Unison at Addenbrooke's

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All out on 28 March

(11/02/09) NEC calls for mass turnout at G20 march to demand: Put people first!

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Unions tell colleges: It's time to pay up!

(05/02/09) Campaign launched to get further education colleges to honour national pay deals

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NHS staff praised for beating weather

(04/02/09) London trust rewards staff who battled in to work on Monday

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Union tells Tories to act on social worker shortages

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Nottingham members rally against job cuts

(03/02/09) Council defers decision as hundreds brave freezing weather

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Put people first!

(02/02/09) 55 days to mobilise for G20 march for jobs, justice and climate

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(30/01/09) Union describes market system as "fatally flawed"

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Glasgow strikers take case to public

(29/01/09) Community service supervisors demonstrate outside Sheriff Court

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Prentis pledges to fight higher ed job cuts

(28/01/09) Support sent to London Metropolitan University over cuts announcement

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Racism shown red card at Old Trafford

(28/01/09) UNISON proud to support new anti-racist educational film

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Medical Secretary: Outsourcing and Campaigning

Lead Officer: Carole Proctor

Outsourcing Victory - Branch formally places Campaign on successfully closed list

December 2007

Due to the succesfull conclusion of our campiagn against local outsourcing of medical secretary work, this campaign section will not be updated in the near future, for the back history and ideas of how to prevent this in your area you may continue to follow the link to the full storey

OUTSOURCING VICTORY! Now med secs fight ‘two-tier’ system

13th August 2007

CAMBRIDGE Health Branch’s campaign against outsourcing of clinical typing has been successful not only regionally, but nationally as well as we not only stopped outsourcing in Addenbrooke’s, but got it on to national television, adopted at the UNISON National Conference, and saved jobs up and down the country as UNISON medical secretaries in other Regions heard of the work we had done.Having set up a highly efficient network in Eastern Region (with contacts in many other regions as well) I circulated all of the group and its associates, and we have decided that we will keep the group running, as it is an extremely effective way of dealing with ill-considered plans for medical secretarial issues. With the group’s agreement, we are therefore moving on to look at opposing the ‘two-tier’ system of secretarial support which is being introduced in Ipswich and Colchester, with the consequence that medical secretaries there are leaving in fairly substantial numbers.

In addition, we want to look at the issue of annual and sick leave cover for secretaries. Where no cover is provided secretaries are effectively working a 52-week year, but having to encapsulate it into 46 weeks. The stress levels of this are taking their toll, with subsequent sickness and stress-related absences, again without cover, and thus a vicious circle evolves.

This is not a simple issue, because as many secretaries have pointed out, having inadequate cover is often worse than having no cover at all, and so something else needs to be worked out. At Addenbrooke’s, in the first instance I will be seeking a meeting with the Director of Operations to discuss this matter, which does, in fact encompass some issues raised by a Working Party set up under his direction last year.


15th May 2007

CAMBRIDGE Health Branch can give itself a real pat on the back for the work that has been done about sending clinical typing abroad. From the early stages of opposing the proposal to pilot a scheme in Addenbrooke’s, the movement grew like Topsy! We formed a regional group of secretaries, who have managed to challenge the implementation of outsourcing of typing, usually with some success. Very quickly groups in other regions were contacting us for advice, and we were able to send out the various papers, letters and articles, so that the campaign was more organised than the Trusts trying to introduce the pilots. We have had coverage in the National Press, and on BBC Television. Our cause was taken up by UNISON at the National Conference last year, when Dave Prentis made a statement to the Press, and a National Seminar was organised at Unison Head Office in December last year, when I was a guest speaker.

Our latest victory was achieved in Cornwall, where approximately 100 redundancies had been threatened, and where not only were these withdrawn, but the proposal to send the typing abroad was abandoned. Christine Dayus, our Unison contact in Cornwall contacted me with a special Thank You for the work that had been done by our Branch on behalf of our Secretarial Members nationally. In this region, I think only the Lister Hospital has gone down the Outsourcing route, with disastrous results, as we predicted.

A recent report from the Lister tells how the Outsourced Agency cannot cope with the workload, and the backlog is being typed by medical secretaries at the Lister, who are being paid overtime rates to do it. There has been at least one incident of a patient with cancer receiving a letter to the effect that they are ‘clear’, whilst someone who did not have cancer has been told that they do have it. In a recent newspaper report, another patient had to wait two months for a letter which was typed in India to reach their General Practitioner to arrange an urgent heart scan.

With the exception of the Lister, our campaign seems to be an unqualified success. We cannot rest on our laurels, however. A new threat is becoming apparent. Already in Ipswich Hospital management has introduced a two-tier system of medical secretaries, with some at Band 4 PA level, and the rest reduced to a Band 3 Typing Pool status. This system is only marginally better than outsourcing, as once again the continuity between consultant, secretary and patient is lost. A similar system is being looked at in Essex, and it looks as though we may need to start another campaign.

