Revised Interim A&E Meal Break Policy (v1.2)

Transcription

1 Revised Interim A&E Meal Break Policy (v1.2) Version: Revised interim 1.2 Ratified by: Meal Break Working Group Date ratified: 8 September 2010 Originator/author: Head of Clinical Scheduling Date issued: 16 September 2010 Review date: October 2010 Target audience: All A&E response capable staff and managers Replaces: Interim A&E meal break policy

2 Document Control Revised Interim Meal Break Policy Manager Responsible Name: Title: Assistant Director of Distribution Directorate: Operations Committee/Working Group Meal Break Working Group to approve Version No. Revised Date: Draft/Evaluation/Approval (Insert stage of process) Person/Committee Comments Version Date Meal Break Working Discussed at MBWG Group review meeting post implementation of interim policy WDC Following sign off by JPF Ratification on behalf of Board Chair of Working Group/Committee: Isobel Simpson Signature: Date: Circulation Records Management Database Internal Stakeholders all staff External Stakeholders all relevant unions Active from (30 days after above signature): Date: Date: Review Due Manager Sue Skelton Period Review due October 2010 Date: Record Information Security Access/Sensitivity Publication Scheme Where Held Disposal Method and Date Public Domain Supports Standard(s)/KLOE NHSLA HCC ALE IG Toolkit Other Criteria/KLOE:

3 Contents 1 Introduction Aims and Objectives Definitions Policy Statement Arrangements Responsibilities Competence Monitoring Audit and Review Equality Impact Appraisal Associated Documentation References... 11

4 1 Introduction 1.1. This policy applies to all A&E operational staff and response capable managers when working front line shifts in the Trust and sets out the principles to be followed in relation to meal breaks. 2 Aims and Objectives 2.1. This policy aims to give guidance to all operational staff and managers on the processes to be followed regarding allocation of meal breaks during an operational shift. 3 Definitions 3.1. A meal break is the unpaid time allocated to A&E operational staff during their shift. 4 Policy Statement 4.1. Getting meal breaks right as an emergency provider of care is a tenuous balancing act balancing the needs of staff with the demands of patients. This policy has been developed to ensure that there is the best balance possible for both patient and staff needs This policy ensures that there is a robust and fair approach to the allocation of meal breaks for all front line operational staff The views of both staff and staff side representatives have been used to inform the development of this meal break policy during a fourteen month consultation period lasting from December 2008 to January In response to the views expressed by both staff and staff side representatives this is a non disturbable meal break policy with exceptions for staff who choose to opt out and be disturbed if they are the closest resource to either a confirmed cardiac arrest or any other emergency incident There are also compulsory exceptions to the non disturbable element of the policy which include Major Incidents, Business Continuity Incidents and direct approaches from members of the public.

5 5 Arrangements Confirming meal break status 5.1. At the point when a meal break is allocated, A&E operational staff will confirm with EDC staff their meal break status for that day. Each member of staff will state whether they are: Fully available willing to be disturbed to respond to all emergency incidents that they are the closest resource to during their meal break including back up on red to support fellow members of staff already on scene Partially available willing to be disturbed to respond only to confirmed cardiac arrests where they are the closest resource to the incident as either a first response or back up to another resource on scene Not available unwilling to be disturbed for any incidents during their meal break unless there is a Major Incident, Business Continuity Incident or the member of staff is approached directly by a member of the public for assistance Once the meal break has commenced the availability status cannot be changed later on in the shift. The meal break length and window 5.2. A 30 minute unpaid meal break will be allocated during any operational shift which is longer than 6 hours For shifts shorter than 6 hours no meal break will apply. This is in keeping with the European Working Time Directive The 30 minute meal break will start with immediate effect where EDC staff contact staff direct at their base where the meal break is to be taken Where staff are tasked to return to their base for the day to take their meal break this will commence after the crew has been at their base for five minutes. This clock will start once crews have acknowledged via radio or MDT that they have arrived at their base If crews require a delayed start to their meal break, this must be agreed with the duty dispatch manager (and the reasons for

