The interim report of the national taskforce on the NCHD workforce has put forward 42 recommendations to improve the working lives and environment for NCHDs.
The interim recommendations to be implemented immediately are around seven priority themes and include recommendations on induction and onboarding, infrastructure, medical manpower support, medical workforce, work-life balance, and governance.
The first category in the report, which was published today (13 April), relates to NCHD induction and onboarding.
It sets out specific standards for NCHDs’ first day of induction, starting from the next rotation in July 2023.
This is part of a broader piece of taskforce work looking at pre-employment requirements, as well as additional induction issues to be completed within the first month of a new NCHD post.
“All NCHDs must receive timely specific induction to equip them for work on the clinical
site,” according to the first of four recommendations in this category.
“This must be mandatory, delivered in protected time (four hours required for induction) within the first two working days, and be complete in a single session.”
The next category relates to induction for international medical graduates (IMGs).
The taskforce recommends that all IMGs “require enhanced and protected induction, bespoke to working in the Irish health service.
In relation to the working environment and supporting infrastructure for NCHDs, the taskforce has developed a ‘Good Standards’ document.
It states all NCHDs on extended or overnight shifts should have access to a private space for rest.
Two recommendations under the working environment category state: “For NCHDs on shifts of < 12 hours duration, the configuration of rest space should be agreed with local NCHDs. This group should be supported by a professional design consultant to create spaces that provide for private rest. Appropriate persons on each site should be allocated by the CEO and have responsibility for coordinating input.”
“For those on overnight shifts > 12 hours duration, rest space must include the provision of a bedroom. Bedrooms should include a comfortable single bed with blackout blinds on windows. Rooms should be equipped with a hospital PC, telephone, and heating.”
Another recommendation within the working environment category is that NCHDs must have access to healthy food 24/7.
“Food provided should be considerate of the dietary and cultural requirements of NCHDs,” according to the document.
The category also contains recommendations in relation to NCHDs with disabilities and ICT supports.
The next category relates to medical manpower (MMP).
The document notes there is a lack of a standardised training programme for MMP staff employed or commencing employment and this lack of training can often translates into a lack of consistency in how NCHDs are treated when they rotate across different sites.
It calls for a dedicated and accessible NCHD/MMP liaison support role to be identified for July 2023 on each site.
The development of a bespoke training for MMP staff to ensure consistency of NCHD experience across all sites in employment and related matters is another recommendation under this category.
Under the workforce configuration category, it is recommended that annualised targets be put in place for the increase of consultant and NCHD trainees.
This should include an increase in the number of training NCHD posts “in line with workforce planning projections to 5,800-6,000 training NCHDs”.
The next category concerns senior administrative leads for NCHD standards and support.
”Each Regional Health Area/Hospital Group requires an administrative lead to be accountable for the implementation of NCHD standards for education and training programmes, including Taskforce recommendations,” according to recommendation 40 of the document, which comes under this category.
“The post must be at an appropriate senior level to carry authority to drive change across the group.”
The final category of the document is for work-life balance and wellbeing/welfare and culture and it contains two recommendations.
The first is for the development of a HSE occupational health specialist support hub for NCHDs.
The second is for consideration of a ‘time and motion study’ to gather an evidence-base on the current roles and tasks of NCHDs such that remedial actions can be considered to support the NCHD workforce.
The taskforce was established by the Minister for Health in September 2022. The purpose is to put in place sustainable workforce planning strategies and policies to address and improve NCHD experience, in support of present and future retention of NCHDs in Ireland.
The second and final phase of the taskforce will develop medium to longer term recommendations by the end of October 2023.
Welcoming the interim report, Minister for Health Stephen Donnelly said: “I recognise that significant change is required to ensure that we improve the NCHD experience and work-life balance through the development and implementation of improved NCHD structures and supports in hospital sites. NCHDs are a critical part of our workforce and need to be supported to ensure they are retained in our health service. I commend the work of the taskforce members and I look forward to engaging and supporting them in the next phase of their work.”
The Minister has written to the HSE Chief Executive Officer to ensure that the recommendations are prioritised and implemented in full.