanery and the nursing school at Staffordshire University, should review its training programmes for all staff to ensure that high quality professional training and development is provided at all levels to and that high quality service is recognised and valued.
Recommendation 5: The board should institute a programme of improving the arrangements for audit in all clinical departments and make participation in audit processes in accordance with contemporary standards of practice a requirement for all relevant staff. The board should review audit processes and outcomes on a regular basis.
Recommendation 6: The board should review the trust’s arrangements for the management of complaints and incident reporting in the light of the findings of this report and ensure that it:
- provides responses and resolutions to complaints which satisfy complainants;
- ensures that staff are engaged in the process from the investigation of a complaint or an incident to the implementation of any lessons to be learned all part of the recommendation
- minimises the risk of deficiencies exposed by the problems recurring; and
- makes available full information on the matters reported, and the action to resolve deficiencies, to the board, the governors and the public.
Recommendation 8: The board should give priority to ensuring that any member of staff who raises an honestly held concern about the standard or safety of the provision of services to patients is supported and protected from any adverse consequences, and should foster a culture of openness and insight.
Recommendation 9: In the light of the findings of this report, the secretary of state and Monitor should review the arrangements for the training, appointment, support and accountability of executive and non-executive directors of NHS trusts and NHS foundation trusts, with a view to creating and enforcing uniform professional standards for such posts by means of standards formulated and overseen by an independent body given powers of disciplinary sanction.
Recommendation 10: The board should review the management and leadership of the nursing staff to ensure that the principles described are complied with.
Recommendation 11: The board should review the management structure to ensure that clinical staff and their views are fully represented at all levels of the trust and that they are aware of concerns raised by clinicians on matters relating to the standard and safety of the service provided to patients.
Recommendation 12: The trust should review its record-keeping procedures in consultation with the clinical and nursing staff and regularly audit the standards of performance.
Recommendation 13: All wards admitting elderly, acutely ill patients in significant numbers should have multidisciplinary meetings, with consultant medical input, on a weekly basis. The level of specialist elderly care medical input should also be reviewed, and all nursing staff (including healthcare assistants) should have training in the diagnosis and management of acute confusion.
Recommendation 14: The trust should ensure that its nurses work to a published set of principles, focusing on safe patient care.
Recommendation 15: In view of the uncertainties surrounding the use of comparative mortality statistics in assessing hospital performance and the understanding of the term ‘excess’ deaths, an independent working group should be set up by the Department of Health to examine and report on the methodologies in use. It should make recommendations as to how such mortality statistics should be collected, analysed and published, both to promote public confidence and understanding of the process, and to assist hospitals in using such statistics as a prompt to examine particular areas of patient care.
Recommendation 16: The Department of Health should consider instigating an independent examination of the operation of commissioning, supervisory and regulatory bodies in relation to their monitoring role at Stafford hospital with the objective of learning lessons about how failing hospitals are identified.
Recommendation 17: The trust and the primary care trust should consider steps to enhance the rebuilding of public confidence in the trust.
Recommendation 18: All NHS trusts and foundation trusts responsible for the provision of hospital services should review their standards, governance and performance in the light of this report.
Indepentant Safeguarding Authority - staff side principles
The following principles have been drawn up in partnership by trade unions and professional organisations which collectively represent over 4 million members affected by the ISA Vetting and Barring scheme. Our principles seek to support effective public protection, but also identify areas of concern surrounding the scheme.
http://www.unison.org.uk/professionalservices/
Other London Trusts who are discussing this matter with staffside members, notably Guys & St Thomas Hospitals have agreed to fund this scheme, other Trusts who understand the significance of this for staff wil be announcing there position soon.
This is a clearly laid out national policy inititiative that needs agreeing and implenting.
This matter was raised at the JSC and it was dissapointing to hear the Trust were not considering paying this fee, of up to£60 per staff member, but expect staff to fund this.
This is to be discussed further at the next JSC, following which UNISON be be counsulting members.The Chair of the has refused to allow this onto the next aganda in March. There will be a robust challenge to that decision in the JSC meeting.