6 requesting clearly outlined by the crew) prior to commencement of the meal break Meal breaks allocated within the window will be taken at the operational base station for the shift. A common sense approach should be adopted and as such there will be room for negotiation on this between crews and dispatchers The first and main meal break window will be determined by the length of shift as follows: 12 hour shift: between hours: three and a half and seven and a half. 10 hour and < 12 hour shift: between hours three and seven. 8 hour and <10 hour shift: between hours three and six. > 6 hour < 8 hour shift: between hours three and five and a half 5.9. The length of a shift is determined by start and fish times of the shift and not by number of hours paid e.g. 07:00 19:00 is a twelve hour shift The Trust recognises that length of the meal break window has been increased and recognises the importance of ensuring that as many crews as possible take their meal break as early as possible during their shift. The meal break during shifts of 10 hours will be profiled across the four hour Meal Break window as follows:, 30% stood down in the first hour 25% stood down in the second hour 25% stood down in the third hour 20% stood down in the fourth hour. Compliance with these standards will be monitored by EDC and reported on a monthly basis The profiling for meal breaks for all shift lengths of > 6 hours < 12 hours will aim to be even across all hours of the window A Key Performance Indicator (KPI) demonstrating compliance of 90% of all meal breaks being taken within the four hour window has been agreed. This will be monitored and reported on a monthly basis. The Assistant Director of Distribution will be responsible for establishing a system to report and monitor compliance with this KPI. Reporting will

7 be included in the Trusts weekly bulletin in order to share with all staff The Trust recognises that if a crew goes outside of their meal break window the priority will be to ensure that the crew commences their meal break as quickly as possible. Meal breaks allocated outside of the window will be taken at the closest location with full facilities e.g., nearest response post, nearest ambulance station or if the crew choose to, the hospital. Crews will not be given the option to return to their own base or any other location if it cannot be reached within pre determined travel times from hospitals (See Appendix A) or a maximum of ten minutes drive from clearing at a scene. Where crews take longer than ten minutes to reach their nearest response post or ambulance station they will immediately contact EDC to confirm the revised start and finish times of their break Meal breaks taken outside the window are still disturbable to the same extent that has been agreed with EDCs. Deleted at the start of the shift Where meal breaks are taken at any facility which is not the designated base for the day and costs for purchasing food are incurred a 5 subsistence allowance will be paid in accordance with Agenda for Change Terms and conditions A request for a service journey will also be considered by crews being asked to take meal breaks at a location that they were not expecting to. Disturbances In addition to section 5.1, a meal break is disturbable under the following circumstances: In the event of a Major Incident being declared. During a Business Continuity Incident. If approached directly by a member of the public requesting clinical assistance When a member of staff agrees to be disturbed for any incident during the meal break for that shift If an operational A&E staff member agrees to be disturbed at the start of the shift, they will receive a payment of 25 if disturbed for each disturbance A disturbance is defined as when a crew have been contacted by EDC and they have physically mobilised e.g. booked mobile and are

8 making their way towards an incident. If the mobilisation results in being re-tasked to an alternative incident(s) without having arrived on scene at the first incident this is still considered a single disturbance A disturbance ends once the crew has arrived on scene with the patient or the crew is stood down and physically returned to their base for the remainder of their break Where a crew is tasked (and arrives on scene) at more than one incident within their 30 minute meal break time slot, a disturbance payment of 25 will be claimable by the responding crew or staff member Where a crew is tasked and mobilised but does not arrive on scene at the incident but is returned to their base for the remainder of their meal break this will be considered a disturbance and a disturbance payment of 25 will be claimable by the responding crew or staff member Once a crew have been disturbed the priority for the EDC team will be to return the crew to their original base for the day to complete their meal break If a crew are outside of their meal break window after having been disturbed the priority for the EDC team will be to ensure that the crew receives their meal break as quickly as possible Meal breaks allocated outside of the window will therefore be taken at the closest location with full facilities e.g. hospital, response post or another ambulance station. This location will be within 5 minutes travel time of the crew which will be protected. Crews will not be given the option to return to their base or any other location if it cannot be reached within 5 minutes Where meal breaks are taken at any facility which is not the designated base for the day and costs for purchasing food are incurred a 5 subsistence allowance will be paid In the exceptional circumstance that a crew who opt not to be disturbed do not receive a 30 minute break in their shift then they are entitled to claim 30 minutes overtime. Taking of outstanding meal break time due Where a crew are disturbed the remainder of the meal break (rounded up to the nearest 5 minutes) will be allocated to the crew or staff member at the earliest possible opportunity.

