The Medical Council has communicated its concern to the national NCHD taskforce about the level of implementation of the ‘transfer of tasks’ from NCHDs to nurses/midwives, which was due for completion in 2016.
The issue was raised at meetings of the Council’s education and training committee (ETC) during 2023, according to minutes obtained under Freedom of Information law.
At a meeting in March 2023, the ETC noted “the ongoing issue with ‘transfer of tasks’” and the “HSE change in wording to ‘sharing of tasks’”, which it had discussed in January. The meeting heard that the Council’s executive had written to the national NCHD taskforce on the matter and would “continue to advocate for trainees”.
At a meeting in May 2023, during a discussion on intern training, the ETC was informed of a response received from the Chair of the national NCHD taskforce Prof Anthony O’Regan. According to the minutes, Prof O’Regan advised that he did not have authority “to direct the national task transfer programme implementation” and that this was a matter for the HSE and Department of Health (DoH). He outlined that Ms Rachel Kenna, Chief Nursing Officer, DoH, would engage with the Medical Council and HSE.
The meeting heard there was a “need to gather data from all sites” and a survey would be conducted by the DoH before the July 2023 changeover, according to the minutes.
In February 2016, a HSE circular communicated the approval by the then Minister for Health Leo Varadkar for the “transfer of tasks” under the Haddington Road Agreement. The following tasks would transfer from medical to nursing/midwifery staff: IV cannulation; phlebotomy; first-dose IV drug administration; and nurse-led delegated discharge. These tasks remained the responsibility of each qualified and trained healthcare professional, and no individual or group was excluded from this responsibility, according to the circular.
The circular stated that the IMO, SIPTU Nursing, and the Irish Nurses and Midwives Organisation (INMO) would ensure the full cooperation of their members with the transfer, “where appropriate training is provided and adequate staffing levels are in place.” The agreement was linked to the re-instatement of an allowance to nurses/midwives for hours worked between 6pm-8pm.
When asked by the Medical Independent (MI) if it held any data on implementation, a HSE spokesperson said: “We are currently awaiting confirmation on whether this data is held, in the meantime the independent Chair signed off on the completion of task sharing and this was accepted by the joint union management implementation group.”
The “provision for re-involvement of the independent Chair process remains available to the parties if so desired”, stated the HSE spokesperson.
An INMO spokesperson told MI that “as per an independent review of these tasks, all areas committed to have been complied with”. They added the INMO has seen “barriers placed to implementing nurse-led discharge” and it “continues to advocate for individual hospitals to develop and implement a nurse-led discharge policy”.
No comment was received from the DoH at press time. The final report of the national NCHD taskforce is due to be published shortly.