The latest news from Ipswich at the time of writing is that following the review to introduce the new two tier system, 17 secretaries have either resigned or retired. This has resulted in the Trust using MediSec – an outside agency – to type the letters (this is another form of outsourcing, of course). The rate for this typing is higher than that paid at the top of Band 4 which is the current Senior Medical Secretary/PA Scale. This once again proves that these measures do not save money in the long-term, and in every case work to the detriment of patients.

Recently on the BBC Local News a Consultant appeared who works for Colchester Hospital reporting that Consultants there had been reduced to hand-writing their letters if they were to be written at all, because of a lack of secretarial staff.

Obviously, there is a lot of work to be done in other areas to ensure that the medical secretaries’ profile is raised so that Trusts appreciate the valuable job they do. This includes ensuring that they have holiday cover. Unlike with nursing or reception work, if a medical secretary goes on leave, the work does not get done automatically by someone else. This means in effect they are working a 52 week year, encapsulated into 44 weeks.

What our experience here has taught us is that there is strength in numbers, and that forewarned is forearmed. Every hospital which was part of our communications group was able to respond quickly, eloquently and in an informed manner when the subject arose, and that is the reason our campaign was so successful. It is perhaps time that we reviewed our purpose to encompass these other issues.


February 2006

In November 2005 a rumour was circulating around Addenbrooke’s that the typing of clinic letters was going to be sent overseas. This was investigated by the Unison Medical Secretarial Stewards, who were able to confirm that the Trust had been approached by a company offering to send typing to the Philippines, with a 24 hour turn around and the scheme was to be tested in the Urology Department.

This raised concerns on several levels. From the position of good practice, there were issues concerning the accuracy of the typing, and also confidentiality.

From the recruitment and retention point of view, there was concern that this practice would lead to redundancies amongst medical secretaries, or the devaluation of their function.

From an ethical point of view, there was concern that there may be exploitation of workers in poorer countries.

As a result of these and other worries, a letter was sent from the three Secretarial Stewards to Richard Sunley, Director of Operations, outlining some possible flaws in the new scheme. As a result a meeting was convened between Richard Sunley and Angela Huxham from the Trust Board, and Martin Booth, Carol Phillips and Carole Proctor from Unison to discuss the matter.

Amongst the issues raised were matters of confidentiality, and the value of sending work abroad, discussion around how it could come back, and whether in fact it would save any time at all, bearing in mind that the errors would need to be checked and corrected, any action involved in the letters would have to be carried out, as per normal, and the whole thing would need, in some way or another to be put on to the Electronic Medical Records system. It was considered by the secretaries present at the meeting, that it would not, in fact be any quicker to have it typed elsewhere, whereas the risks of dangerous errors remaining undetected was considerably higher than if the typing were done in-house, with the notes and all relevant patient information to hand. Letters would then, of course, have to be printed out, and one of the worries the secretaries had was that their function in this regard would be reduced to that of ‘Girl Friday’ to the new ‘Audio Typists’ in the Philippines.

The effect of the suggestion of outsourcing typing would further lower the morale amongst medical secretaries in Addenbrooke’s. Secretaries already feel undervalued, a fact which is reflected in the problems with recruitment. The lack of career pathway, finance for training and the fact that by not being in the ‘front-line’ of patient care, theirs is always seen to be the area where cuts fall first are all contributory factors to this low morale, and any threat to take away a significant part of the current Medical Secretarial role, without replacing it with any more rewarding or administrative duties only serves to exacerbate this situation.

The outcome of the meeting was very positive. Richard Sunley agreed to address a meeting of the Medical Secretaries’ Forum, which was chaired by Unison on this occasion. The meeting was well attended, with over 100 secretaries being present, and everyone who spoke after Richard Sunley had addressed the meeting expressed concern about this new proposal.

In addition, it was agreed that the three Unison Medical Secretary Steward Carol Dwane, Carol Phillips and Carole Proctor (the Carollary as it is affectionately known) should sit on the panel evaluating the pilot scheme which had been anticipated to start on 1st February 2006. In the event, this date has been abandoned for the time being, but we welcome the invitation to participate.

One of our major concerns was that there were very negative reactions from other Trusts where this system had already been tried. In one Trust the matter is going to arbitration. In several others the pilot trials are not proving to be very accurate. The Addenbrooke’s Trust Unison Medical Secretary Stewards therefore approached the Regional Office and have now set up a Regional Group of Unison members who are medical secretaries, representative of virtually all hospitals in the region (one or two still have to provide nominees, and no hospitals have declined to join.

This group will first of all outline what experiences they have had, if appropriate, of outsourcing. Those who have successfully opposed the measure are invited to tell the group how they went about this, and it is hoped that this interchange of ideas will form a comprehensive report of Outsourcing regionally, if not nationally in the near future. Once the report is prepared, a meeting will be held of the Group, funded by Region, to discuss the best way of dealing with the situation.

In all of this, we would like to point out that we are not Luddites, and do not oppose measures just for the sake of doing so. We are acutely aware of difficulties in recruiting medical secretarial staff, and are happy to help in looking at ways of resolving the problem. However, we cannot allow decisions of this magnitude to be taken without proper consideration of the implications not only to staff, but to the quality of patient care, and as such feel we have an important contribution to make.

Article added 2008-02-25 11:49:21