Leo Varadkar hopes deal can tackle A&E crisis

Health Minister Leo Varadkar said he hopes “a deeper level of trust” will develop between hospital management and nursing staff after agreement was reached on a deal designed to tackle overcrowding in emergency departments (EDs).

The breakthrough means a deferral of industrial action — planned for seven EDs next Thursday — to allow nurses time to consider and ballot on the revised proposals which emerged in the early hours of yesterday after a marathon session at the Workplace Relations Commission (WRC).

The executive council of the Irish Nurses and Midwives Organisation (INMO) is recommending acceptance of the deal which contains a number of assurances that measures agreed before Christmas to tackle ED overcrowding and understaffing will actually be implemented. It also clarifies procedures for early identification of the risk of overcrowding, and of the operation of crisis protocols known as escalation policies.

INMO members rejected initial proposals last week on the grounds that nurses did not have faith in local management to implement them on a 24/7 basis.

The INMO said last night that the revised deal specifically provides for weekly meetings between senior hospital management and INMO ED representatives, to monitor implementation of the agreement, and in particular, implementation of escalation policies, where additional beds are placed on wards to move patients out of overcrowded EDs.

The INMO said the revised deal explicitly provides for enhanced health/safety and risk management/mitigation measures which “clearly acknowledge” that ED overcrowding “leads to an unsafe work environment which must be addressed and mitigated”.

INMO general secretary Liam Doran said the union’s executive council was “heavily influenced” by its national ED committee in deciding to defer strike action and recommend acceptance of the new deal.

“This committee felt that the measures, within the revised proposals, addressed the significant lack of communication, trust, and confidence, amongst ED nursing staff, with regard to the full implementation of these measures,” Mr Doran said.

He said it was imperative that the HSE at national level and hospital group level “immediately commits to fully operate the revised proposals”.

The parties will return to the WRC in a month’s time to assess progress on implementation.

Welcoming the breakthrough, Mr Varadkar said the interests of patients “are always best served through negotiation and by avoiding industrial action”.

“I hope that ED nurses will regard the proposals as sufficiently detailed and robust to address their concerns around activation of the escalation policy, health and safety concerns and implementation of the agreement itself.

“In particular, I expect that a deeper level of trust will develop between hospital management and nursing staff through the active implementation and monitoring of the proposals.”

The breakthrough came as the INMO’s own figures showed there were 434 patients on trolleys or in wards awaiting a bed yesterday morning, including 42 in Our Lady of Lourdes Hospital, Drogheda.