Minister for Health Leo Varadkar has welcomed approval by Brendan Howlin, Minister for Public Expenditure & Reform, of an agreement between the health service and unions to transfer four key tasks from doctors to nurses including taking blood, discharging patients, giving first dose antibiotics and administering drugs intravenously.
“Since I was a medical student, people have been talking about nurses taking over these tasks from junior doctors. I am really delighted to have got it over the line as Health Minister,” Minister Varadkar said.
“This is a win-win for everyone. Nurses will be able to use their new skills and they will benefit financially in return for taking on this additional work. Junior doctors will benefit as the reduced workload will help us to continue to reduce their working hours and they will be less likely to miss out on important training time in theatre and in clinics. Patients will benefit as there will be fewer delays when it comes to getting their IV antibiotics, their bloods taken or discharge papers, and there will be fewer delays for patients in the clinic waiting rooms as doctors won't be expected to be on the wards and in a clinic at the same time as frequently as they are now.”
The four tasks and their associated elements are:
· Intravenous cannulation
· Phlebotomy
· Intravenous drug administration (first dose)
· Nurse led discharge
Training will come into effect immediately and it will operate mainly in acute hospitals but also in some district hospitals.
“The agreement on the Transfer of Tasks from non-consultant hospital doctors to nurses and midwives under the related provision in the Haddington Road Agreement has been finalised with the approval of Minister Howlin. This agreement enables the most appropriate person to undertake four specific tasks which were previously undertaken by doctors in training. They will now transfer to nursing personnel when appropriate and necessary for patient care or safety,” Minister Varadkar said.
“This is a practical reform at ward level that will make things better for patients and staff alike. It is expected to be cost neutral as the costs of implementation will be offset by reduced unscheduled overtime by doctors. It is also a good example of the Haddington Road Agreement in action with pay being restored in return for valuable changes in work practices and reform.”
Allowing the nurse treating the patient to undertake these four tasks will enhance patient care by ensuring early and timely intervention by the person most appropriate to provide that care. This will ultimately lead to better outcomes for patients leading to quicker recovery times and earlier discharge of patients. This agreement reflects the Government’s commitment to public sector change and reform.
This reform compliments the initiatives from the Emergency Department agreement between the HSE and the INMO. It is envisaged that the transfer of tasks from medical staff will allow doctors to undertake tasks more appropriate to their training and will support NCHD compliance with the European Working Time Directive.
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Further information
Local management have primary responsibility for the implementation of this agreement with national oversight. There will be a training and implementation phase followed by a verification and evaluation phase. Pursuant to the Haddington Road Agreement and the related Chairman’s note under the Lansdowne Road Agreement the mechanism for determining payment will be the payment of the arrangement, in quantum and related conditions, which previously applied between the hours of 6:00pm and 8:00pm. This ensures that the savings are applied in a manner which achieves best value for money.
This reform was agreed between the Department of Health, the Department of Public Expenditure and Reform, the HSE, IMO, INMO and SIPTU Nursing under the chairmanship of an independent facilitator, Mr Sean McHugh.