The following principles have been drawn up in partnership by trade unions and professional organisations which collectively represent over 4 million members affected by the ISA Vetting and Barring scheme. Our principles seek to support effective public protection, but also identify areas of concern surrounding the scheme.
http://www.unison.org.uk/professionalservices/
Other London Trusts who are discussing this matter with staffside members, notably Guys & St Thomas Hospitals have agreed to fund this scheme, other Trusts who understand the significance of this for staff wil be announcing there position soon.
This is a clearly laid out national policy inititiative that needs agreeing and implenting.
This matter was raised at the JSC and it was dissapointing to hear the Trust were not considering paying this fee, of up to£60 per staff member, but expect staff to fund this.
This is to be discussed further at the next JSC, following which UNISON be be counsulting members.The Chair of the has refused to allow this onto the next aganda in March. There will be a robust challenge to that decision in the JSC meeting.
| isa_staffside_principles.pdf |
| isa_facts.pdf |
| isa_referrakl_guide.pdf |
PAYROLL ISSUES
We regularly recieve complaints regarding payroll errors, staff are under or over paid, recently a member had their pension contribitutions stopped two years ago and did not realise she was not in the pension scheme. Its very important that you check your payslips monthly as mistakes are a common occurance but can usually be resolved quickly. Are you getting the correct London Allowance and/or recruitment premium. If you are concerned please call payroll (020 8591 4700 )in the first instance to establish some facts and seek an explanation. Following that speak with your line manager. If you do got get a satisfactory answer contact your local steward.
Leanne McGee, Borough Director for Tower Hamlets and previously Forensic Service Director left the Trust on 21st January.
UNISON would like to acknowledge her constructive approach to working with UNISON in addressing and resolving workforce and service issues.
We wish her well in her new role.
UNISON would like to acknowledge her constructive approach to working with UNISON in addressing and resolving workforce and service issues.
We wish her well in her new role.
JHC Facillities staff transferred to White Oaks on 1st March 2010.
Although the transfer feels like it was rushed through with some indecent haste, the staff have had maximum support from UNISON locally and regionally.
UNISON is recognised by White Oaks and we look forward to a good working relationship with the new employer, as with any major change, there will be teething problems and challenges but its in both UNISON and White Oaks interest to see a successful service that can only be provided by motivated and loyal staff group.
Aneurin Bevan, In Place of Fear, p100
The collective principle asserts that... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means
Last year the Prime Minister asked the Commission to advise him on how to build the future of health care, and give nurses and midwives a bigger say in service design and leadership as well as care delivery. The Commission proposes a number of specific ways to bring this about.
One key proposal is that ward sisters, charge nurses and equivalent team leaders in the community and midwifery should be restored to their former traditional positions of authority as visible care champions. To do so they need optimum support and training.
The Commission makes it clear that responsibility for high quality and compassionate care starts at the front line and goes right up to board level. To ensure accountability all boards should include a Director of Nursing. This was debated when the Foundation Trust was created and UNISONs strong support for a Board Level Nurse Director ensured we were not one of the Trusts without a nurse at the most senior level of management. Alongside the Mid Staffs report, it is very clear, clinical staff must take the lead in defending services from meaningless tick box systems or cuts that have no regard for our service users or primary purpose.
One key proposal is that ward sisters, charge nurses and equivalent team leaders in the community and midwifery should be restored to their former traditional positions of authority as visible care champions. To do so they need optimum support and training.
The Commission makes it clear that responsibility for high quality and compassionate care starts at the front line and goes right up to board level. To ensure accountability all boards should include a Director of Nursing. This was debated when the Foundation Trust was created and UNISONs strong support for a Board Level Nurse Director ensured we were not one of the Trusts without a nurse at the most senior level of management. Alongside the Mid Staffs report, it is very clear, clinical staff must take the lead in defending services from meaningless tick box systems or cuts that have no regard for our service users or primary purpose.
Electronic Rostering (MAPS)is coming your way......
Across the Trust In-patient wards are busy implimenting the e rostering system, this follows a lenthy consultation period and agreement with staffside that the system was of benefit to staff and the service. There are initial set up difficulties, on wards that have been using the system for a while it has clearly benefited the wider team, making the rota fairer and easier to manage.
