UNISON, with the joint staff side in Oxford Health Trust, has written to the Trust managers following concerns raised by members about the changes in community teams following a organisational change and dangerously low staffing levels in the Crisis team. In particular staff are worried about the risk to patients who will need new care coordinators as a result of the implementation of the new model requiring some staff to move to other teams.

For example, in Bicester, where services are moving to the city, none of the existing staff will be moving with their patients, and all Bicester patients will require new care coordinators. In addition, no doctors who know the patients will be moving with them. Evidence suggests that change/transition is likely to generate higher risk for patients. When consulted about the model, patients expressed a desire that their care coordinators would not change.

However staff changes in other teams will mean patients will need new care coordinators – despite the fact this is not what patients want. Management have been asked to assure staff that there is an assessment of risks to patients and staff during the implementation phase and that safe and adequate resources will be put in place to manage these risks. For other staff the changes have brought additional costs. Staff who have been asked to move because of the organisational change are being told they can’t have their mileage paid “because you have expressed a preference to move”.  An informal grievance has been raised about this, and management are reviewing the list.

UNISON members have also raised concerns about the crisis team running below establishment with high workloads for existing staff. Members are fearful of being blamed for Serious Untoward Incidents when senior managers have failed to put in enough staff to deliver a safe service and have allowed vacancies to go unfilled.  One team member told how support is found to be lacking “Senior managers are quick to blame us when they haven’t provided enough staff for us to do this job safely.”  Another reported “The fact is we don’t have enough staff to run this service safely.”  A third said “We are missing things because we don’t have enough staff to manage all the referrals coming in”. 

Staff report the pressure is taking its toll on staff, with one team member telling her UNISON rep:  “My confidence has completely gone. I feel so stressed all the time and constantly feel I have to check everything”. Management have been asked to tell staff side what is in place to ensure the safety of staff and patients during the transition.

The Francis Report into care failings in Mid Staffordshire Hospitals Trust revealed a worrying lack of knowledge about the problems of care there. The Director of Nursing informed the inquiry that she did not know of the problems. Stewards in Oxford Health have written to the Trust Director of Nursing to ensure no such deficit occurs in our Trust. 

If you feel staffing levels are dangerously low in your area, you can contact UNISON stewards to take up your concerns.  Staff have a duty of care to raise issues with managers to avoid being culpable for problems brought about by management failure to provide adequate staffing.  This needs to be evidenced to avoid management denying knowledge of unsafe situations.  Of course staff should call their seniors to alert them to problems, but incident forms and emails provide a train of evidence to prove concerns have been raised in the event of any dispute.

UNISON has also produced the “Be safe” pack” which includes a simple form for groups of staff to raise concerns. The pack can be downloaded from http://www.unison.org.uk/at-work/health-care/key-issues/be-safe/resources/