Contract terms for healthcare ancillary staff

Hospital ancillary and support staff may be NHS employees, or increasingly employed by specialist support services companies. This latter, and now very common, arrangement creates many problems usually due to the different terms and conditions of service applicable.

“Cleaners, porters and catering staff at Wycombe Hospital are set to begin two days of strike action today due to a dispute over sick pay.

There will also be a 48-hour walkout at Amersham Hospital starting at 10am, said the Unison union.

Those set to strike are contract workers for private company Medirest, who only get statutory sick pay of £79.15 per week.

‘In-house’ NHS staff, by contrast get full pay for at least one month when sick. NHS sick pay also kicks in immediately, whereas statutory sick pay – the legal minimum – is only payable after three days of illness.

There is no need to pass comment on this dispute, save to consider just one broad issue that is applicable to the management of clinical wastes.

When contract staff are responsible for the management of clinical wastes – closure and removal of filled containers, cleaning of sack holders and replacement of sacks, bulk collections etc – there will be different lines of management control. This predisposes to differences in the level and quality of training and supervision – mostcontractors will have a core staff population but rely heavily on sessional staff who may appear from the dole queue at short notice then dissapear just as quickly – with contract staff having much less training , supervision and control that directly employed staff. This leads to poor standards of performance, and many will remember the various television exposés of this very situation.

Additional concerns extend to matters of safety. With inadequate training, accidents will be more common. PPE provision may be limited or non-existent, and without proper training and supervision PPE use is likely to be poor.

When accidents do happen – blood splashes to the face and eyes, or a sharps injury – provision of first aid and subsequent specialist care may be refused as contract terms have not considered this for at risk contract staff. The advantages of a comprehensive NHS occupational health or infectious diseases service are not available for contractors, who instead are left with nothing.

This is of great concern, and must be addressed as a matter of urgency by Trust managers and contractors alike.

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