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There is “no central collation” of data on Covid-19 staff derogations during the pandemic in either acute or community sites, according to the HSE.
“This was a local issue and was managed by local managers,” a spokesperson informed the Medical Independent (MI).
The HSE’s derogations policy permits healthcare workers to be brought back to work while restricting their movements (eg, as a close contact) if certain criteria are met. The healthcare worker must be “essential to critical service needs”.
However, healthcare unions have said the policy was misused.
In October 2020, Director of Industrial Relations at the Irish Nurses and Midwives Organisation, Mr Tony Fitzpatrick, told MI local managers had been “derogating left, right, and centre” due to staffing deficits.
At the time, Dr Lynda Sisson, Clinical Lead of the HSE Workplace Health and Wellbeing Unit, told MI the data was not collected and examined at national level, but efforts were being made to address this.
According to an email obtained under Freedom of Information law, on 11 January 2021 Dr Sisson requested National Director of Community Operations Ms Yvonne O’Neill to “confirm that there is a process in place to monitor the number and type of derogations in the community”.
Ms O’Neill responded that she would “ensure that there is a reporting process put in place for cases of derogation”.
The derogations policy was most recently revised on 12 March 2021. It specified derogation cannot be applied to healthcare workers “who are self-isolating following travel from a country with a Covid-19 ‘variant of concern’” or identified as close contacts of confirmed/suspected cases of a variant of concern.
In terms of being a close contact of a suspected or confirmed Covid-19 case in their home (household contacts), healthcare workers can only be derogated in “very exceptional circumstances”.
Approval for these derogations must be received from the Office of the National Director of Acute Operations or the Office of the National Director of Community Operations, outlined the policy. All derogated healthcare workers must have a negative test immediately prior to returning to the workplace, according to the policy.
In regard to vaccination, the policy stated: “Healthcare workers who are close contacts and have completed the full
Covid-19 vaccination course and the vaccine-specific time period to achieve full immunity (as per the licensed indications) can be considered for derogation from restricted movements, in preference over other healthcare workers.”
“Currently, this is limited to those vaccinated within the two months from when vaccine immunity is reached, given the current maximum follow-up data for the licensed vaccines.”