The Trust have stated they want all Trust staff to move onto the system as it is a very effective attendance record. We have no objections to that but would want to see this universally accepted with no privilidged groups being excluded.
The Trust have stated they want all Trust staff to move onto the system as it is a very effective attendance record. We have no objections to that but would want to see this universally accepted with no privilidged groups being excluded.
27th January 2010 - Branch Officers/Stewards Meeting:
Key decisions:
Ratified nomination of John Lalor as a new steward based in the reception at the JHC.
In response to the tragedy in Haiti, the Branch has sent a donation of £250 to the TUC Haiti Appeal.
Service Group Executive(Health)
The Branch Officers/Stewards meeting also endorsed the nominations of Len Hockey (Whipps X Branch), Janet Maiden (UCH Branch) & Sandra Payne(our very own!) for election to the Service Group Executive. A postal ballot will follow in the next few months.
We have also nominated Sandra Payne for the vice-chair of the Greater London Regional Health Committee.
Discussion regarding the new Independent Sageguarding Authority was had, concern expressed that staff were being expected to fund this themselves - agreed to address this initially via the JSC
Sandra Payne was nominated and agreed is the Health Conference.
Discussion regarding the transfer of services and ancillary staff to 'White Oaks' concluded with a commitment to work with the new arrangement to ensure members their conditions of emplyment and had represenation rights from UNISON. Contact to be made with senior management at White Oaks.
A review of Branch IT equipment; agreed to upgrade Office and lapstop systems.
UNISON now requires all Branches to have local Branch Rules and Finance Rules, drafts of both were approved to be ratified at the Branch AGM on 8th February.
Key decisions:
Ratified nomination of John Lalor as a new steward based in the reception at the JHC.
In response to the tragedy in Haiti, the Branch has sent a donation of £250 to the TUC Haiti Appeal.
Service Group Executive(Health)
The Branch Officers/Stewards meeting also endorsed the nominations of Len Hockey (Whipps X Branch), Janet Maiden (UCH Branch) & Sandra Payne(our very own!) for election to the Service Group Executive. A postal ballot will follow in the next few months.
We have also nominated Sandra Payne for the vice-chair of the Greater London Regional Health Committee.
Discussion regarding the new Independent Sageguarding Authority was had, concern expressed that staff were being expected to fund this themselves - agreed to address this initially via the JSC
Sandra Payne was nominated and agreed is the Health Conference.
Discussion regarding the transfer of services and ancillary staff to 'White Oaks' concluded with a commitment to work with the new arrangement to ensure members their conditions of emplyment and had represenation rights from UNISON. Contact to be made with senior management at White Oaks.
A review of Branch IT equipment; agreed to upgrade Office and lapstop systems.
UNISON now requires all Branches to have local Branch Rules and Finance Rules, drafts of both were approved to be ratified at the Branch AGM on 8th February.
Bedal vs UNISON
Branch to buy new banner
At the Branch Officers/Stewards meeting is was agreed to purchase a new banner. The old East London Mental Health Banner has travelled the length of the country showing support to workers such as the Liverpool Dockers, Save Whipps X Hospital, the Sheila Foley/UNISON dispute in Manchester and all the big London Demonstations in support of the NHS. It's hoped the banner will be available for Defending the welfare state and public services rally on 12th April.
18.1.10
LONDON REGION UNISON MENTAL HEALTH BRANCHES MEET..
Today Mental Health Branch Representatives met at TUC Congress House to discuss and address common concerns and service development issues affecting members working in Mental Health.
Branches present were SLAM, Camden & islington, West London, East London, Barnet, Enfield and Haringay, St Georges and SW London.
The meeting was Chaired by Conroy Lawrence Chair of the UNISON Regional Health Committee.
There was a generic discussion covering a number of significant issues which are common to most Mental Health Services:
Violence towards staff and the increasing number of serious injuries being sustained. It was agreed we would be making a public statement encouraging staff to undertake appropriate training as well as challenging employers who are providing inadequate training. It was also noted of concern that significant numbers of staff are not in the NHS pension scheme which leaves them unprotected whilst working in very high risk jobs, this should be given additional priority at induction sessions.
