LCR23049

PARTIES:

DIVISION:

SUBJECT:

CNM2 Shift Leads & Appointment of CNM3 Intensive Care Unit

BACKGROUND:

This dispute could not be resolved at local level and was the subject of a Conciliation Conference under the auspices of the Workplace Relations Commission. As agreement was not reached, the dispute was referred to the Labour Court on 17th June 2024 in accordance with Section 26(1) of the Industrial Relations Act, 1990. A Labour Court hearing took place on 1st October 2024.

UNION'S ARGUMENTS.                

1. Email correspondence was provided in March 2021 by the HSE confirming that €1.6m was provided to address expansion and staffing issues in the ICU in Mayo University Hospital (MUH). This was to include six Clinical Nurse Manager (CNM2) Shift Leads and  one CNM3 post for the Intensive Care Unit.                

2. Despite this confirmation of funding, which was available from November 2020, management at MUH has declined to fill these posts.

EMPLOYER'S ARGUMENTS.                

1. MUH has sought sanction for two of the additional posts but cannot advertise for the new posts without regional and national approval.                

2.  The money allocated was non- pay and pay costs  but was used to set up the additional beds.

RECOMMENDATION:

The issue in dispute between the parties is in respect of the staffing structure in the expanded ICU in Mayo University Hospital (MUH).  In September 2021 following a series of internal meetings between the HSE National Critical Care Programme (NCCP) and the management of MUH it was agreed to increase the critical care bed capacity from 4 to 8. This necessitated an increase in staffing requiring 6 CNM2 posts (shift leaders) and a CNM3 post.   A business case setting this out was submitted to SAOLTA.

 At a meeting between the IMNO and MUH/SAOLTA the group director of HR advised that there was no funding stream available to implement the staffing requirements despite the fact the additional beds were put in place. However, the INMO subsequently became aware that a sum of €1.6m had been allocated to facilitate the increase in the critical care bed capacity. The INMO are seeking that the money now be used to put in place the correct staffing structure as agreed with the NCCP.

The Employer stated that as it is required to do, it had submitted a business case to the SAOLTA group based on the agreement with the NCCP. However, under the ECC the employment controls and approvals process, so far only two shift lead posts have been approved. There are further internal processes to complete before MUH can move to fill the posts as these are new posts.  To date MUH has not received approval and funding for these posts.

The hospital has carried out costings on the provision of a further four post including looking at converting posts. However, they confirmed that the Labour Court hearing was the first time that they had shared this information with the INMO. In respect of the €1.6 million the Employer stated that money was allocated for pay and non-pay costs associated with the setting up of the additional critical care beds. The Union confirmed this was the first time that they had been told this.

The Employer stated that there are also other hospitals in the Saolta group that do not have the agreed staffing structure. The Employer stated that while it is not ideal not having the correct staffing structure, they are managing the situation. However, they accepted that they are relying on the goodwill of the staff to do so, but without approval and funding from the Saolta group they cannot create and fill the posts at the levels recommended.

The Court notes that despite the parties having numerous meetings both locally and under the auspices of the WRC, the Employer in their submission to the Court shared information which had not previously been shared with the Unions, and which may have gone some way to inform their position on this dispute. There was no obvious reason why this information could not have been shared at an earlier stage in the process. The Court struggles to understand how the Employer believes that withholding information can in some way contribute to the resolution of a dispute.

 It cannot be disputed that in the Health sector there are always competing demands for limited funds. However, where the Employer is relying on the good will of the staff to carry the increased service without the agreed staffing structure, it is incumbent on the Employer to be open and transparent with the Union as to the steps it is taking to achieve the desired outcome.

 The Court recommends that the Employer engage with the Union locally and brief them fully in respect of where in the internal process the additional 2 posts are, including timelines for them coming on stream. In respect of the remaining posts, and accepting that the Employer cannot rely on the goodwill of the Workers indefinitely to deliver this critical service, the Employer should map out how they propose to achieve the optimum staffing level agreed with  the NCCP and a time frame for same. 

The Court so recommends.

	Signed on behalf of the Labour Court
	Louise O'Donnell
AR	______________________
18 October 2024	Deputy Chairman

NOTE

Enquiries concerning this Recommendation should be addressed to Aidan Ralph, Court Secretary.