NHS - My pot of goodwill is running low

[OutingIfYouKnowMe]

I’m pretty sure none of my colleagues are on Mumsnet, but if you are able to identify me please be discreet.
I’m not going to say anything I shouldn’t, it’s just a whiny rant really.
If you really know where I work feel free to pop up to the office and hear me moan in person.

I work with a small team in an area not dissimilar to a specialist theatre, within a large department, it’s a Monday to Friday 9-5 service, but there is an unofficial out of hours on call system to provide cover for emergencies, which works entirely on our goodwill and commitment.

The way it works is on “availability”.
This is not an official on call rota, we are not contracted or paid to be on call although we are paid overtime if we are called in.
Someone gets called in on average about two times a month, sometimes, like buses there will be three in quick succession and then a quiet spell.
There is a list of us all - when a doctor needs someone to come in they call the first person on the list, and if the first person doesn’t pick up or is unavailable then the doctor will have to call the next person and so on, working their way down the list. When someone has been called in, they go to the bottom of the list, and the next person rises to the top and stays there until they are called in - sometimes a person is at the top of the list for weeks, and if someone else comes in because the first person was not available, then they go to the bottom and the first person remains at the top. As a colleague is wont to say, there has never been an occasion when no one was available so it works, in its way.

Sometimes if the doctors have had a struggle to get hold of someone then the topic of an official on call rota pops up. I don’t blame them, they find ringing around stressful and annoying, they just want one number they can ring and tell that one person to come in.
So it rumbles on from time to time without any conclusion, it is rearing its head again now.

The problem is numbers.

When I started in the department there were seven of us on the list so it would be quite a long time before having a spell in number one slot.
Then people left for various reasons and for about a year there were just four of us on the list which meant one felt the weight of responsibility to be available more, obviously annual leave and /or sickness reduced the available pool even more. Now there are five, with a sixth who should be trained up sufficiently to join the list soon.

I have worked an on call rota before in another job - from memory there were six of us and we did about one night a week and one weekend a month, and I never found it onerous.
We were all full time and unless someone was off sick and extra cover was needed it was not a problem.
We were never on call before days off or during days off.

The problem we currently have is some of my colleagues are part time.
Good on them, they often cheerfully come in in the middle of the night when they are on their days off.
But as soon as the matter of an official rota comes up they insist they must only be on call on a pro-rata basis, which is fair enough.
Except that means that those of us who are full time would have to do full time pro-rata PLUS the additional on calls that aren’t covered by those who don’t do a full share.
Then there is the matter that one team member (not the one being trained up) is not competent to cover on call.
Don’t get me started on that as I could fill a thread, but its best I say no more, believe me I have griped about it ever since the situation arose.

A pro-rata on call divided between 5 or six of us would see the full time members doing far more than one night a week and one weekend a month and I'm definitely not going to spend half my life being On call.

Meanwhile, back to our unofficial "availability". Guess who's top of the list as we head into Christmas...
I’m not overflowing with the spirit of Christmas good will at present. One colleague is going away, fair enough.
Another is working agency on the day, to earn top rate money.
So that leaves three of us on the list with me at the top, expected to be available to drop everything and head in to work.
Do I want to spend all of Christmas sipping water and wondering if I will have to abandon the cooking, leave everyone to get on with the meal and I'll warm mine up later?
No I bloody well don’t.

But I will feel guilty if I don’t pick up my phone and it falls on one or other of my other two colleagues.

I’m just so over it.

Thanks for the replies, it's interesting to see how this is managed elsewhere, especially part time staff being expected to do as many on calls as the full time. I see two sides to that, both unfair. I feel strongly that part time staff should be entirely free to spend their non contracted time as they please. So for someone who worlks Monday, Tuesday, Friday they should be free to care for grandchildren, have a second job, take a short break holiday, whatever, walk out Tuesday evening and not back til Friday morning. But on the other hand we don't have enough staff to allow some to do less and the full time staff shouldn't have to make up the shortfall as the amount of on call we'd have to do to cover it would be ridiculous. Split evenly between six it shouldn't be too onerous, it shouldn't be much more than one night a week and one weekend a month which is acceptable to me.
A couple of the younger staff often work bank shifts at the weekends to top up money. It's their days off. They are entitled to do as they please on their days off. But it does mean they aren't available...

You don't have to take yourself out of normal life for weeks on end when you are at the top of the list - it is availability so you can be unavailable and the next person is called. Mostly it's not a problem, I don't have a wild social life, but it bites at Christmas time because you feel bad for your colleagues if you are not available.

I would much prefer a formal on call, but i can't really resolve the pro-rata v even split dilemma and this is why there isn't a formal on all because no one will agree. I'm hoping to go part time next year, and definitely won't be available on non rostered days.

It's not really possible to use agency as what we do is quite specialist and you need to know where all the equipment is etc.

@Port1aCastis

If you are not formally on call and no-one is then no-one is obliged to be ready/not drink including you.

As a patient If the role is critical for patient safety to allow vital treatment I don’t want a chance of no one available so there needs to be a formal rota. I presume there is a standard way that call rotas are worked out if there are part timers national or Trust level.

