Health Service

Retirements under the “Grace Period”

HSE contingency planning Process

1.Introduction

There has been detailed planning work at national, regional and site-specific levels to proactively manage the impact of staff retirements under the ‘Grace Period’ on front-line services. In the development of the National Service Plan all factors, including budgets, staffing levels and the impact of the retirements were factored in. This applies to the regional service plans also. The principal focus is on protecting and maintaining critical services such as Emergency Department, maternity, critical care and neonatal services.

The HSE is seeking to mitigate the impact of these retirements through the implementation of the National Clinical Programmes, targeted investment and recruitment as set out in the National Service Plan and utilising the provisions of the Public Service Agreement to bring about greater flexibilities.

2. Retirement Numbers

At 16th February 2012, the total number of staff who had indicated their intention to retire in the period September 2011 to February 2012 was 4,326. The HSE estimates that this would convert to approximately 3,800 Wholetime Equivalents but the actual WTE number will not be available until all retirements during this period have been analysed and the appropriate calculation made.

The table below shows the cumulative number of staff (headcount) who had retired by specific dates.

Date / Numbers who had left ; / %
31st December 2011 / 1,759 / 41%
31st January 2012 / 2,176 / 51%
8th February 2012 / 2,303 / 53.2%
16th February 2012 / 2,347 / 54%
Balance to leave over February / 1,979 / 46%
Total retirements / 4,326 / 100%

The 4,326 retirees are 3.33% of the health service WTE staff numbers of 104,392(based on health service personnel census September 2011).

Of the 4,326

  • 1,052 (24%)are early retirees under the Cost-Neutral Early Retirement Scheme. This allows people to retire before reaching full pension age, and with reduced benefits to take account of the early payment of the lump sum and the longer period over which pension will be paid.
  • Approximately 2,300(53%) are aged over 60 years.

The tables below show the current number of retirements by Region, Care Group and Staff Category.

Retirements by type
Early retirement / Retirement Min Age 55 (Psychiatric) / Retirement Min Age 60-64 / Retirement Max Age 65+ / Retirement on Other Grounds / Total
Total / 1052 / 283 / 1766 / 498 / 727 / 4326
% of Total / 24% / 6.5% / 41% / 11.5% / 17% / 100%
Retirements by Region
Region / Dublin
Mid Leinster / Dublin
North East / South / West / National / Total
Grand Total / 998 / 888 / 1217 / 1194 / 29 / 4326
% of Total / 23% / 21% / 28% / 27% / 1% / 100%
Retirements by Care Group
Acute Hospitals / Ambulance Services / Children & Families / Corporate Functions / Disability
Services / Elderly Care / Mental Health / Primary Care / Other / Total
1490 / 38 / 66 / 101 / 478 / 572 / 586 / 676 / 319 / 4326
34% / 1% / 2% / 2% / 11% / 13% / 14% / 16% / 7% / 100%
Retirements by Staff Category
Staff Category / General Support Staff / Health & Social Care / Management/ Admin / Medical/ Dental / Nursing / Other Patient & Client Care / To be Determined / Total
Grand Total / 468 / 419 / 400 / 170 / 1994 / 821 / 54 / 4326
% of Total / 11% / 10% / 9% / 4% / 46% / 19% / 1%

The figures may still change somewhat as:

  • Notifications of retirement made at local level are approved and then recorded in the national pensions office in Manorhamilton;
  • Some staff are only required to give two weeks’ notice of their intention to retire.
  1. Mitigation measures

The main focus is on reform and achieving greater productivity. The national levers being used to minimise the impact on frontline services and to support local contingency measures across hospital and community services are as follows:

  • Flexibility - Public Service Agreement– Maximising staff flexibility and productivity through the Agreement by staff redeployment, streamlining of management structures, changing business processes, service integration, rostering and changes to skill-mix etc.
  • Increased Productivity- National Clinical Programmes– Maximising productivity through the Clinical Programmes by reductionsin average length of stay, improving day of surgery admission rates, increasing the proportion of day cases over inpatient, wait time targets etc).An investment of €23.4m is allocated in the National Service Plan for Clinical Programmes.
  • Strategic allocations in the National Service Plan 2012(€35m Mental Health, €20m Primary Care)
  • Targeted recruitment for critical posts (€16m to fill critical key essential service posts to minimise impact on frontline services).

