Posts Tagged ‘Sick leave’

Too many GPs are complicit in welfare scrounging

By Tom Goodfellow - 26th November 2010 10:30 am

So I am ‘on the sick’ again, signed off for a couple of weeks by my nice GP. Despite having served the NHS blamelessly for 36 years with hardly a day off, my thirty seventh is turning into a bit of a nightmare. I am sure my colleagues are beginning to roll their eyes and mutter well-meaning comments along the lines of: “Poor chap, surely enough is enough, and it is time…” Well, you get the drift.

My complaint this time is really rather embarrassing (no don’t worry, not that); in fact I had never actually heard of it until my GP told me. I have had, he informed me, an episode of micturition syncope. Or to put it another way I got up in the middle of the night for a pee and promptly fell over, unfortunately fracturing about 37 ribs on the way down (well that’s what it feels like). So I am now propped up in an armchair (I can’t lie down) with a ‘hottie’ against my chest, a laptop on my lap (obviously), being fed mugs of warm soup by the daughter, while trying to stop the wretched cats jumping on the keyboard every five minutes.

The more I think about it the more the diagnosis sounds like something out of Strictly rather than something medical. Brucie announces: “And now dancing the Micturition Syncope, please welcome Samson and Delilah”. The couple emerge to wild applause, clad in what appears to be scanty nightwear, and perform an exotic routine which seems mainly to consist of falling over. (Sorry for this hallucinogenic flight of fantasy but these buprenorphine dermal patches have interesting side effects).

However meditating on this has brought to mind a case which I have been following closely for the last year or so. For the sake of confidentiality I will call him (or her) Charlie. He worked for a very small but worthy company, a charity as it happens. Over a year ago he developed a mild chronic condition requiring minor surgery (day case). Normally a sufferer would have a week or two off work at most. Charlie took off a full seven months; three on full pay, three on half pay and a final month on statutory sick pay. On seven months plus one day (when the cash finally ran out) he returned stating that he had never felt better.

I will spare you the details, but he subsequently worked only nine half days (on a phased return basis) and on the tenth phoned in sick. Sure enough the doctor’s sick note duly appeared stating the reason for absence to be - yes, you’ve guessed it - work-related stress.

Predictably the charity shortly received a solicitor’s letter claiming £8,500 on behalf of Charlie in compensation for the “bullying and harassment” he suffered during his brief re-appearance. Part of the settlement was to include a “positive” (i.e. dishonest) reference. Many larger organisations, including the NHS, will simply pay up to get rid of such people, but to its credit this charity refused. The matter still rumbles on, but of course Charlie is now on sickness benefits, being paid to sit on his bum by you and me.

The dishonesty and sheer wickedness of much human nature never surprises me. However what has disturbed me has been the regular stream of sick notes provided monthly by Charlie’s GP. These covered initially his original complaint, moved on to “work related stress” but subsequently morphed into “stress related to work place harassment”, a completely untrue statement for which the GP had no evidence whatsoever, other than Charlie’s sob stories.

I hate being off work, if for no better reason than I understand the pressure it puts on all my colleagues who have to do my job on top of their own. I also accept that there are many who cannot work for genuine reasons. But based on Charlie’s manipulations I am equally convinced that there are a very large number who will screw the system for whatever they can get and for as long as they can get away with it. This is something the politicians dare not say for fear of the tabloid press, but which is nevertheless true. But what I don’t understand is why the GPs seem to be complicit in this. Perhaps I am being unfair, I am sure someone will be able to tell me.

Writing this has made me very cross indeed and my ribs hurt even more. I think I had better go and stick on another dermal patch.

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Nudity and day-time TV are no substitute for work

By Tom Goodfellow - 26th May 2010 3:31 pm

It is 9am on Wednesday morning and the rest of the household (including the cats) have all departed to their various destinations. It’s just me and the dogs left facing an endless day together. You see I am still ‘on the sick’, signed off by my excellent GP Dr Keith (I promised I would write something nice about him). So what to do?

Start off by wandering round the house aimlessly wearing only underpants (or less). Now I don’t want to put you off your muesli and I realise that this is probably a man thing, but there is something strangely liberating about promenading throughout home and garden in the buff especially when the sun is shining, so long as family and neighbours are out and there is no one to laugh at you. However the dogs seem puzzled and are getting a tad over-friendly, so I put some kit on. I love them but I don’t want them licking my, err, legs. 

I refuse to get guilty about not taking them for a walk. “Sorry guys but I am supposed to be resting. It would not look good if someone from the department was to telephone to enquire about my health and I wasn’t in”. Eat healthy breakfast, yuk!

Spend thirty frustrating minutes trying to crack the security code on son’s computer. It surely can’t be that difficult – he is not the imaginative type. I want to find out exactly what he is up to and what sites he visits when he retires to his room and surfs away half the night with the door closed. He works for a company which, among other things, does a lot of work for the military and consequently has had to sign the Official Secrets Act. They have obviously taught him a few tricks because I fail to break in.

