Nipsa Branch 730 members, working as daytime Approved Social Workers (ASW) in the Belfast Health and Social Care Trust (BHSCT), have today commenced industrial action. This action is related to a range of concerns, such as health and safety issues and the use of compulsory overtime by the employer, outside of national terms and conditions.
Whilst some of these concerns have been around for a significant period of time, they are compounded by a lack of regional psychiatric beds for acutely unwell individuals who require hospitalisation following an assessment under the Mental Health (NI) Order.
It is NIPSA’s view that the Dept of Health (DOH), through the Strategic Performance Planning Group (SPPG), has failed to provide an adequate number of regional psychiatric beds. This in turn is having an impact on ASW’s waiting with acutely unwell individuals, stuck for hours on end following assessment, where the individual requires to be admitted to hospital. Often these delays can be in clients’ homes, where the ASW will be left alone, with limited support and without regular breaks. Whilst waiting times for admission to hospital can vary, members have informed Branch representatives that it has taken in excess of 12 hours and even on occasions up to 48 hours for a bed to be identified.
ASW members have stated of their appreciation of the support provided to them through the relevant GP, who conducts the assessment with the ASW, and the PSNI. However, once the assessment is completed and the decision is made the individual requires to be admitted to a psychiatric hospital for their own safety, ASW’s advise they are often then left alone, waiting on confirmation of a hospital bed. For many of these workers, it then means they are forced into working outside of their contracted hours.
Following a recent Branch meeting with ASW NIPSA members on this issue, legal notice was served to the BHSCT and it was agreed the following industrial action will commence on Monday 3rd July 2023 from 9am:
• ASW’s NIPSA members will be instructed due to workload pressures and health and wellbeing concerns not to participate on the daytime rota more than twice a month.
• Due to workload pressures reported by members ASW, reports will be produced within 5 days of assessment instead of the normal 3 days that some managers require
• Due to the workload pressures reported by members, NIPSA ASW’s will be instructed not to complete more than one assessment per ASW shift. Additional ASW support may be required for the rota if multiple assessments present on the one day. This is an employer responsibility
• ASW’s will not accept any new requests for assessment after 4pm
• Two ASW’s will be required for community assessments (private addresses) unless confirmation of police presence is confirmed in writing to the relevant staff for the duration of the assessment, including up to conveyancing or if the client should be taken to place of safety
This industrial action will remain under regular review.
NIPSA Branch 730 Officers have already engaged in discussions with senior management in the BHSCT, to resolve these issues and to seek how the individual ASW, and the patient who is unwell, can be best supported. These discussions have been approached in a positive manner and progress has been made on a number of important issues. However, we are not yet at a point of resolving our members concerns. NIPSA Branch 730 Officers will continue to engage with the BHSCT to identify what their responsibility is in such situations, and how quickly additional supports can be identified and put into place.
However, while each HSC Trust holds legal responsibility for discharge of statutory function, as defined within the Mental Health (NI) Order, it is NIPSA’s view that the resolution to this issue lies with the Department of Health.
Timely access to psychiatric beds must be addressed as a matter of urgency, while clear guidance is required in relation to who holds legal responsibility for individual patients following assessment, and before formal conveyancing, when a patient is admitted to the required hospital. What appears to be confusing legal advice from the DOH, compared to that given to the BHSCT on this issue, is not helpful in resolving this matter, as the DOH has not shared its legal advice with NIPSA, despite requests to do so, claiming this information is “privileged”. The DOH have currently advised that the ASW, who has no clinical role following an assessment, is deemed to hold sole responsibility for the patient up to and including conveyancing. Given the absence of any clinical role for the ASW, this position is problematic.
These issues are long standing, and NIPSA’s ASW members are committed to providing a caring and professional service to acutely unwell individuals who require significant mental health support within their homes and in hospital. However, our members can no longer work under such conditions. There is a lack of available mental health services following assessment, there are extended periods of high-risk lone working, workers are forced into compulsory overtime, and there is a lack of support for mentally unwell patients that continually fail to be properly addressed in accordance with the needs of the patient and safety of both the patient and the attending ASW.
NIPSA, on behalf of our ASW members, will continue to engage locally and regionally with HSC Trusts and the DOH on these matters.