P 23
Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon
Inquiry into the Priorities for the Health, Social Care and Sport Committee
Ymateb gan: UNSAIN
Response from: UNISON
1.1 UNISON Cymru/Wales is Wales’ largest public sector trade union. UNISON has 100,000 members working in public services across Wales. We welcome the opportunity to feed into the National Assembly Wales priorities for the Health, Social Care and Sport Committee.
1.2 We represent full-time and part-time staff who provide public services, although they may be employed in both the public and private sectors.
1.3 UNISON’s health service group welcomes members employed or contracted by the NHS in all four UK countries. Our members are from all non-medical occupational groups including: nurses and health care assistants; midwives; health visitors; administrative, finance and HR staff; ambulance staff including paramedics, technicians, control room and maintenance staff, therapy and healthcare science staff; estates and housekeeping staff; technicians and maintenance staff; commissioning staff; allied health professionals; scientific staff; healthcare managers.
1.4 This paper will outline issues UNISON has identified as being a priority. We will also respond to the Committee’s Forward Work Programme proposals.
2.1 Mental health is a long standing and complex health issue. One in four people will experience mental health problems at some stage in their life. Mental health is still surrounded by prejudice and stigma. UNISON believes that mental health should be given equal status with other health and community services.
2.2 Mental health problems are increasingly associated with workplace stress which in turn leads to a significant number of lost work days. Workers in the public sector are expected to meet a growing demand on services at a time of financial pressure. This is an inevitable cause of stress and anxiety. UNISON is aware of public sector workers who have experienced mental health issues as a direct consequence of workplace stress. In addition, many public sector workers are involved in the delivery of services that those with mental health problems access.
2.3 As a union, we are dedicated to supporting the welfare of our members and have launched a campaign to establish mental health champions in workplaces across Wales. Our mental health champions have completed training designed and run with the assistance of a mental health practitioner.
2.4 Mental health champions are not responsible for providing counseling but are working to raise the profile of mental illness and elicit a cultural change in workplaces. Champions are working to ensure that effective action is being taken against causes of workplace stress, and to ensure that employees suffering mental health problems are adequately supported by their employers.
2.5 The Health, Social Care and Sport Committee could consider the value of UNISON’s mental health champion campaign for wider use across workplaces in Wales.
2.6 In addition, the committee could consider UNISON’s proposal that the Welsh Government should appoint a Mental Health Minister. We believe a Mental Health Minister should have responsibility for improving access to mental health services, particularly for children and young people. A Minister could also focus on removing the stigma often associated with mental health.
3.1 UNISON supports the committee’s proposal to assess the progress of integration of health and social care. Our member’s experiences demonstrate that there is a lot of work yet to be done in this area.
3.2 UNISON believes that the integration of health and social care would be of benefit to everyone. We want to be fully involved in discussions for the future of the care sector.
3.3 It is important, however, to recognise there are distinct challenges faced by health and social care as separate entities, and that culturally there is a lot of work to undertake to ensure a true integration of the services.
3.4 Allowing the private sector a greater role in social care has not increased the quality and choice for all patients. It has created an unregulated sector where there is little incentive for employers to invest in training.
3.5 In addition, we believe there should be an end to the two-tier workforce that exists between health and social care workers, and that raising the generally inferior social care employment conditions should be a priority.
3.6 Care workers, including those whose work is informal, must be provided with professional support. Additionally, we seek formal registration of care workers paid for by the Welsh Government.
3.7 Many of these principles are outlined in UNISON’s Ethical Care Charter.[1] The over-riding objective behind the charter is to establish a minimum baseline for the safety, quality, and dignity of care by ensuring employment conditions which do not shortchange clients and ensure the recruitment and retention of a more stable workforce through more sustainable pay, conditions and training levels.
3.8 In order to achieve this, the focus needs to move away from profit-making in the care sector and realign with the publically delivered ethos of the Welsh NHS and so local authorities should directly deliver care services
3.9 An Ethical Care Charter could be implemented across NHS Wales and the care sector. The implementation of this charter would allow for greater parity between the workforce in health and social care.
3.10 Furthermore, in order to progress the integration agenda benchmarking needs to occur and areas of good practice need to be identified. This needs greater direction at governmental level.
4.1 Whilst UNISON supports the committee’s plan to consider Ambulance Services, we also believe emergency care in its’ entirety should form a part of the Forward Work Programme.
4.2 There is rising demand on emergency care, including 999 and emergency departments. We believe that the committee could consider the Welsh Government’s approach to educating people about the misuse of emergency services, or the alternative services that are available. Anecdotal evidence suggests that GP practices and nursing homes are amongst are amongst those who use emergency services inappropriately.
4.3 The Choose Well campaign has been given very limited funding and we are concerned at the ability to produce an effective, far-reaching campaign with such limited resource.
4.4 Furthermore, it is our view that the committee should keep a watching brief on the 111 services about to be launched in ABM Health Board.
5.1 UNISON agrees the committee should continue the work of the previous committee and examine the outcomes of the new clinical response model.
5.2 UNISON campaigned for the new model, although we have been made aware of concerns in rural areas such as Ceredigion and some parts of Powys where the eight minute clock for serious, life threatening red calls is being stopped by volunteer community first responders with ambulance resources sometimes 20 minutes behind.
5.3 Community first responders are clearly essential for effective working in rural areas especially around stroke, cardiac arrest and other life threatening conditions. However, the role of the community first responder is to stabilise patients in those early minutes and not to effectively nurse the patient for a 30-40 minute period before an ambulance arrives.
5.4 Ambulance workers are experiencing waits outside of Emergency Departments. This clearly has impacts on patients, but also on staff who over-run their shifts staying with patients. The new agreement to allow fresh crews to take over from those at the end of shifts only works where there is available resource – this is a particular issue in rural areas.
6.1UNISON Cymru/Wales welcomes the opportunity to feed into the priorities for the Health, Social Care and Sport Committee.
6.2 We understand this consultation exercise is to set the future work for the committee and we would welcome the opportunity to feed in further detail and evidence to inquiries relevant to UNISON members and public services.
[1] UNISON’s Ethical Care Charter is available online: https://www.unison.org.uk/content/uploads/2013/11/On-line-Catalogue220142.pdf