It is mid-morning so decide to watch daytime TV. It appears that Jason (shaven head, naff tee shirt, NEET) has impregnated his girlfriend Kylie (doughnut, acne). However her Mum Sharon (Croydon face-lift, smoker’s rattle) with whom she resides, has suddenly announced that she is also up the duff but she refuses to name the father. Although he denies it, Kylie is quite convinced that Jason has been two-timing her with her Mum and she is gutted. She thinks she will never be able to trust him again. At which point I scream and throw the remote at the TV. “Of course he is two-timing you, you silly bint, he is just a penis on two legs; surely you can see that?” Then realise that this is definitely not helping the blood pressure, so switch over to watch a DVD.

Avatar! Boy arrives with colonising army, meets (blue) native girl and falls in love. Boy goes native and joins with girl and other (blue) natives in defeating cruel colonisers. That largely sums up the story which has been told a thousand times before (and better), and the rest is pretty pictures reminiscent of Bambi. Did this garbage really cost $280m to make? Yawn and turn off after three minutes.

Check e-mails, 47 in total, all spam. Nothing from the hospital or my colleagues; have they forgotten me already? I am sure they cannot be coping without me, the department must be falling apart. Who will do the endo-anal scans? What about the poor junior doctors who relied on me to sort out all their problems? They must be missing me terribly. Or is it me missing them?

It’s only 11am! Please Dr Keith let me go back to work soon.

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Juniors look after up to 400 patients at night

By Mike Broad - 21st April 2010 1:19 pm

There are large variations in the provision of medical cover at night following the introduction of the Working Time Directive, with some doctors being responsible for up to 400 patients, a study finds.

The research, by the Royal College of Physicians, reveals that doctors were responsible for an average of 61 patients at night but the range was from 1 to 400.

The seniority of doctor in charge of a ward also varied considerably; 63 teams reported that, on the night the survey was carried out, the most senior medical cover was a junior doctor in their first two years of training. Consultants were involved in the direct delivery of overnight care in only 6% of teams.

Day cover on the ward ranged between two and 65 patients per junior doctor, with the highest ratio per doctor in Wales and the lowest in London. This reflects a much higher number of trainees in the capital (in 2008 there were 1,135 specialist training posts in London compared with 146 in Wales). The average number of patients per doctor also varied considerably between specialties.

Dr Andrew Goddard, director of RCP’s medical workforce unit, said: “The very low number of doctors per patient at night in some hospitals raises serious concerns for patient safety and there are also worrying reports of very junior doctors being left unsupported, which urgently require further investigation.”

The survey - sent to consultant physicians in England and Wales on a specific date in November - also raises concerns about junior doctors’ welfare. Fifty eight percent of consultants reported an increase in sickness rates of juniors working under them compared with before the introduction of WTD-compliant rotas.

The survey claims to be the first to get independent evidence of current sickness rates for junior doctors across England and Wales, and shows that they are higher than a recent survey by the NHS Information Centre suggests.

The study proposes that high sickness rates in second year trainees may reflect a loss of team working and sense of belonging in doctors a year into their training.

It also shows a vacancy rate of 8.6% among specialist trainees.

Goddard said: “The 48-hour week was brought in to improve the wellbeing of doctors, and by extension prevent mistakes in patient care. The apparent rise in sickness rates of junior doctors since the introduction of the European Working Time Directive highlights the additional stresses that are being put upon trainees by new rotas.

“Far from benefiting their welfare, the poor implementation of the directive means that juniors are missing out on crucial support and valuable training opportunities, and patient care is being spread too thinly.”

On the day of the survey, data was available on 887 hospital teams at 11am, including 4,004 junior doctors caring for 18,854 medical patients, and on 670 teams at 11pm, including 2,263 junior doctors caring for 97,561 medical patients.

 

 

 

 

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Will the electorate believe rash promises?

By Bob Bury - 30th March 2010 9:57 am

I wasn’t going to bother this week as I’m on holiday. But it’s a Sunday afternoon in Cornwall, it’s raining (again), and my granddaughters are noisily and messily occupied making Rice Krispie cakes with Auntie Kate, so I thought, why not?

Driving down here last week I was as reassured as you will have been to hear on the radio that Gordon is going to shave billions off the NHS budget by cutting back on the excessive sick leave taken by health service staff. It’s so simple, it’s a wonder no-one thought of it before (not least this government, who have, after all, had nearly 13 years during which you might have thought the penny would have dropped). Except, of course, they aren’t going to do any such thing, any more than following through on the promise that every pregnant woman would have one-to-one care from their own midwife. They didn’t deliver on that one, predictably, because they didn’t have enough midwives to sustain the current service, let alone extend it. This latest example of willing the end but not the means, the most recent in a seemingly endless list of empty promises (or targets, as Nulabour spin would have it), really does beggar belief. I begin to wonder just how gullible the electorate would have to be to swallow it. Again.

I’m thinking of bringing the same strategy to bear on my personal life. I’ll be retiring soon (I think I may have mentioned it before), and I had been a bit worried about the consequent precipitous drop in my income, but I realise now that it won’t be a problem. By the time I’ve halved our expenditure on electricity and gas, and reduced the food bills by 75%, I’ll actually be better off than I am now. And of course, the beauty of this approach is that I don’t have to actually achieve the savings. What’s more, I don’t even need to have the remotest idea of how I might go about doing so. All I have to do is say it will happen. Simple.