@OutingIfYouKnowMe

it's interesting to see how this is managed elsewhere, especially part time staff being expected to do as many on calls as the full time. I see two sides to that, both unfair. I feel strongly that part time staff should be entirely free to spend their non contracted time as they please

FWIW ( and for I only offer this as a comparison from completely different industry) in our contract, both former and current, the part timers cannot be touched for work when on part time days off, either for rostered standby or by simply being contacted whilst on days/time off and told they had to come into work to cover a shortfall.

It was in part the increase in the percentage of people going part time over the years that loaded up those remaining as full timers with an increasing exposure to on call commitments (sound similar has happened in your case) that led to pressure on the Union to negotiate a major change in contracts and T&Cs.

"it shouldn't be much more than one night a week and one weekend a month which is acceptable to me."

For free? that shouldn't be acceptable to you. That's masses of money you're giving up each year.

Agenda for change has very clear on call payments. You should have a look and insist it's done properly and fairly

That sounds like a really difficult way to manage it as whilst you're not 'on call' you're kinda always on call given you might be contacted if someone else higher up is unavailable! Lot of trust involved too as what if your colleagues don't pick up much?
No solutions but sympathy. Good luck for Xmas and finding a resolution for the new year.

You should never have agreed to any of this in the first place & neither should your management.

Because what happens to the emergency when the unit can't get hold of anyone?

Why is the Doctor wasting time on the phone?

Its sounds a total F up.

Hmm I think you work in IR or endoscopy…
It’s totally u reasonably for them to do this. You have NO duty to be sober or available over Christmas. You are not paid an availability supplement - just given the opportunity to earn extra overtime.

I would do as you normally would and don’t pick up the phone if you have had a drink or don’t want to attend.

I don't know what the oncall rate is but we'd be paid to be on call if we had an official rota. As it is we aren't paid to be nice and keen and helpful but we do get paid overtime when we come in.

Thanks @notimagain That's useful to know for comparison.

I stopped at the 9-5 Mon to Fri…presumably you don’t work bank holiday either. Are you working in a private hospital? This was the way it worked at a private hospital I worked at. You work these hours to suit your situation, the team occasionally have an on call service which you don’t want to do over Christmas which is your choice, sorry I think are being unreasonable as you have allowed this situation to happen, and now that you might be called you don’t like it. Look for another job.

Well dare I say there is someone who lives close to the hospital, doesn't drink and likes to be indispensable.
Though even that person has commitments at times.
But it's been going on for years, long before my time, and there has always been someone available.
There's always a first though I suppose.

Except that means that those of us who are full time would have to do full time pro-rata PLUS the additional on calls that aren’t covered by those who don’t do a full share.
Except they would be doing their full share if they're part-time. You're being unfair on your part-time colleagues. And it's not hard to work out a rota that allows for FT and PT staff.

A & B are FT, C & D are PT.
Rota: ABCABDABCADB, etc.

Private hospital maybe

NHS, no we don't work bank holidays. Four days means there's bound to be a call out. I'm hopeful it will be tomorrow then I'll have done my bit and forget about it

Call your union and raise a grievance

Eh? Poor old A&B seem to be doing a lot.

I am not being unfair to part timers - I have already said, I don't believe they should be on call on their non rostered days and it should be pro-rata. But that would leave a shortfall compared to how it would be split if it was a straight I/6 for all, dividing it six ways between six staff.

I’ve seen the kind of thing you mention in a private hospital as they are too tight to pay for someone to be on call, but not in an NHS one, that’s a ridiculous situation tbh. It’s too late in the day to change it now but seriously you all need to have a meeting with management regarding this and changes need to be made.

My DH’s work has a rota’d on call system but if someone goes off sick they go to the ‘hit list’ and whoever is at the top gets contacted first. If for some reason they can’t do it (childcare, out, whatever) then it goes to the next person. They then go to the bottom of the list after the on call. It also means some staff volunteer for on calls to get back to the bottom of the list.

They get paid for being on call but it’s not much.

This is crackers. Some people can remove themselves because they are doing other work but you can't because you want to do something sociable?

You are all enabling management not to put a proper system in place. It shouldn't be up to you to all argue over it. What @Catsonskis said makes complete sense and if gaps can't be filled by agency due to lack of specialist knowledge, then management need to sort it out.

I'm guessing a formal on call system would be a significant change in your contract.

If any of your colleagues are a single parent for example could it be that while they use childcare to work they can't cover childcare for a low paid on call system? Would it then become a redundancy situation? Obviously in the current system they can decline to come in but in the new formal system they would have to be available for their on call shifts.

Rota wise I would hate to be available for random days and would rather do a week of on call and then have several weeks off.

If the on call becomes paid could people who don't want to do it hand it over to people who are happy to do it for the money?

This is crazy. I work in the NHS and have an official on call rota. That doesn’t mean I get called in every time. But the fact that I am ‘available’ to be called in, (so cannot drink alcohol, go too far away from my house, have to keep my work phone switched on in case someone calls) means that I am paid an ‘availability’ supplement. You are doing all of this but not being paid unless you actually have to go in. You need to speak to HR. It doesn’t sound in line with all other hospitals I have worked in (there have been many as I moved around for training for several years). Not sure it’s even legal, speak to your union.

This makes no sense. You should be paid to be on call. Why have you and your team agreed to this for so long? Sadly I think it is too late to kick up a fuss before Christmas…

And thanks to @Catsonskis that's a good explanation to work with when it gets raised in the new year.