9 5.28. The time of the disturbance will count from when the incident details are passed to the crew e.g. if the meal break commenced at 10:00 and the details of an incident are passed at 10:14 the outstanding time of 20 minutes will be allocated to the crew or staff member as soon as possible after the disturbance. Part of a crew responding Where only part of a crew make themselves available to respond during a meal break the disturbed crew member will be tasked to return to their base to finish their break and collect their fellow crew member once they have completed their response to the incident Once the disturbed crew member has returned to their base their fellow crew member who has completed their meal break will be available to respond on their own with the vehicle if they are the nearest response to an incident. KPIs In recognition that this is a non disturbable meal break policy which has been developed in response to the wishes of both staff and staffside a Key Performance Indicator (KPI) demonstrating compliance of 90% of all meal breaks not being disturbed has been agreed This will be monitored and reported on a monthly basis The Assistant Director of Distribution will be responsible for establishing a system to report and monitor compliance with this KPI. Reporting will be included in the Trust s weekly bulletin in order to share with all staff. Refreshment Break A second break called a refreshment break is to be allocated before the last hour of a shift and taken at any location decided by EDC The length of the refreshment break will be 20 minutes for 12 hour shifts and 15 minutes for shifts between 8 hours and <12 hours Shifts <8 hours will not be entitled to a refreshment break The refreshment break is disturbable for back-up on red and any category of call except category C. Where a crew is disturbed during a refreshment break they will be tasked to all emergency incidents and stood down for a category C as soon as the category of call is

10 confirmed. The crew can choose to keep running on the category C call if they would like to. Use of radios during meal breaks During an allocated meal break, operational A&E staff can turn off their radios for the duration of their meal break but must continue to wear them in case they need to contact EDC urgently if approached by a member of the public during their break Operational A&E staff must ensure their radios are turned back on as soon as the meal break is complete For staff who choose to remain disturbable for either confirmed cardiac arrests, or responding to all emergency incidents, radios must be left on and worn at all times. 6 Responsibilities 6.1. The Trust will ensure that all A&E operational staff are aware of this policy The Director of Operations will be accountable for the effective implementation and monitoring of this policy The Assistant Director of Distribution will be responsible for implementing this policy within the operations directorate All operational managers have the responsibility for ensuring that staff comply with this policy All staff are informed about the content of this policy and the grievance / complaints procedures. 7 Competence 7.1. All operational managers and staff must be familiar with this policy and its requirements. 8 Monitoring 8.1. Compliance with this policy will be monitored by the appropriate line manager and any issues will be raised with the responsible manager and/or the relevant directorate. 9 Audit and Review

11 9.1. This policy will initially be reviewed by the Meal Break Working Group members six months following implementation The Meal Break Working Group will aim to include the views of staff in the initial review The policy will remain in place while the review is undertaken Any amendments to the policy following the initial review will be discussed by the meal break working group and communicated to all staff The Meal Break Working Group will agree future review periods following the initial review. This will be no longer than two years. 10 Equality Impact Appraisal The Trust has undertaken an equality impact appraisal to identify the impact this policy may have on the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. 11 Associated Documentation Working Time Regulations 12 References None.