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Letterkenny requires 30 extra NCHDs to implement IMO agreement Archive.php

Letterkenny University Hospital (LUH) requires approximately 30 extra NCHDs to implement the IMO/health management NCHD agreement reached in late 2022.

Since October, non-training NCHD posts are subject to the HSE recruitment embargo.

A spokesperson for Saolta University Health Care Group said the terms of the NCHD national agreement are being progressed at LUH. The hospital is also “working proactively” to implement the recommendations of the NCHD taskforce and the Model 3 Hospitals Report.

LUH has been chosen as the pilot site for the Model 3 Hospital Project, which will involve a “significant focus” on recruitment and retention of medical staff.

On 24 July 2023, a meeting of the LUH executive board heard that a “minimum of an additional 30 NCHDs” would be required to comply with the 2022 NCHD agreement, according to minutes obtained under Freedom of Information law.

Saolta’s spokesperson commented: “LUH, similar to all other hospitals nationally, have identified areas where expansion is needed in order to meet the recommendations without impacting on patient care or service activity. This list, which amounted to an additional 30 NCHDs, requires national approval.

“LUH has reviewed the NCHD rosters in all departments in line with the recommendations of the IMO/HSE DOH agreement.

“The hospital is working towards the full implementation of all recommendations and has fully implemented new measures to deal with emergency tax and expenses related to relocation for trainees. Entitlements around leave for mandatory exams and minimum guaranteed entitlement for each six months are also complete.”

In terms of the NCHD taskforce report, LUH has “undertaken steps to enhance the physical environment, health and wellbeing, education and training and ICT for our NCHD colleagues”.

Meanwhile, Saolta is engaging with postgraduate colleges to support NCHD specialist training in LUH. The hospital has recently been approved for core specialist training in emergency medicine and higher specialist training in obstetrics and gynaecology. 

NCHDs still pressurised to fill rota gaps on days off Archive.php

Most NCHDs continue to be pressurised to fill rota gaps on their rostered days off, heard the NCHD meeting at the IMO AGM on 6 April.

NCHD committee Chair, Dr Rachel McNamara, presented findings of an IMO survey of NCHDs on workplace issues. Some 77 per cent reported being pressurised to work additional shifts in lieu of a locum being found.

“This is something we have seen consistently,” stated Dr McNamara at the meeting in Killarney. “We have seen evidence of [NCHDs] being directly messaged on their days off and very much pressurised – that is how it feels to be told, look, if you don’t come in, your co-SHO or intern colleague will be left to do more work, or they will have to stay on potentially overnight.

“This is very much unacceptable in that there is no other profession, I would think or hope, that would see that level of being pressurised to come into work when you had not been rostered.”

Dr McNamara said the onus contractually is on the clinical director or employer to determine if there is a requirement for a locum and to make the necessary arrangements.

The IMO’s survey also found that 83 per cent of NCHDs reported having to routinely work, on average, over 48 hours per week in the previous three-month period. Dr McNamara said this practice breached the Organisation of Working Time Act and NCHD contractual rights.

Twenty-two per cent of NCHDs reported working more than two 24-hour shifts in a two-week period. Dr McNamara said this figure was somewhat more reassuring, although she added that not all specialties have 24-hour shifts in place.

The 2022 NCHD agreement, which introduced new rostering rules into the NCHD contract, requires that no NCHDs should have to work more than two 24-hour shifts in a two-week period (it allows for a third shift in exceptional circumstances).

The NCHD meeting passed a motion calling on the HSE to immediately rescind the recruitment freeze on NCHD non-training posts to ensure “the integrity” of the 2022 agreement is upheld.

It also called on the Minister for Health Stephen Donnelly and HSE to publish a fully funded implementation plan for the NCHD taskforce recommendations and to engage with the IMO on same.

At the conference, Minister Donnelly said a meeting with the IMO is scheduled in the coming weeks. He said he has asked officials to use this meeting to “work through an engagement process” on a new NCHD contract.

He told IMO delegates he fully endorsed the recommendations in the final report of the NCHD taskforce, published in February, “and we’re getting on with implementing them”.

Speaking to journalists, Minister Donnelly said consultant numbers had grown by 1,000 in the lifetime of the Government. He said as the consultant body grows the “unreasonable asks” of NCHDs, including 24-hour shifts, would decline.

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The Medical Independent 11th June 2024

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