THE SOLUTION TO ANY PROBLEM IS A SURVEY.
We have come to the conclusion that most often a DHB’s first response, when a broad issue is brought to their attention, is to run a survey. With on-line survey websites being cheap and easy to use this can be an efficient tool to use to collect data and sometimes a survey is warranted. However we would suggest DHBs consider the following before embarking on one:-
1. Is a survey warranted?
2. Are the questions relevant?
3. How long is the survey?
4. Has this information been collected already?
Sometimes it feels as though the survey is being considered as an option just so it seems something is being done; “this problem is just too hard so let’s carry out a survey”. Or it can be the case that those in charge really do have no idea what the problem is and the hope is that the survey will illuminate the matter for them.
If a survey takes longer than 5 minutes then chances are it will not be completed. If advised in advance that the survey will only take 5 minutes and you find yourself approaching the 10 minute mark you will most likely join the majority and bail out. Your time is precious and to find half an hour free to complete a survey that you have little or no faith in, is often a bridge too far.
Relevance is also important: when the question is “what do you think of the food in the cafeteria” what is the relevance of your gender or the department you are working in? If you are answering questions you have already been asked, most likely you will think “why bother, nothing changed when I completed this survey last time” or “are they just going to keep asking until they get the response they want”?
In a 2012 article in The New York Times it was claimed that constant surveying “has led to a condition known as survey fatigue and declining response rates”. This would appear to be what we are hearing from the DHBs as fewer of you are taking part in their surveys than ever before. More and more it would seem that an incentive is needed to encourage participation; if this is going to lead to a safer roster and working conditions then I am prepared to take the time.
So if a survey is not the answer, how do DHBs go about getting the information they need in order to form policy and make change? We would suggest in most instances open, safe and honest engagement is more likely to provide the data or information necessary. However until we reach that utopia you may still have to take some time and fill out that survey. It may be the only time you get “heard”.
One final word of caution please don’t be tempted to use social media to give your opinion on work related matters instead of the survey. Rescuing members from what is a public forum discussing their employers “finer features” is something we would prefer to avoid.
PREVOCATIONAL TRAINING CHANGES
MCNZ has recently confirmed what they intend “community practice” to be. It is NOT, as some have assumed, simply a GP run. Whilst primary care is an important part of community work, it is not the whole story. The MCNZ definition is:
“An educational experience in a Council accredited attachment led by a community focused specialist which involves the learner in caring for the patient and their illness in the context of the community and their family.”
MCNZ have advised that General Practice will NOT be a compulsory component of the community attachment, and further that general practice settings will NOT be required to be cornerstone-accredited (i.e. are not dependent on RNZCGP approval) but MCNZ accredited.
Council have approved a staged transition and want indicative targets for DHBs to meet 100% compliance with community experience by the end of 2020. This is a change from the previous 2015 implementation timeframe.
This does not mean that the central role of the general practitioner is not acknowledged. Council’s reasoning is that the community setting is designed to give house officers a view of how medicine is (as well as could be) delivered outside the hospital setting. General Practice is expected to be the major setting for most community attachments but it would be detrimental to insist on it being compulsory because Council wants to see house officers exposed to innovations such as integrated care or out-reach attachments that are being established by some hospital based specialists and services. This is NOT the same they have emphasised, as going to a hospital based specialist’s private rooms – this would not be an acceptable community attachment as it is simply replicating hospital-out-patient work in a different setting.
The ballot for the GPEP CA has closed; the vote was in favour of accepting the settlement.
However the vote was only 53% in favour, the lowest ratification percentage we have ever had in NZRDA with the previous lowest recorded ratification ballot being 90% in favour.
This low level of support for the settlement indicates a concerning level of dissatisfaction with the offer, and notably from people who know first-hand what it is to be a GPEP1.
So what how? As the settlement has been legally ratified, NZRDA will now complete the paperwork and sign the collective. Copies will be distributed after the College has also signed it and a lump sum payment will also become payable to members of NZRDA in GPEP1.
Despite the disappointing attitude of RNZCGPs towards GPEP1, NZRDA will continue to lobby for w better deal for GP registrars. We are told some 200 applications have been received for the programme starting in December 2014, up from 114 at the same time last year. The 172 available places that have not been filled for 4 years now; may be this year! How many applicants are hedging their bets however will only be known once definitive appointments and acceptances have occurred later in August.
Whilst applications to GPEP1 are up, they are down in other specialties the Medical Workforce Reference Group was informed last week. We have asked for more information about which schemes and in which regions and will report back when we have that information.
One of the queries we are frequently asked relates to sick leave/parental leave. What kind of leave are you entitled to if you are feeling unwell for reasons relating to pregnancy? What kind of leave is it for antenatal appointments etc?
Under the MECA you are not entitled to sick leave for absences during or in connection with the birth of a child, this should be covered by annual leave or parental leave. If your “ailment” is not related to the pregnancy (you have the flu etc) then you are still entitled to sick leave.
So the question is can you take parental leave prior to the birth of a child and what about appointments?
Under the Act you can commence maternity leave from “date of confinement” which may start up to six weeks before the expected date of birth or adoption. In certain cases maternity leave can start earlier than six weeks. Your doctor or midwife can direct you to start your leave earlier if they believe it is necessary for the health of you or your baby. Your employer can also direct you to start maternity leave early if you cannot continue to do your job safely or cannot perform your job adequately.
If you and your employer agree, you can start maternity leave at any other time before your baby is due. It is also important to remember the reduction in hours clauses in the MECA as follows and note that these reductions do not have any impact on payments you are entitled to under the contract:-
(a) From 28 weeks of pregnancy (or earlier if considered medically appropriate by the employee’s lead maternity carer), no night shifts shall be worked.
(b) From 32 weeks of pregnancy (or earlier if considered medically appropriate by the employee’s lead maternity carer), no long days in excess of 10 hours shall be worked.
(c) From 36 weeks of pregnancy (or earlier if considered medically appropriate by the employees lead maternity carer), no acute clinical workload shall be allocated.
So what about the numerous appointments that you seem to have to attend prior to the birth of a child. Under the Act special leave of up to 10 days can be taken by a mother before maternity leave for reasons connected with pregnancy. Please note these entitlements apply to maternity leave only rather than parental leave.
Please note that payments and entitlements in relation to parental leave are one of the more complex areas in the MECA so we suggest you communicate with either your local delegate or send us an email if you are at all unsure.