Workforce planning issues and the lack of clarrity about the role of band 4 roles for non registered staff alongside the drop in the number of RMNs being trained.
A discussion about the reduction in CPN posts and role of STaR workers was also had and further clarrity is to be sought.
Given that the issues faced are common to many branches it was agreed to meet more frequently to share ideas,and best practice, invite specialist speakers as well as start communicating more regularly with members via newsletters and mailings
Branches present were SLAM, Camden & islington, West London, East London, Barnet, Enfield and Haringay, St Georges and SW London.
The meeting was Chaired by Conroy Lawrence Chair of the UNISON Regional Health Committee.
There was a generic discussion covering a number of significant issues which are common to most Mental Health Services:
Violence towards staff and the increasing number of serious injuries being sustained. It was agreed we would be making a public statement encouraging staff to undertake appropriate training as well as challenging employers who are providing inadequate training. It was also noted of concern that significant numbers of staff are not in the NHS pension scheme which leaves them unprotected whilst working in very high risk jobs, this should be given additional priority at induction sessions.
Workforce planning issues and the lack of clarrity about the role of band 4 roles for non registered staff alongside the drop in the number of RMNs being trained.
A discussion about the reduction in CPN posts and role of STaR workers was also had and further clarrity is to be sought.
Given that the issues faced are common to many branches it was agreed to meet more frequently to share ideas,and best practice, invite specialist speakers as well as start communicating more regularly with members via newsletters and mailings
NHS Neutron Bomb - John Lister outlines the scale of cuts being planned, see link below
| onthebrinkfinal.pdf |
Staff working in Hackney and at the JHC are to be badly affected by the lengthy closure of the overland line. The Trust and UNISON made representation to TFL but got very little sense that they understood the inconvienience caused by the works and wholly inadequate cover arrangements put in place.
2010/11 Agenda for Change PAY AWARD
The advance letter authorising the payment of the final years payment of a three year pay deal was isued on 21st February. As a result of tough national negotiations between the government and NHS unions our pay rates will rise by 2.25% on 1st April 2010. This is one of the biggest increases in the public sector. There will be additional monies for Band 1, 2 and 3 staff and for some pay points on Bands 5 & 6 making the total value of the uplift 2.5%. Band 1 staff will gain 3% from a £420 flat rate increase for Bands 1, 2 and 3. For full pay and conditions see attachment below.
| pay_circular_afc_2-2010.pdf |
UNISON defeats Monitors attempy to privatise FT Trusts in the High Court
Monitoring the regulator (18/12/09) UNISON has successfully applied for a judicial review against the independent regulator of foundation trusts, Monitor.
The application that the union brought before the court was against Monitor, which is directly accountable to Parliament and it has three objectives:
to assess NHS Trusts in order to decide whether they qualify for foundation trust status;
to provide a regulatory framework to ensure that NHS foundation trusts are well led and financially robust so as to deliver quality health care and value for money;
to support the development of foundation trusts.
The case that UNISON brought before the court for judicial review concerned the proper interpretation of Section 44 of the National Health Service Act 2006.
The issue the court had to consider was the extent to which NHS foundation trusts are able to provide goods and services for purposes other than those of the NHS. In effect, UNISON was challenging the method used by Monitor to calculate how much income foundation trusts could earn from private patients.
It has always been UNISON's case that private patient income was being used to undermine the provision of a public NHS.
It was accepted before the court that the legislation creating foundation trusts allowed them to treat private patients, but that the legislation also included a cap on how much income foundation trusts could earn from this type of work.
The cap was designed to ensure that private patients could not buy their way to the front of the queue at the expense of NHS patients, and that foundation trusts would retain their core focus of public service.
Monitor fiercely resisted the application brought by UNISON. The court delivered its review on 9 December 2009 – essentially finding that Monitor had been in breach of the legislation and that the guidance that it had provided to foundation trusts as to how to comply with the private patient income cap was erroneous.
