Do you think the Government will now get rid of NHS enhanced payments (unsocial hours)?

[MaryKatherine]

I really hope this isn't true! I have read that the Government plans to cut all the enhanced payments for out of hours working in the NHS...as part of their 7 day working. Every shift will become flat rate.
I know that payments aren't as lucrative as they used to be but I am sure this will be the final nail in the coffin for a lot of NHS staff (especially, if like me, you have to pay childcare).
So worried now the Cons are in again for another 5 years.

[FromMeToYou]

Every shift flat rate? That doesn't sound good. Is it a real possibility or just another rumour?

[MaryKatherine]

They are looking at different options. One was flat rate for everything, another 10% for nightshifts and flat rate for other stuff. Hope not!

[FromMeToYou]

So what about the staff who only do nights, surely some of them will want to work days if there's not much pay difference? And others who don't do nights will be made to as they need the staff? The system works ok as it is, why change it?

[Hedgehogparty]

If these cuts go ahead,expect a further staff exodus from the NHS.

[PoppyBlossom]

It wouldn't surprise me. I wonder if it will also involve a media spin job to criticise the nhs staff who complain against such a change, start to fracture trust and allegiances within the nhs and the publics opinion.

[MissDemelzaCarne]

I don't doubt it for a moment but they'll provably change the legislation regarding public sector strike ballots first.

[prh47bridge]

I understand the feelings of those on the receiving end. At the same time I am aware that the mortality rate in hospitals is higher at weekends, in part because most hospitals run on a skeleton staff due to the higher cost of weekend staff. Not sure what the right answer is. The government could direct trusts to increase staffing at weekends but that would require additional funding or cuts elsewhere. Another option would be to abolish these payments but compensate staff by rolling a significant proportion (possibly all) of it into basic pay. That would take away the incentive to reduce staffing at weekends without increasing costs. For staff it would mean pay wouldn't depend on which shifts were rostered. No idea if this would work although I'm sure it wouldn't be popular with any staff who would end up with less pay as a result.

Note that I don't have any inside knowledge here.

[MaryKatherine]

It will hit staff in other NHS departments. Radiology, pathology...

Feeling very uneasy about this especially with recent events.

[VivaLeBeaver]

Yes, I can see it happening.

In our trust it is an e Rosta system. So there wouldn't be the problem of people refusing to do nights or weekends. What there would be though is a refusal to do extras at nights or weekends to cover sickness. I'm frequently asked to do extras and often do them at the minute, if it's a flat rate I won't bother.

Like has been previously stated its Dr cover not nurse or midwife cover which is less at weekends.

[rugbychick]

This been discussed for a long time, and isn't a new thing

[prh47bridge]

Nursing staffing is the same at weekends, it's medical cover that is diminished

I know. And the stuff I've seen in the press suggests this is aimed at consultants, doctors, etc. rather than nursing staff. But we won't know for sure until they announce their plans. There is nothing in their manifesto beyond ensuring that there is the same level of cover on weekends as there is on weekdays.

[stevemLS1]

Given that this year the contractual right to incremental progression was removed at a stroke from middle/senior level staff, nothing would surprise me.

[VivaLeBeaver]

God knows where they're going to get the extra staff from. In Obs and gynae there is one Reg, one sho in the hospital at weekends and a consultant on call.

If it's to be the same medical staffing levels then they'd that would mean approx 13 consultants in the hospital and similar amount of Registrars and SHOs. These are people who work 5 days a week so if they're not on call their two days off is at the weekend.

So either days off are staggered and people have them in the week which I work isnt feasible. We run on the minimum number of staff to ensure every list, every clinic, labour ward, etc is covered. So if less Drs in the week then theatre lists or clinics would have to be cut or moved. Do people want to come to clinic at the weekend?? It might suit some people but others might have problems with kids not been at school, etc. they won't get a choice to attend a weekend or weekday clinic as they're allocated a consultant and have to go to that consultants clinic. It would mean that a specific consultant would have to have their clinic on a different day every week to fairly rotate who has their clinic at a weekend.

Other option is more consultants, more junior Drs to ensure that its 13 of each level every day. Who pays for this uplift in staff? What happens to hospitals who are already struggling to recruit and relying on locums. What happens if there aren't enough Doctors in that deanery to cover every hospital?

[easterlywinds]

At our local hospital the surgical consultants have problems getting into theatre at the weekend because of a lack of support staff ie nursing staff, radiologists etc. the hospital is also running its beds at full capacity ie patients are being turned away frequently and operations cancelled because there are not enough beds. Its no good throwing money into 7-day staff and services if there's nowhere to put the patients.

[Hedgehogparty]

Discussing this at work, people are saying they will stop working nights and weekends. If it becomes compulsory, they will leave.

There's plenty of agency and private work around here, also a couple of them have said they will simply take early retirement.

[VivaLeBeaver]

Hedgehogparty, people said that at my hospital......we obv still get unsocial payments but people didn't used to volunteer for nights. Then it became e Rosta and compulsary. People said they'd leave and only one did.