I wish getting the back off my mobile phone was as straightforward. My children and wife can all do it with ease - they just flip it off with the merest hint of pressure from their thumb, then click it back into place. I push with both thumbs until the sweat runs down my face and I weep tears of frustration, but the bloody thing won’t budge. As my daughter helpfully remarked: “I don’t know how you manage with all that complicated scanning equipment at work.” Quite. As for why I need to get the back off the wretched thing…I just don’t want to go there.

Still, no need to worry about that now. It’s still raining, but it’s six o clock, so I can get to work with the corkscrew. Don’t work too hard y’all.

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New data reveals high NHS absence rates

By Mike Broad - 14th December 2009 10:51 am

Sickness absence rates in the NHS were 4.1% in the first three months of year, but it wasn’t medical and dental staff letting the side down.

Medical and dental staff recorded the lowest average at 1.1%. It’s the first study using data from the electronic staff record in the NHS and is the government’s next step in tackling high sickness absence levels.

Healthcare assistants and other support staff recorded the highest average sickness absence rates at 6.2%, and ambulance trusts were the organisational type with the highest rates at 5.2%.

Regionally, the north east had the highest sickness absence rates.

Produced by the NHS Information Centre, its chief executive Tim Straughan said: “These statistics will enable managers to get faster access to comprehensive data and to compare sickness absence levels in their organisation with others. They will also now be able to track sickness absence levels over time as recommended by the Boorman Review.”

The Boorman Review examined the health and well-being of staff in the NHS, and its links to productivity, efficiency and patient experience. It found that 10 million working days are lost each year to sickness absence in the NHS at a cost of £1.7bn. The review suggested that £555m could be saved and patient satisfaction improved if employees were better looked after.

Read the full statistics.

Read the Boorman Review and the government response.

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Will NHS leaders tackle our sick leave culture?

By Stephen Campion, HCSA chief executive - 20th August 2009 11:36 am

When is the NHS not the NHS? It seems to me that the answer is: whenever it suits the politicians.

I am not sure there is anything remotely ‘national’ about the NHS these days. Of course the health service is publicly funded and has some common frameworks and standards but the service has rapidly fragmented.

That in itself is not necessarily a bad thing; I have always been a firm advocate of the centre letting go. But my rule of thumb guide is that the NHS is national when boasting its achievements - but very much local when things go wrong.

It is amazing how the NHS can be both the largest employer in Europe when politicians point to success but an individual, self-managed hospital trust is rapidly distanced from mainstream NHS at times of failure. ‘Hands on’ when the news is good; ‘Hands off’ when politicians want to be disassociated with the bad. 

So, is the news that 45,000-odd staff employed within the NHS are absent daily from work a ‘hands on’ or ‘hands off’ issue? Well, it is certainly uncomfortable news, although comes as no surprise.

At last Dr Boorman has the courage to bring it into the open. But I am not convinced that counselling, gym facilities and occupational health will restore NHS staff to rude health. If prevention really is better than cure surely the real issue is how illness should be avoided in the first place rather than dealing with it when it strikes. Why are doctors at such high risk of self-harm or worse? Why are managers driven to achieving targets through bullying their staff? How long can sustained and often unreasonable pressure be applied to NHS employees whose health needs are secondary to the overriding requirement to satisfy the political imperative?

These are issues of culture within a health service driven by ‘hands on’ imperatives. That same influence must now be galvanised into recognising that the health and welfare of all NHS staff is crucial.

At last Dr Boorman has put his finger on it. His report concludes that there must be a complete NHS culture change to make workforce health the responsibility of every single member of staff. He is right in his assessment. Will those with ‘hands on’ responsibility act? Or will this report and further research become ‘hands off’?

Talking of hands I only hope that the health and welfare of NHS staff does not become a two fingered exercise! It is far too important for that.

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Sorry everyone, no blog this week…

By Sarah Burnett-Moore - 9:50 am

…I have rung in sick today, like 44,999 other healthcare workers!

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Staff sick leave costs the NHS £1.7bn per year

The Guardian - 19th August 2009 12:59 pm

Huge savings could be made if the NHS could reduce the amount of sick leave taken by staff, which costs the service £1.7bn a year, a report says.

But the government-commissioned interim report, by occupational health expert Dr Steve Boorman, also reveals that many NHS staff struggle in to work when they feel unwell.

The Boorman report presents a picture of an NHS where staff fall sick not only because of the proximity of illness but also as a result of pressure and stress.

More days are lost through staff sickness in the NHS than elsewhere in the public sector - 10.3 million days a year, which is an average of around 10.7 days a year for each employee, compared to a public sector average of 9.7 days. The average in the private sector is 6.4 days a year.

Cutting sick leave even by a third could save the health service a substantial amount of money that could be spent on patient care, says the report. “A reduction of a third would mean an extra 3.4 million working days a year, and annual direct cost savings of over half a billion pounds (£555m).”

The highest rates of sickness were among those who worked hardest - more than eight hours a day.

Read more at The Guardian.

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