The court commented that at the heart of the case was the point that "the central purpose of the cap is to ensure that the principal activity of NHS foundation trusts remains their core function of providing healthcare to NHS patients. The concept of income derived from private charges must be given an interpretation by reference to that statutory purpose."
The court highlighted the fact that Monitor had excluded from its calculations income "charges, in particular, for the provision of facilities, goods or services to the providers of private healthcare."
The court also provided other examples of what it deemed private patient income that was excluded from the calculation of the cap.
The court ultimately concluded by saying that "properly interpreted the concept of 'income derived from' means that any income from an intermediate structure, interposed to perform private work in this way, is caught by the cap ...
"Monitor's decision to adopt option 2 as to the application of the statutory cap on private patient income for NHS foundation trusts was wrong in law. Option 2 does not reflect the intention of Parliament, as expressed in the legislation."
This decision represents an important victory for UNISON and its defence of a public NHS. It is still to be seen whether Monitor take steps to appeal against the decision, but we await with interest their response.
As always, it is important to bear in mind that within any judicial review application comes significant dangers, and we must be careful to ensure that in any application for judicial review that both our case and the facts supporting it are strong.
(InFocus, January 2010)
The application that the union brought before the court was against Monitor, which is directly accountable to Parliament and it has three objectives:
to assess NHS Trusts in order to decide whether they qualify for foundation trust status;
to provide a regulatory framework to ensure that NHS foundation trusts are well led and financially robust so as to deliver quality health care and value for money;
to support the development of foundation trusts.
The case that UNISON brought before the court for judicial review concerned the proper interpretation of Section 44 of the National Health Service Act 2006.
The issue the court had to consider was the extent to which NHS foundation trusts are able to provide goods and services for purposes other than those of the NHS. In effect, UNISON was challenging the method used by Monitor to calculate how much income foundation trusts could earn from private patients.
It has always been UNISON's case that private patient income was being used to undermine the provision of a public NHS.
It was accepted before the court that the legislation creating foundation trusts allowed them to treat private patients, but that the legislation also included a cap on how much income foundation trusts could earn from this type of work.
The cap was designed to ensure that private patients could not buy their way to the front of the queue at the expense of NHS patients, and that foundation trusts would retain their core focus of public service.
Monitor fiercely resisted the application brought by UNISON. The court delivered its review on 9 December 2009 – essentially finding that Monitor had been in breach of the legislation and that the guidance that it had provided to foundation trusts as to how to comply with the private patient income cap was erroneous.
The court commented that at the heart of the case was the point that "the central purpose of the cap is to ensure that the principal activity of NHS foundation trusts remains their core function of providing healthcare to NHS patients. The concept of income derived from private charges must be given an interpretation by reference to that statutory purpose."
The court highlighted the fact that Monitor had excluded from its calculations income "charges, in particular, for the provision of facilities, goods or services to the providers of private healthcare."
The court also provided other examples of what it deemed private patient income that was excluded from the calculation of the cap.
The court ultimately concluded by saying that "properly interpreted the concept of 'income derived from' means that any income from an intermediate structure, interposed to perform private work in this way, is caught by the cap ...
"Monitor's decision to adopt option 2 as to the application of the statutory cap on private patient income for NHS foundation trusts was wrong in law. Option 2 does not reflect the intention of Parliament, as expressed in the legislation."
This decision represents an important victory for UNISON and its defence of a public NHS. It is still to be seen whether Monitor take steps to appeal against the decision, but we await with interest their response.
As always, it is important to bear in mind that within any judicial review application comes significant dangers, and we must be careful to ensure that in any application for judicial review that both our case and the facts supporting it are strong.
(InFocus, January 2010)
MEMBERS DIARIES 2010
MEMBERS DIARIES ARE NOW AVAILABLE AND BEING DISTRIBUTED, PLEASE CONTACT Sandra Payne if you have not recieved one.
Please note in 2011 we aim to send all diaries out to home addresses so it is important we have up to date records for you. If you are not recieving regular UNISON mail, please use link below to update your record.
