UNISON Cymru/Wales response: Inquiry into winter preparedness 2016/17

Introduction

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 inquiry into winter preparedness 2016/17.

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

Access to Services

2.1 Improved access to GP and dental surgeries outside of ‘normal’ working hours would take pressure off emergency services. People are reluctant to use out-of-hours services as these are often not easily accessible and patients frequently turn up at Emergency Departments.

2.2 GP services should be available 24/7 in Emergency Departments to allow for the patient to be directed immediately to a GP rather than taking the time of an emergency doctor.

2.3 This could work in conjunction with the proposed 111 services.

Choose Well

3.1 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 those who use emergency services inappropriately.

3.2 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.

3.3 An effective campaign could alleviate the pressures on services during the Winter period.

Ambulance

4.1 UNISON has received reports from our ambulance staff members that they are already seeing waits outside emergency departments.

4.2 This has a negative impact on both patients and on the staff who overrun their shifts to continue care for patients.

4.3 The agreement that allows fresh crews to take over and relieve crews at the end of their shifts is a positive measure; however this only works where resources are available. We have reports that this is a particular issue in rural areas where shifts regularly continue to overrun. There are health, wellbeing and family implications for the workforce in this scenario.

Handover to Emergency Departments

5.1 Historically, it was not uncommon for altercations to occur between ambulance and emergency staff due to the high pressured environment and pressures being faced by both parties.

5.2 Local Health Boards and Welsh Ambulance Services need to be working seamlessly and in partnership. Improvements have been made since the establishment of the Ambulance Services Special Committee, but increasing pressures on in the run up to and during Winter could undo some of this good work.

5.3 Ultimately, Welsh Ambulance and Local Health Board staff work tirelessly to provide high quality and efficient health services. Decent organisation and effective resources must be in place to allow this to happen.

Staff Absence

6.1 Whilst staff absence is obviously unplanned, it can often be predictable in nature when there are episodes of contagious illnesses.

6.2 Contingency plans must be in place to overcome the challenge of staff absence as a part of the Winter preparedness strategy.

6.3 The workforce should be protected from infectious illnesses where possible through available vaccines in order to minimise absence.

Conclusion

7.1 UNISON Cymru/Wales welcomes the opportunity to feed into this inquiry on Winter preparedness.

7.2 The ultimate aim of the Winter Preparedness plans should be to ensure that patients are provided with the right care, at the right place, by the right person, at the right time. By delivering this effectively, the heightened Winter demand on services will be more manageable.

7.3 UNISON would welcome the opportunity to further input into this inquiry as appropriate.