24/7 NHS

Could well be so When
Personally I think it started as an 'efficiency' saving decision made by the hospital Trust, and has been dictated to the ward sisters.
Certainly the sister on the ward couldn't see what was wrong with 12 hour shits (ironically she worked 9-5, no weekends), and wasn't prepared to even consider anything else. So it becomes established practice and that's that.
If I did agency nursing I could theoretically do the 8 hour shifts on the same ward because the hospital won't pay for 12 hours!

Do you think the fact that the profession is not only dominated by women, but by women who are (by definition) good at putting themselves out for other people has something to do with it? What I mean is, that when nurses are told that that 12-hour shifts will be cheaper, they assume that that is correct, and each nurse assumes that she herself is just getting less able to deal with long hours. I don't mean this to sound patronising in the slightest, but we all know that we women can sometimes be too accommodating for our own good and perhaps if enough nurses, particularly those who want to work on for longer, got together to say that they cannot do so under these conditions, something might change. To go back to the GP contract, it took a long time to get these changes in out-of-hours work which permitted some GPs to go on working longer, but they got there eventually!

Often the 12 hour shifts don't permit a break, it's so busy. I did three and it nearly finished me off. I consider myself pretty fit, I can easily walk 12 miles cross country, but my ankle ballooned up and by the end of the last one I could barely drive home. It's never been that bad before and it took several days to go down.

I don't understand the thinking that the savings from having 12 hour shifts (in man power, time spent on handovers etc) will a) encourage nurses to return or stay on and b) give effective and efficient nursing care. After 10 hours I wasn't totally sure of my judgement on a highly dependent older persons unit.

Other girls on the course working in A+E said they'd be so tired they felt ill.

I'm sure sickness rates must have rocketed too.

I loved the work, which made my decision even harder.

Indeed it is their loss, loopylou. I've often wondered how many nurses are put off or are driven to earlier-than-necessary retirement, by the 12-hour shifts. It seems ludicrous to me that people are expected to work hours like that, and I don't think that the rest breaks are all that wonderful either. Nobody, whether at work or doing housework, does that sort of stretch at a time. Even when you're on call for 168 hours a week as a breast-feeding mother, you get to sit down at every feed, and the odd bit of sleep as well!

I have a friend who must be in her 50s who does 12-hour shifts at the local hospital, and I can see her getting more and more tired. It wouldn't surprise me at all if she were to retire before she's 60, but she enjoys her work and I'm sure would carry on happily if the shifts went back to the old 8-hour pattern.

True, although my experience of trying return to nursing put me off forever, it wasn't because of this particular issue.

There is no flexibility for returning nurses at the nearest DGH, although they are obscenely overspent (£3.2m) on agency nurses.

As I've said elsewhere, I was perfectly happy to work 30 hours a week flexibly, could not do 12 hour shifts because of old ankle injury but happy to work 7.5 hour shifts and including weekends but couldn't do nights (am carer to my elderly parents) and happy to work on any ward.

I was told only full time, 12 hour shifts, hours averaged out over a calendar month, minimum of 7 nights a month. No room for discussion let alone flexibility so the NHS has written off 40 years of experienced nurse (DN, care of Older People and Rapid Assessment)

Their loss, not mine.

Difference between not getting a pay rise and getting a pay cut because they have changed the designation of working hours, though, loopy.

People working in the voluntary sector generally don't get any pay rises unless the organisation uses NJC scales, which is fairly unusual. Not even Cost of Living rises.

GPs have just voted on this.

www.pulsetoday.co.uk/home/finance-and-practice-life-news/gps-say-no-to-offering-top-up-payments-for-private-primary-care/20010029.article#.VV7wCI5Vikp

Thank heavens they voted against it.

Just read in the paper today, Eloethan, that HMRC are after £1 billion from Bernie Ecclestone. He's fighting it, of course. It will be interesting to see what happens, as you say.

Well, I would imagine whether they strike or not it would have a huge negative impact on morale and performance to impose a completely different contract on people which would in effect amount to a pay cut.

Would Conservative supporters think it fair to treat NHS staff in such a way? I 'm not sure they would - at least I hope they would not.

I don't think the many people - both private and public service workers - whose wages have remained at the same level for three or four years should be taking a pay cut. I'll be interested to see if the Conservatives' tough talk regarding tax dodging will really be carried through now that they've won the election.

Are you saying that it would be all right for nurses to get a pay cut if pensioners did as well?

I have a lot of sympathy for people threatened with a pay cut, as do many of the people I know, including some who voted Tory.
Pensioners will not have to take a pay cut. Why should nurses?

That will be good for the NHS then, durhamjen...

The general public doesn't usually support strikes by public service workers when their own convenience is or may be compromised, whatever their political persuasion.

I think Jeremy Hunt is saying that 24/7 means no extra payments for evening/weekend work, as 24/7 will be the norm.
That's why the nurses' union is calling for strike action if that happens, Eloethan.