Please note in 2011 we aim to send all diaries out to home addresses so it is important we have up to date records for you. If you are not recieving regular UNISON mail, please use link below to update your record.
15.10.09
ANNUAL HEALTH CHECK - CARE QUALITY COMMISSION REPORT
The Trust along with most inner London Mental Trusts had their ratings reduced from Excellent to Good for 'Use of resources' and 'Quality of services. Use the link below to get full details of the Trust rating.
Comments would be welcome via the comments page.
Comments would be welcome via the comments page.
Private health care dangers....
Stewards and Activists news...
Reminders:
An extraordinary meeting of Branch Officers only has been called for Thursday 25th Feb at East One at 2pm
The next Branch Officers/stewards meeting will be held on 24th March 2010. 09.00-11.00 ( Annual General Meeting)Meeting Room 2, 1st Floor East One
UNISON in LONDON
The latest edition of the newsletter for stewards and activists in London can be downloaded.
An extraordinary meeting of Branch Officers only has been called for Thursday 25th Feb at East One at 2pm
The next Branch Officers/stewards meeting will be held on 24th March 2010. 09.00-11.00 ( Annual General Meeting)Meeting Room 2, 1st Floor East One
UNISON in LONDON
The latest edition of the newsletter for stewards and activists in London can be downloaded.
| b4867.pdf.pdf |
FOUNDATION TRUST COUNCIL
The recent FT council meeting met to discuss the Trust 'Quality Accounts' and Care Quality Commission submission. The scale of the task was quite significant given the couple of hours allocated.
A later session focussed on the size of the council which primarily due to it being a 3 London Borough Trust has over 40 representatives, of that 40+ only 7 are staff members. The discussion about how or if we should reduce the size of the council was very dissjointed and fragmented with nothing clearly agreed.A proposal to break up the staff seats into constituences was rejected by all staff council members.
As Council members, the three UNISON members are clear that there should be no reduction in the number of staff representatives as we are already under represented and with the pending inclusion of Newham PCT we would want additional seats.
Baroness Meacher will present a more detailed paper at the next full FT Council Meeting.
A later session focussed on the size of the council which primarily due to it being a 3 London Borough Trust has over 40 representatives, of that 40+ only 7 are staff members. The discussion about how or if we should reduce the size of the council was very dissjointed and fragmented with nothing clearly agreed.A proposal to break up the staff seats into constituences was rejected by all staff council members.
As Council members, the three UNISON members are clear that there should be no reduction in the number of staff representatives as we are already under represented and with the pending inclusion of Newham PCT we would want additional seats.
Baroness Meacher will present a more detailed paper at the next full FT Council Meeting.
NHS injury benefit scheme review
The partnership review of the NHS Injury Benefit scheme has commenced. The review is being carried out in partnership between NHS Employers and NHS Trades Unions. The Department of Health, the Scottish Government and Northern Ireland are observers, with NHS Pensions and occupational health experts contributing to the review. The Review Partners are currently in the process of agreeing the terms of reference for the review.
The injury benefit discussions previously commenced as part of the NHS ill health retirement review, which was concluded in 2008.
The injury benefit discussions previously commenced as part of the NHS ill health retirement review, which was concluded in 2008.
Bank Staff required to undertake mandatory training unpaid!
The Trust is requiring Bank Staff to undertake mandatory training by attending unpaid sessions, some of which is 5 days long!
Any Bank staff who is a UNISON member should contact Sandra Payne as we believe this action is discriminatory and would recommend a course of action to challenge this.
Any Bank staff who is a UNISON member should contact Sandra Payne as we believe this action is discriminatory and would recommend a course of action to challenge this.
Older People Services
The Trust have initiated the early stages of the development of the long awaited MHCOP Directorate in appointing the Director: Michael McGee and Clinical Director: Dr O'Mahoney. Both have extensive experience of MHCOP services and a vision to improve these servcies.
UNISON looks forward to participating fully in encouraging and shaping this important service. Mental Health Care of Older Persons services is often overlooked and staff can feel marginalised, the new directorate recognises the uniqueness and speciality that it is. We support this development and look foward to hearing more details as the service moves forward. Further details of the service plans are being drawn up but its likely that consolditation and mergers of wards are probable and staff redeployed in order to fund the improved community based services.