National, Regional and Site-specific Contingency Plans continue to be refined as more information becomes available. Reconfiguration and integration of services, reorganisation of existing work and redeployment of staff underpin these detailed contingency plans. The main principle is to minimise in as far as possible the impact on service delivery and to maintain critical essential frontline services.

  1. Contingency plans for hospitals and community services

The main areas that have been impacted by the ‘grace period’ retirements are set out in the table below.

Hospital services / Community services
  • Maternity services
  • Neonatal/ Paediatric services
  • Specialist nursing in ICU, theatre and emergency departments.
  • Hospital Consultant posts in areas such as anaesthetics, orthopaedics.
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  • Community nursing, including public health nursing
  • Mental Health services including the CentralMental Hospital.
  • Nursing in Community Nursing Units

Detailedcontingency plans have been developed for each hospital and community service and continue to be refined as additional information becomes available.

Hospital CEOs and individual community service managers have undertaken an assessment of risk and have prepared their individual site-specific plans on this basis.

The HSE aimsto maintain essential frontline services such as emergency departments, intensive care, neo-natal and maternity services. Theplans identify the following:

  • The profile of staff who are retiring.
  • The impact these departures will have
  • The specific contingency measures that are being put in place to address/manage these risks.
  • Numbers and category of critical staff that services believe need to be replaced.
  1. Review of Plans and Assurance Process

Individual meetings to review contingency arrangements and provide the necessary level of assurance have been held between the National Director for Integrated Services, Regional Directors for Operations, eachHospitalCEO and other community service managers. These meetings concluded on 15th February.

The review of contingency plans and assurance process shows that contingency measures are in place for each region to minimise the impact on essential frontline services. The CEOs have provided a written assurance that the risks associated with the ‘Grace Period’ retirements have been identified and that the appropriate measures to minimise impact on frontline services are being managed, including:

  • Staff being redeployed across services;
  • Consolidation of clinical management roles;
  • Reorganisation of services;
  • Changes to staff rosters;
  • Improved skill-mix;
  • Significant personal flexibility being shown by staff. This includes cancelling leave during the transition phase, working overtime for time off in lieu but without additional pay etc.;

A similar planning exercise is underway across the Community Services.

  1. Addressing areas of key risk

The key risk areas within the hospitals include key consultant posts, midwifery, neonatal care, ICU, theatre and emergency department staff.

The critical staffing risks identified in each Region and some of the specific measures to be undertaken are detailed below.

  • Additional Funding for critical posts:

A limited amount of funding (in the order of €16m) has been allocated in the National Service Plan to replace some critical posts where there will be gaps in essential frontline services(e.g. in maternity, paediatrics, emergency departments, intensive care etc.). Local contingency plans are focusing only on the replacement of key essential posts that cannot be filled through other means such as reconfiguration, reorganisation of services, etc.

  • Recruitment Panels

The HSE National Recruitment Service has put in place a number of recruitment panels including nursing, midwives, mental health and psychiatric nurses etc, from which health services can draw from to fill critical vacant posts. Having these panels in place will help to ensure a faster turnaround time in filling key vacancies that arise.

  • Short-term measures

A series of short-term measures are also being put in place during and immediately after the retirement deadline. These include where required, postponing of leave, staff working overtime (unpaid but time offered in lieu). It is important to note that the level of flexibility being demonstrated by staff in many cases exceeds what is expected of them under the Public Service Agreement.

  • Agency

In some cases Agency staff may also be used where there is a critical service requirement. (This particular measure is taken in the context of the HSE’s objective to reduce overall agency costs by 50% in 2012). Some of the cost associated with routinely using agency staff, will where local budgets allow, be converted into recruiting permanent staff.

22 February 2012

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