National 29 November 2016
Dear Member,

Welcome to the 15th issue for 2016 of ASMS Direct, our national electronic publication.

You can also keep in touch with the latest news and views on health issues relevant to public hospital specialists via our website www.asms.nz, which contains links (at the top of the home page) to our Facebook and LinkedIn pages, as well as our quarterly magazine The Specialist. We’re also on Twitter at https://twitter.com/ASMSNZ.

A quarter of SMOs intend to leave in next five years

Dr Chambers has also looked at the number of SMOs intending to leave either medicine or their district health board employers in the next five years, and her initial findings were presented at the ASMS Annual Conference in Wellington this month.

She surveyed DHB-employed members about their work intentions with a view to better understanding the factors influencing their decisions as well as the link with demographic factors such as age, gender, medical specialty and levels of job satisfaction.

She found that up to a quarter of survey respondents intend to leave in the next five years.  Of those who intend to stay, 40% might look at reducing the hours they work, 30% would like to decrease their on-call and/or shift work, and 8% would like to stop doing on-call altogether.

Coupled with the findings on presenteeism and burnout among SMOs, these results add to the picture of a senior medical workforce increasingly under pressure and struggling to cope.   We will be taking up the results with individual DHBs to encourage greater workforce planning to manage the pressures.

A full report of Dr Chambers’ research will be available early next year but the results are summarised in an ASMS media release: http://www.asms.org.nz/news/asms-news/2016/11/17/significant-number-senior-doctors-intending-leave-next-five-years-survey-finds/. A video of her conference presentation will also be available online soon.

Burnout in the BMJ Open

The extraordinary results of ASMS research into burnout among New Zealand’s public hospital senior medical workforce have just been published in the BMJ Open: http://bmjopen.bmj.com/content/6/11/e013947.full?keytype=ref&ijkey=drr5XIHfT3hfuXZ

In August we released the findings from a survey carried out by Dr Charlotte Chambers, ASMS Principal Analyst (Policy & Research), which found that half of all hospital specialists who took part in the survey reported symptoms of burnout. Nearly half (42.1%) said this was due to their work and cited frustrations with management, intense and unrelenting workloads, under-staffing and onerous on-call duties.

As we said at the time, the findings are extremely concerning and require urgent action to address the high levels of burnout in the SMO workforce (ASMS media release: http://www.asms.org.nz/news/asms-news/2016/08/12/burnout-rife-among-senior-doctors-dentists-working-public-hospitals/).

To the best of our knowledge, this study was the first in the world to investigate levels of burnout using the Copenhagen Burnout Inventory (CBI) in a cross-vocational nationwide survey of senior doctors and dentists. The full report of Dr Chambers’ findings is available online at http://www.asms.org.nz/wp-content/uploads/2016/08/Tired-worn-out-and-uncertain-burnout-report_166328.pdf

It is very pleasing to see these research findings published by the BMJ Open, with the article co-authored by Dr Chambers, Christopher Frampton, Murray Barclay and Martin McKee – and I encourage you all to read it.

Update on the DHB MECA negotiations

The DHBs’ MECA settlement offer was discussed in some detail at the ASMS Annual Conference, and delegates voted unanimously to reject it. As a result, formal negotiations will need to resume, most likely sometime in the new year. 

An update on the MECA negotiations has been sent to you all but the latest Bargaining Bulletin (number 9) is also available on our website at http://www.asms.org.nz/wp-content/uploads/2016/11/Bargaining-Bulletin-9-25-November-2016-campaign-monitor.pdf

Orthopaedics situation at Waikato DHB requires investigation

Many of you will have read or heard about the serious concerns raised by orthopaedic surgeons at Waikato DHB. They say that DHB managers have stopped them from making follow-up checks on patients so they can assess new patients instead to meet national health targets (http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11753565). Waikato DHB has rejected the surgeons’ claims – but we think an independent investigation is needed, with the agreement of the orthopaedic surgeons. This incident has similarities with the recent ophthalmology situation, where follow-ups (which are not counted for the target) were delayed to the detriment of patient safety in order to focus on activities that were counted.

This is a very serious situation which needs to be addressed in the interests of patient safety. The full ASMS media release on this issue is available at http://www.asms.org.nz/news/asms-news/2016/11/24/independent-investigation-needed-waikato-dhb-orthopaedics-revelations/.

Did you know… about payment for public holidays over Christmas and New Year?

This year the four public holidays over Christmas and New Year fall on a Sunday or a Monday. This means that these holidays will be officially observed a day later (on a Monday and a Tuesday). 

Special rules apply for the holidays that fall on the Sunday (25 December or 1 January).

If the Sunday would otherwise be a working day for you, then this day must be treated as your public holiday, and your public holidays will be Sunday and Monday that week.

If the Sunday would not otherwise have been a working day for you, then the following Tuesday must be treated as the public holiday, and your public holidays will be Monday and Tuesday that week.

If you work on “any part of” the days designated as your public holidays, you are entitled to your usual pay for the day worked, plus an additional 50% of your “relevant daily rate” for every hour worked during routine hours on the public holiday.  You are also entitled to a day-in-lieu on full pay at a later date.

If you are a shift worker, eg, in ICU or ED, and you are rostered off on a public holiday, you are entitled to a day-in-lieu on full pay on another mutually convenient day.

More information is available here:

http://www.asms.org.nz/employment-advice/agreement-info/nz-dhb-senior-medical-and-dental-officers-collective-agreement/part-three/clause-24/

and here:

http://legislation.govt.nz/act/public/2003/0129/latest/DLM237128.html 

http://legislation.govt.nz/act/public/2003/0129/latest/DLM237121.html


Kind regards

Ian Powell
Executive Director