The idea that doctors should complete a number of years' service in this country before taking their skills elsewhere is appealing. But do doctors pay for their training? If they do - even if their training is subsidised - surely they should be treated like any other student who, after qualifying, chooses to leave this country to work elsewhere?

My husband was a nurse for several years and he was expected to work various day shifts, night shifts, weekends and Bank Holidays. I assume that nurses still have to do that but they receive extra pay for the anti-social hours they work. If all departments are open throughout the weekend for non-urgent appointments: blood tests; eye, ENT and physiotherapy appointments, etc., then the wage bill would be much higher - even if part-time weekend staff were appointed at "flat" rates.

Won't the main issue be that consultants and senior medical staff will be very unwilling to be available 7 days a week - even if they are financially compensated? If elective surgery was done throughout the weekend, presumably staffing levels would have to be substantially increased - for medical staff, nursing staff and support staff?

If the NHS is experiencing a financial crisis now, surely these proposals would require significantly more funding to be made available. I just don't understand the reasoning behind it unless it's to make so many demands on the service with insufficient resources that it eventually collapses completely and is then pronounced to be "unviable".

I think the answer is GillT57 that doctors vary more than firemen and police officers and also work in smaller teams.
If for instance a hospital has 2 consultants covering a particular specialism you cannot provide consultant cover 24/7. You'd need about 5, I would guess to cover 7 days of shifts, holidays, training etc
If you have a rural GP practice with a small number of GPs, the same applies.
As to the "masses of clerical staff" I doubt you would find they are twiddling their thumbs. They are busy making appointments, changing appointments, typing out the dictated letters of consultants and making sure medical records are ready for clinics and filed properly afterwards. And then there are the HR departments who are flat out trying to recruit plus all the other things they do to make the workforce more efficient.
One thing for sure, is that if the PM wants the NHS to work more efficiently there will be a need for competent and creative managers to bring staff and teams together in order to work out better ways to do things.
I noticed that the PM always used the negative word "bureaucrats" when talking about these hard working public servants.

I have read this thread with interest, especially those with direct family experience of GPs in the family, and I do of course understand that an exhausted Doctor is a danger, but so is an exhausted police officer or fireman. My DF was a police officer and often had leave cancelled, worked long shifts due to work pressures/staff absences. I really dont see why all medical staff, nurses. GPs surgeons etc cannot work on a 7 day week basis like the other emergency services. Surely shifts could be worked out by the masses of clerical staff? A GP would expect an ambulance to come when he orders one, would expect a fire engine if he/she has a fire. This is not an anti GP comment, I just do not understand why it cannot be done. As to recruitment, then a simple change of policy there would sort some of it out; a commitment to work for NHS for a minimum of 5 years after qualifying, just as graduates who qualify through Army or Naval grant schemes have to commit to a certain no of years. As a taxpayer, I am funding the training and the facilities to do it in and I think it grossly unfair if a graduate can then leave the country to take up a position elsewhere.

An overly pessimistic view from GPs.

www.onmedica.com/newsarticle.aspx?id=80568b3c-7ecd-4408-821b-4ce4ba3bdc3e

5000 new GPs over the next five years but 10,000 retiring. I do not call that overly pessimistic. Time the government was realistic.

www.theguardian.com/healthcare-network/2015/may/21/general-practice-permanent-decline

lilygran, I too wish that politicians would listen to people actually doing the work in any field where they feel the urge to meddle, but what are the chances?

When we did our house jobs (the first job after graduation but before full registration in those days), you expected to work anything from 80 to 120 hours per week, and the pay was good, particularly compared to the student grant (remember?) that we had lived on before. What made it even more like instant riches was that it built up in your bank account as you had no time to spend it.

I think that there is an element, probably quite a big one about helping people. His mum was a nurse for many years. That is part of the reason that he has gone into medicine.
But I am also know that the money very much matters to him too. And matters to him as to which branch he chooses.

And the young doctors know that in the long run they'll work less hours but earn much more that a GP

I think part of it is because society in general measures success by how much you earn.

Isn't it funny how "pay" is so often linked to "ambition" and "aspiration". Isn't it possible to be ambitious/aspirational in ways that don't necessarily rely entirely on what you are paid? I do understand that if you have studied very hard for a qualification and, particularly in the case of doctors, are taking on huge life and death responsibilities, then your salary should reflect that, but surely there should be some desire to help people/contribute to society as well?

In the US, where doctors can - and many do - earn vast amounts of money, it appears that money can become the primary motivator, leading to all sorts of unnecessary but profitable procedures being carried out.

I'm not, by the way, someone who believes that medics and other "caring professionals" should not be concerned with how much they are paid - everyone has bills to pay. I'm just reflecting on what drives people to follow a certain profession or occupation and wondering whether those who see money as their primary goal are necessarily the people who are best suited to the caring professions.