Response to the Health, Social Care and Sports Select Committee inquiry into the COVID-19 outbreak - AUGUST 2020

MiP welcomes the opportunity to respond on behalf of its members, National Committee and MiP Team to the above inquiry. Throughout the pandemic, MiP has been supporting its members, working in close partnerships with its partner and affiliated Unions, as well as with the range of organisations it represents across Wales including:

·         Local Health Boards (LHBs) - Aneurin Bevan UHB; Cwm Taf Morgannwg UHB; Cardiff & Vale UHB; Hywel Dda HB; Swansea Bay UHB; Betsi Cadwaladr UHB; Powys Teaching HB;

·         Public Health Wales;

·         Welsh Ambulance Services Trust;

·         Velindre NHS Trust;

·         Welsh Government;

·         Shared Services Partnership;

·         Health Education and Improvement Wales (HEIW);

·         NHS Wales Informatics Service (NWIS).


MiP continues to support and promote understanding of the vital roles of managers in the NHS. We emphasise why the role is so important and what managers continually strive to achieve as part of the delivery of NHS care. MiP recognises there are several key priority areas that remain at the forefront for senior managers and staff within this difficult time:


Pay & Conditions – Annual Leave; sickness; Time in Lieu/Overtime; redeployment; Working from home;

Supporting Health & Well Being – Support for managers to manage others; Individual support for Managers; Physical & Psychological Wellbeing; access to occupational health services.

Managing Issues/Crisis – Internal and External comms support;

Personal protective equipment supply – Supply and Guidance;

Staff Testing – Travelling for tests; Process in place; Monitoring;

Redeployment – Are there agreed processes in place;

Employee/Employer Relations - Engagement of Staff side; Grievances & Disciplinaries; Reorganisations/OCP.


MiP also recognises the policy support given to all staff and organisations in Wales and were particularly pleased to see several key documents since the start of the Covid situation (see below).  These have been very much welcomed by MiP and were circulated to members appropriately. 


Covid 19 Moral and Ethical Advisory Group Wales (CMEAG-Wales) – 12th April 2020

A Framework of ethical values and principles for health care delivery.  The three key areas covered in the document are:

1.   Core values to inform planning & decision making for health care delivery for all people in Wales;

2.   Using the Framework to deliver health services equitably;

3.   Principles & Law underpinning ethical delivery of healthcare.


Framework to Lead Wales out of the Coronavirus Pandemic – released by Welsh Government - 24th April 2020

This Framework is based on three key pillars:

1.   Measures & evidence to judge the current infection level and transmission rates;

2.   Set of principles to examine proposed measures to ease current restrictions – grounded in scientific evidence & wider social & economic impacts;

3.   Enhance public heath surveillance and response system to track the virus as restrictions are eased.


Covid 19 – FAQs for NHS Managers & Employers – NHS Wales - 23rd April 2020

In summary, this is an extremely useful update document produced by NHS Wales through collaboration across WG, trade union partners and UK colleagues.  It outlines guidance and support to ensure consistent advice in relation to aspects on employment and management responses.  It encourages local level plans to also be developed in partnership where possible.


NHS Wales – Guidance on supporting shielding employees return to the workplace – July 2020

This document provides guidance for managers and employees to facilitate, enable and to continue to support home working, where it is appropriate and safe to do so.

Recently MiP has undertaken some key areas of work to focus on member issues in this unprecedented time. Firstly, a Wales members survey in July from which the headlines were:

  1. Members are doing a substantial amount of unpaid overtime (many more than 20 hours per week)
  2. Members are struggling to take time off in lieu (TOIL), increasing the likelihood of exhaustion and burn out
  3. More than 50% of members say working hours are having a negative impact on their wellbeing
  4. Members (70%) feel personally ready to resume business as usual service provision but most are unsure that their organisations are ready to resume working as usual

Secondly, MiP also held a webinar open to all members in Wales at the beginning of August to discuss the following questions:

  1. How manageable is flexible working/working from home?
  2. How is member wellbeing affected by working hours/how is work culture currently (and can we use changes during pandemic to improve culture)?
  3. Are organisations ready for resuming services?
  4. Are members able to access support needed from organisations/have members had risk assessments?

Key points from the members’ webinar

There many questions about the inconsistent approach across organisations in Wales in terms of overtime payment & TOIL.  Members felt that communications have not been consistent and the management of the local arrangements has differed. As a result, MiP recommend that there needs to be a consistent national approach across Wales, leaving this to local interpretation and delivery is not seen as a successful process.


Another key issue raised was how Annual Leave carry over and usage needs to be consistent, with a national message across Wales – again not left to local variations as members feel very strongly they will not have the capacity to take all leave or TOIL owed by end of year deadline.


It was very encouraging to hear from some members about where organisations had taken forward some good practice - for example, Welsh Ambulance NHS Trust - such as a staff survey and a well-managed approach to the situation by agreeing early on to pay overtime and by encouraging leave so staff were feeling refreshed.  Working from home was also encouraged and split across working arrangements and IT support was easily set up.


Another highlight was how NWISS have been particularly excellent in terms of support with the pressures to have IT infrastructure set up and support in place.  This needs to be headlined as the Digital Reset Report last year was very critical.  The management of the response to the pandemic could not have happened without this support package in place. It is also clear that we need a National IT Strategy to support long term home working, increase capacity and standardise practice.


MiP will be continuing this dialogue with members and organisations across Wales. In our further work we have identified the following priorities:


1. Benchmark management practice from other organisations and identify good/not so good practice

2. Beyond contractual arrangements, focus on issues of health and safety, wellbeing and the attendant risks for all staff, including managers, and ultimately patient safety. Staff are exhausted from the long period of pressures.

3. Staff being treated fairly and consistently within organisations and across Wales.

4. Moving to 'business as usual' - elective activity and Flu/winter pressures and Covid all coming together into a perfect storm – how will we manage it?


Next Steps

MiP recognises fully the pressures of the current crisis, however, we also have some robust future plans in place for further discussion with NHS Wales Organisations in relation to the following priority areas: 


Jon Restell, Chief Executive

24th August 2020