n Last Friday (26th November) Guidance and FAQs on working arrangements and temporary assignments for the civil and public service was updated by the Department of Public Expenditure and Reform.
Last week, a decision was taken by the Government to introduce new rules which required people who had a Covid-19 close contact living in their household to stay at home for 5 days and undertake 3 antigen tests during that time. Following that decision, the HSE publicly announced its intention to seek a derogation of all HCWs.
SIPTU, FORSA and INMO representatives made public statements outlining our opposition to any attempt to exempt our members from public health guidance. This position was supported given the high level of HCW infection.
On foot of this intervention, there were several meetings at national level with senior clinicians, HSE management and union lead officials over the last number of days. Arising from these discussions and negotiations an updated policy has been developed.
The updated policy for fully vaccinated HCWs confirms:
- The default position remains that fully vaccinated HCWs should adhere to public health guidance including the requirement to stay at home for 5 days and undertake 3 antigen tests (one completed every second day) during that time.
- This is the same advice as members of the general public. The antigen tests will be sent out by public health when contacted. The HSE has confirmed the employer must provide work from home for a fully vaccinated HCW who is isolating in line with public health guidance.
- If the HSE contend there is a serious risk to service if a HCW does not present for work, a process for derogation of that HCW may be sought within this agreed policy.
- The derogation request will only apply to the individual HCW.
- A request for derogation of a HCW must be undertaken by a senior manager.
For the derogation to be applied, the healthcare worker must agree to the derogation.
- The senior manager must complete the checklist (see Appendix 2 of the policy) in order to make the decision regarding derogation.
- Consideration should be given to the risk to patient safety from absences of essential HCWs. This process should include an assessment of available personnel who can be redeployed within the service. This process may result in there not being a need to derogate a HCW who is a close contact of a household confirmed case.
- The senior manager must ensure all practical efforts have been made to recruit alternative HCWs with the necessary skills and experience.
- The senior manager must ensure there is a discussion with the HCW regarding the reason derogation is necessary.
- The senior manager must note a risk assessment may be necessary to minimize the risk created by the HCW attending work
Any asymptomatic fully vaccinated HCWs who agree to a derogation request will have to have 1 clear antigen test before returning to work. They will be required to maintain antigen testing every second day until they have 3 negative test results. They will also be monitored with a temperature check twice daily following their return.
Should a HCW agree to a derogation request, they will also be required to adhere to public health guidance outside of their working hours.
Union representatives believe this robust process is the best that can achieved considering the level of extreme stress on our health service at this time. The process ensures our members will have a say in whether they wish to return to the workplace or maintain the public health guidance of restricting their movement for 5 days.
All HCWs remain under strict instructions to self-isolate and arrange PCR testing should they become symptomatic, or they have a positive antigen test result. The HCWs must also resume the restricted movement when not in the healthcare facility for work.
Following the announcement by HSE Chief Executive Officer, Paul Reid, that he is seeking a derogation for healthcare workers to be exempt from the new five-day rule to self-isolate if a member of their household becomes infected with COVID-19, the National Joint Council group of healthcare unions have written to the HSE opposing this plan.
“Healthcare unions – the Irish Nurses and Midwives Organisation, SIPTU and Fórsa are strongly opposed to the comments made by HSE CEO, Paul Reid at a press conference earlier today where he stated that he will be seeking a derogation to exempt healthcare workers from the new five-day isolation rule.
In the letter the officers of the National Joint Council said:
“We cannot repeat the mistakes of previous derogations that allowed healthcare workers to be exempt from public health advice. We know in the past that allowing healthcare workers to be exempt we saw infections spike among healthcare workers and patients, particularly when it came to the care of older people.
“Healthcare workers should not be treated differently in terms of public health advice. The HSE and Government need to take the concerns of patient-facing staff seriously. We cannot have a situation where the highest cohort of workers who are dealing with unvaccinated patients and working in environments with poor ventilation like many of our healthcare settings, are putting their colleagues and loved ones at further risk.
“The derogation that the CEO of the HSE is seeking will not help to prevent the spread of the disease.
“As representatives of healthcare workers, we want to make it clear to the Health Service Executive, Taoiseach and Minister for Health that our members will not accept this. We are already seeing over 4,500 healthcare workers out of work because of this virus, we cannot allow a carte blanche decision that is not rooted in public health advice to be made.”