UNISON looks forward to participating fully in encouraging and shaping this important service. Mental Health Care of Older Persons services is often overlooked and staff can feel marginalised, the new directorate recognises the uniqueness and speciality that it is. We support this development and look foward to hearing more details as the service moves forward. Further details of the service plans are being drawn up but its likely that consolditation and mergers of wards are probable and staff redeployed in order to fund the improved community based services.
Download the full NMC Code here
| nmc_code.aspx |
Surpluses or Cuts
Times are a changing and its now clear cuts are heading our way, we have asked the Trust to consult with us before making decisions and any announcments. If you are working in an area were cuts /savings/ surpluses being made are causing a deterioration in the service you provide, we want to know about it. Please use the comments page to tell us.
UNISON does not understand how in the 2 years since we have become a Foundation Trust we have had two difficult years with serious financial challenges. Applying for FT status was mean to prevent this annual saga of recovery planning. How has the Trust got itself into this position? March everything is fine then in April it all seems to be up in the air with no clarrity of purpose or clear budget setting agreed. We will be asking questions at the next JSC
A number of managers have complained to UNISON about the undue pressure being placed on them to reduce expenditure, stating that they feel bullied & harrassed, that patient welfare is not considered and they fear for their own professional careers. There have been changes to the nursing budgets which are illogical and we would argue these services are not funded appropriately.
Registered staff should be very aware of the NMC Code when drafting recovery plans in services that are underfunded.
The NMC code guidlines state:
If a nurse or midwife is asked to deliver care they consider unsafe or harmful to a person in their care, they should carefully consider their actions and raise their concerns to the appropriate person. Nurses and midwives must act in the best interest of the person in their care at all times.
The NMC Code states:
Manage risk
You must act without delay if you believe that you, a colleague or anyone else may be putting someone at risk
You must inform someone in authority if you experience problems that prevent you working within this Code or other nationally agreed standards
You must report your concerns in writing if problems in the environment of care are putting people at risk
If you feel that your service is unsafe or compromised by a lack of resources please contact UNISON for advice.
UNISON does not understand how in the 2 years since we have become a Foundation Trust we have had two difficult years with serious financial challenges. Applying for FT status was mean to prevent this annual saga of recovery planning. How has the Trust got itself into this position? March everything is fine then in April it all seems to be up in the air with no clarrity of purpose or clear budget setting agreed. We will be asking questions at the next JSC
A number of managers have complained to UNISON about the undue pressure being placed on them to reduce expenditure, stating that they feel bullied & harrassed, that patient welfare is not considered and they fear for their own professional careers. There have been changes to the nursing budgets which are illogical and we would argue these services are not funded appropriately.
Registered staff should be very aware of the NMC Code when drafting recovery plans in services that are underfunded.
The NMC code guidlines state:
If a nurse or midwife is asked to deliver care they consider unsafe or harmful to a person in their care, they should carefully consider their actions and raise their concerns to the appropriate person. Nurses and midwives must act in the best interest of the person in their care at all times.
The NMC Code states:
Manage risk
You must act without delay if you believe that you, a colleague or anyone else may be putting someone at risk
You must inform someone in authority if you experience problems that prevent you working within this Code or other nationally agreed standards
You must report your concerns in writing if problems in the environment of care are putting people at risk
If you feel that your service is unsafe or compromised by a lack of resources please contact UNISON for advice.
Trust cuts training funding..
10.11.09
To staff from managment
In order to increase compliance with statutory and mandatory training, a decision was made by Trust HQ to pilot training by means of DVD as opposed to face to face delivery – this will be piloted with 2 sessions each of General Manual Handling, Infection Control, and Annual Fire Training all on the same day (6 sessions in total).
Each DVD lasts about 35 minutes or so
UNISON has already written to the Trust formally complaining about the proposal to downgrade this important training, it is evidence of a very remote training team managing a tick box excercise that patronises staff and no doubt has a cost savings element.
