Wednesday, March 02, 2005

Consequences of Agenda for Change

I've been meaning to blog about this for a while, since I think it is a pretty good lesson about short-term thinking in the NHS.

Agenda for Change is this endeavour to bring in a supposedly fairer system of pay into the NHS. I'll blog another time why I think it is seriously flawed, but I want now to concentrate on a very specific consequence. One of the results of A4C (as it is acronymed) is that we are all getting extra holiday - in my case 5 extra working days, for a total of 27 working days per annum plus bank holidays. Sounds great, but there is a problem: cover, or the complete lack of it.

Even before Agenda for Change was implemented (and for holiday purposes my Trust has implemented A4C) we had grave problems with staff holiday. The sort of problems that end up getting a reasonable degree of high-level attention. In our office on a good week we slowly catch up, an average week we stand still, when we are all there. Absent one person for one week and we are lucky not to fall a complete week behind. And now Agenda for Change basically lumbers us with another 3-4 weeks a year being short-staffed, and absolutely no thought has been given to the effect of this.

The effect, incidentally, is dangerous practice as our work falls 4+ weeks behind. And perfectly justifiable patient complaints (how would you feel when you learn nothing has been done 4-5 weeks after you saw the doctor?). Then a great flapping about and finally the hiring of expensive agency staff to provide cover - which we are not meant to be able to afford in the first place (though we seem to be able to hire extra managers at inflated wages - funny that). And this is before those extra 3-4 weeks are taken out of our year. I am really not looking forward to the holiday season this year.

Someone in Whitehall, probably lots of people in Whitehall, and elsewhere, have simply not applied any common sense. That should not surprise us - this is government we are talking about after all - but it is typical of my experience in how the NHS is run. Someone has a 'bright' idea, and no one bothers to look at the perfectly obvious consequences.

For the record I would rather get the extra week's pay than the extra 5 days - the other difficulty is that it is pretty difficult as it to use up my holiday days, with all of us in the office tripping over each others' dates. That will also only become harder to negotiate.

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