Hansard

I am grateful for the opportunity to update Parliament on the progress that has been made towards resolving the rest break issue within the Scottish Ambulance Service.

I want first to provide some of the background to the issue. The background is important because it explains why the Ambulance Service is in this situation and what it has done to address the issue over a number of years.

As members will be well aware, 2004 saw the introduction of the national health service agenda for change, a new pay system for staff employed by the NHS across the United Kingdom. Agenda for change harmonised the terms and conditions of service in relation to annual leave, working hours, sick pay and work done in unsocial hours for all non-medical staff in the NHS across the UK.

Prior to agenda for change, Scottish Ambulance Service staff were employed on a 40-hour week inclusive of meal breaks. Following the introduction of agenda for change, the arrangements were harmonised with the rest of the NHS, resulting in a change to a 37.5-hour working week exclusive of meal breaks.

At the time of implementation, it was not possible to agree a common approach across the UK on how ambulance services should handle the rest break issue. In order to fulfil the desire to continue to provide adequate emergency cover, the Scottish Ambulance Service management and the trade unions reached an agreement in 2006 to introduce a voluntary arrangement.

The arrangement allows for front-line operational staff who volunteer to make themselves available to work during their unpaid break to be paid an annual allowance of £250. The allowance is paid on the basis that staff will continue to receive a rest break but will be prepared to be flexible about when it is taken and are willing to be disturbed in an emergency. In addition to the £250 annual payment, an activation payment of £5 is paid when a staff member is required to respond to a call during a rest break.

All staff are asked on an annual basis whether they wish to be available during rest breaks. Take-up of the voluntary scheme has remained fairly constant over the past five years at around 20 per cent of eligible staff. It is worth pointing out that the 540 staff who signed up in 2010-11 were disturbed in total 2,150 times during their rest breaks in that year. That is an average of fewer than four times per person over the course of a year.

Notwithstanding the voluntary scheme, the current arrangements can still lead to a situation in which a critically ill person is not attended to by a nearby ambulance crew. That is not an acceptable situation. Not only does it potentially compromise patient safety, but it is not in the interests of ambulance staff either. Staff in those circumstances are abiding by their contract of employment. As they are on a break, the command and control system used to deploy crews does not recognise them as an available resource. However, as a result of where they are when they take their rest break, the staff can subsequently find themselves the subject of public and media anger.

Two recent tragic cases in Tomintoul and Crieff have highlighted the degree of concern that the public and members of this Parliament have about the issue. The Scottish Ambulance Service management and trade unions therefore entered into extensive negotiations in an attempt to resolve the rest break issue in July this year. Negotiations concluded on 12 August, with an offer being put to staff in a ballot. The three trade unions involved recommended acceptance but, in spite of that recommendation, the offer was rejected by all three unions towards the end of September.

In the light of the ballot results, I met the unions on 29 September—last Thursday. I made it clear to the unions that I heard the message of the ballot results and reiterated my strong commitment to working with them in partnership to address concerns and, if at all possible, to find a longer-term solution that staff would feel able to support. Talks between management and trade unions will, therefore, continue.

However, while supporting those continuing talks, I and the Scottish Ambulance Service have a responsibility to ensure that patient safety is protected. In my judgment, simply leaving things as they are while those further talks take place is not consistent with fulfilling that patient safety responsibility. Therefore, I have decided, in agreement with the majority of the unions involved, that the terms of the offer will be implemented for an interim three-month period while talks continue. That interim arrangement will be in place from 6 am on Monday 10 October.

I will lay out the key elements of the interim arrangements, including who will be covered, what category of calls they will apply to and what the compensation for staff will be. I will also explain how the arrangements will be monitored.

It is fundamental that the Scottish Ambulance Service gives an absolute guarantee that rest breaks will be provided for staff. Any member of staff who is disturbed on a rest break will be able to take their rest break later in their shift. Nothing in the new arrangements will be allowed to compromise the health and wellbeing of our hard-working ambulance staff. Staff will be disturbed during a rest break only if it is to respond to a category A call or a major incident; in other words, the arrangements will be invoked only on rare occasions. The arrangements will apply to all accident and emergency operational vehicle crew staff, urgent tier staff, air wing staff and special operations response teams.

In return for requiring staff to be available during rest breaks, the Scottish Ambulance Service will pay an annual fee of £250 to all staff to whom the arrangements apply. Initially that will be paid on a pro rata basis for the next three months. In addition to the £250 annual payment, staff will receive an activation payment of £100 if they are disturbed during a rest break. That is a doubling of the £50 activation payment that was proposed in the offer that was put to staff last month. I stress that the purpose of the activation payment is twofold: it is designed to compensate staff for being disturbed during a rest break and to be a disincentive to the Scottish Ambulance Service to invoke the arrangements. I hope that it will give an assurance that the Ambulance Service will not disturb staff unless it is absolutely essential to do so.

As I have indicated, the arrangements will apply from 6 am on Monday 10 October and will remain in place for an interim three-month period, during which talks with the trade unions will continue.

The interim arrangements will be supported by a standard operating procedure, which will provide detailed guidance on when it is appropriate to interrupt a rest break. It will set out the dispatch protocols for control room staff and it will detail the monitoring arrangements that will be put in place to ensure that staff are not being inappropriately or unnecessarily disturbed. The monitoring arrangements are particularly important, as they will allow the Scottish Ambulance Service to demonstrate to staff—and demonstrate to me—over the next three months that the arrangements are being used appropriately. They will include the nomination of a union steward in each control room to monitor the application of the rest break policy. A report will be sent from each control room on a weekly basis to the Ambulance Service’s executive team, detailing the number of times that rest breaks have been disturbed and the reasons for that. Over the next three months, I will receive that weekly report and will discuss with the Ambulance Service and the unions any issues or concerns that arise from it.

These interim arrangements are in the interests of both patients and the staff who work so hard on our behalf in our ambulance service. However, the Scottish Government is committed to continuing to support the Ambulance Service in finding a longer-term, sustainable solution to the issue. I have, therefore, tasked my officials with working closely with management and unions over the next few months to consider any necessary redesign support to improve operational deployment and to ensure that, at the end of the interim period, we have a permanent solution to put in place.

The steps that I have outlined allow me to be assured and, more important, allow me to reassure the public that patient safety is paramount, that the views of the workforce are respected and that the Scottish Government and the Scottish Ambulance Service will continue to seek a way forward in partnership.

I am happy to answer any questions that members have.