Yet again the Trust have failed to even consider the implications and failed to consult with the staffside organisations regarding this fundamental change in Training delivery. How anybody thinks that watching 30 minute DVDs is a valid alternative to facillitated training is of concern and raises doubts about the true cause of this change.
Either the Trust does training properly or it can may as well ask staff to watch a you tube video on the subject if its ticking boxes that has become the priority.
The debate about the downgrading of mandatory training continues and was discussed at the Trust TED meeing, the Trust is under pressure to push through as many people as quickly as possible in order to satisfy performance targets, staff on the recieving end of this process are feeling overburdened and the evidence of the feedback could easily be interpreted as staff just want it over and done with. This may meet a number of short term agenda's but misses some fundamental points about the meaning of training. This is noted as a downaward turning point in the Trusts commitment to high quality training.
11.2.10
Having moved quickly from pilot to full roll out of the DVD training a number of staff have complained about the quality of the session, how generic it is and lack of feedback forms being provided. The issue of fire training for staff is of particular importance within in-patient services and being taught how to manage and respond to a fire on a ward has been lost, many of us are aware or have experienced of a number of serious fires on wards and the problems caused. The DVD fire training currently provided does not equip staff with either knowlege or skill. In the unfortunate event that an incident occurs we will be drawing our concerns the the Health & safety Excecutive.
Its clear this is now nothing less than a cost saving exercise and which satisfies external audit compliance but exposes staff and service users to higher risk due to its poor quality. UNISON will be monitoring how extreme it becomes and formally notfying the Trust that the training provided is inadequate.
In a further move to save costs the Trust have midway through the training programme being roled out to all staff regarding child protection training it has merged levels 1& 2 and condensed the original training into two or three hours. Again, the focus on ticking boxes rather than knowledge and skills based training.
10.11.09
To staff from managment
In order to increase compliance with statutory and mandatory training, a decision was made by Trust HQ to pilot training by means of DVD as opposed to face to face delivery – this will be piloted with 2 sessions each of General Manual Handling, Infection Control, and Annual Fire Training all on the same day (6 sessions in total).
Each DVD lasts about 35 minutes or so
UNISON has already written to the Trust formally complaining about the proposal to downgrade this important training, it is evidence of a very remote training team managing a tick box excercise that patronises staff and no doubt has a cost savings element.
Yet again the Trust have failed to even consider the implications and failed to consult with the staffside organisations regarding this fundamental change in Training delivery. How anybody thinks that watching 30 minute DVDs is a valid alternative to facillitated training is of concern and raises doubts about the true cause of this change.
Either the Trust does training properly or it can may as well ask staff to watch a you tube video on the subject if its ticking boxes that has become the priority.
The debate about the downgrading of mandatory training continues and was discussed at the Trust TED meeing, the Trust is under pressure to push through as many people as quickly as possible in order to satisfy performance targets, staff on the recieving end of this process are feeling overburdened and the evidence of the feedback could easily be interpreted as staff just want it over and done with. This may meet a number of short term agenda's but misses some fundamental points about the meaning of training. This is noted as a downaward turning point in the Trusts commitment to high quality training.
11.2.10
Having moved quickly from pilot to full roll out of the DVD training a number of staff have complained about the quality of the session, how generic it is and lack of feedback forms being provided. The issue of fire training for staff is of particular importance within in-patient services and being taught how to manage and respond to a fire on a ward has been lost, many of us are aware or have experienced of a number of serious fires on wards and the problems caused. The DVD fire training currently provided does not equip staff with either knowlege or skill. In the unfortunate event that an incident occurs we will be drawing our concerns the the Health & safety Excecutive.
Its clear this is now nothing less than a cost saving exercise and which satisfies external audit compliance but exposes staff and service users to higher risk due to its poor quality. UNISON will be monitoring how extreme it becomes and formally notfying the Trust that the training provided is inadequate.
In a further move to save costs the Trust have midway through the training programme being roled out to all staff regarding child protection training it has merged levels 1& 2 and condensed the original training into two or three hours. Again, the focus on ticking boxes rather than knowledge and skills based training.