Betsi Cadwaladr University Health Board intends to press ahead with “hugely contentious” plans to scrap paid breaks for nurses.
The health board, which provides primary, community, mental health and acute services for a population of around 678,000 people, is standardising its nurse shifts, handover periods and break durations.
It has noted that, at present, there are 100 different shift patterns in operation across the Health Board and a variance in unpaid breaks from no unpaid break to one hour 15 minutes.
The changes are aimed at standardising shift patterns, handover durations and breaks, as well as introducing a consistent system across the Health Board for the first time, which will reduce reliance on agency nursing staff and deliver £527,000 of savings, according to the Health Board.
These changes will take effect as of January 2020 and the roster period will be extended to 12 weeks from the current four weeks to enable greater forward planning and to extend the period in which contracted hours must be worked.
From January, all nurses will have an hour unpaid break if they are working a 12.5-hour shift and a half an hour unpaid break if they are working a six- or eight-hour shift.
They will have 30 minutes for handovers.
However, health bosses have admitted that the changes will mean staff would have to work the “occasional” extra shift to meet their contracted hours as a result of the unpaid breaks.
Loss of morale among staff was acknowledged in the documents as a risk to the implementation of the plans along with increased turnover and reputational damage for the organisation.
Following a staff consultation on the plans it noted that “many” had made it known that they believed the proposals “lack compassion, will be detrimental to their work/life balance, welfare and that the proposal is not in line with BCUHB values”.
The plans have also been criticised by the union Unite Wales and Plaid Cymru, who both submitted petitions opposing the changes signed by 3,500 people each.
Peter Hughes, regional secretary for Unite Wales, said he was “deeply disappointed” with the board’s decision to go ahead with the changes, which he described as “draconian and wholly unacceptable”.
“This flies in the face of the overwhelming opposition of both the board’s own employees and the wider public,” he added.
“Their actions show that the health board has absolutely no intention of engaging in any meaningful consultation process with Unite over this hugely contentious issue.
“We remain deeply opposed to the roster changes which are a fundamental attack on the terms and conditions of our members.”
He added that Unite would “redouble its efforts and pursue every avenue available to us” to force the board to drop the plans.
Meanwhile, Llyr Gruffydd, Plaid Cymru’s North Wales assembly member, said nurses were already working through their breaks and taking on extra hours due to nurse shortages at the board.
He noted that the situation was at risk of getting work because “many nurses” had pledged to quit, retire or take sick leave if the new roster scheme was introduced.
“Plaid Cymru and the unions have fought this tooth and nail and the battle is not over yet,” warned Mr Gruffydd.
Mr Gruffydd said he had contacted health minister Vaughan Gething to ask him to intervene and squash the plans. “He has the power to overturn this,” he added.
The board claimed it had listened to the concerns raised through the consultation and would be introducing measures to try and address them.
For example, the roster period in which contracted hours must be worked will be extended to 12 weeks from the current four weeks to allow for greater forward planning and flexibility for staff who are forced to work extra shifts.
The health board also pledged to launch a new monitoring system overseen by matrons to ensure breaks are taken.
If a nurse is unable to take their break in their allocated slot, the time will either be given back in another shift or will be deducted from any time they owe the board.
If their break is interrupted by an emergency, the remainder of the break will be provided later in the same shift.
While paid breaks will be eliminated as a standard rule, the board recognised that there may be some exceptions.
“For example, community hospitals staff have said that where RN levels are one or two on shift at night, breaks may not or cannot be taken,” said the board paper.
“Should the full one-hour break not be utilised due to patient care and safety, the time owing to the RN can be owed back to the RN within the roster period or paid.”
A spokesman for Betsi Cadwaladr University said: “The changes to nursing rotas are intended to protect the health and safety of nursing staff and to ensure that they are deployed in the most effective way.
“Making sure we have sufficient numbers of appropriately qualified staff to match the demands of our services will help to further improve safety and consistency of care.”
The two petitions led by Unite Wales and Plaid Cymru were submitted to the board after it had issued its response to the consultation.
In the board papers, it said the petitions would be “formally noted” at the health board meeting on 7 November 2019.
A statement from BCUHB said: “We recognise the concerns raised by some colleagues who will be affected by the nursing rota changes and will continue to work with staff groups and trade unions to ensure their smooth implementation.”
The full consultation is available here: https://bcuhb.nhs.wales/news/updates-and-developments/updates/roster-optimisation-consultation/
