Freedom of Information Request Response Request Ref: FOI/652 Date of Response: 15/09/11 Request: 1. What is your Trust's current policy regarding the payment of staff during meal/lunch breaks in case of emergency call-outs, and when was the last time this policy was changed (if it ever has been)? If your Trust does pay staff for emergency call-outs during meal breaks etc, please specify how much is paid for each call-out. 2. How many times have staff been called out during meal-breaks/lunch breaks, requiring a payment to be made? Please provide details for each of the last three financial years for which figures are available? 3. What has been the total cost to your Trust for payments made to staff who have been called out during meal or lunch breaks in each of the last three financial years for which figures are available?

Response West Midlands Ambulance Service NHS Trust was created in July 2006 following the merger of four other Trusts covering the following localities; Birmingham and the Black Country Coventry and Warwickshire Hereford, Shropshire & Worcestershire (West Mercia) Staffordshire (Joined in October 2007) 1. The Trust is currently working towards a Trust wide policy, however, this is still in draft form and has not been ratified. Staffordshire and Hereford, Shropshire & Worcestershire did not have a policy in place at the time of the merger, therefore, the Trust is currently working alongside the Coventry & Warwickshire and Birmingham and the Black Country’s policies, a copy of both are attached. We currently pay £20 each time a meal break is disturbed to respond to a Red, life threatening emergency call or a Green call that is deemed serious and a delay in responding to the patient could be detrimental to their condition.

2. Unfortunately, we did not begin to capture meal break call out data for the Birmingham and Black Country and the West Mercia areas until 01 April 2010 and Coventry and Warwickshire and Staffordshire areas until 01 June 2010, therefore, we are unable to provide any information prior to this date We have provided the information for the financial year 2010/11 and 2011/12 to date broken down by crews of rapid response vehicles (RRVs) and ambulances (AMB).      Total Number of Meal Breaks 

Total Number of Meal  Breaks Interrupted 

RRV 

50415 

1150 

AMB 

112732 

2072 

WMAS 

163147 

3222 

Total Number of Meal Breaks 

Total Number of Meal  Breaks Interrupted 

RRV 

18821 

295 

AMB 

46500 

627 

WMAS 

65321 

922 

2010/11

2011/12

    3. Please see below the breakdown of how much has been paid by the Trust for interrupted meal break emergency call outs for the last three financial years; 2008-09 2009-10 2010-11

£1,580,134 £1,582,887 £1,495,939

Voluntary arrangements

WEST MIDLANDS AMBULANCE SERVICE NHS TRUST

SUB-POLICY REST/MEAL BREAKS FOR ALL STAFF

APPROVED BY:

Trust Board

IMPLEMENTATION DATE:

1st October 2005

REVIEW MONTH:

None

IMPLEMENTATION DUE

January 2006

Issue No

02

Page 1 of 8 Pages

Voluntary arrangements

SUB-POLICY – REST/MEAL BREAKS FOR ALL STAFF 1

INTRODUCTION

1.1

The prime task of the Emergency and Urgent service is to provide a rapid response to all incidents, provide quality pre-hospital treatment and care, and safe supportive transport to treatment centres or onward referral to appropriate facilities where they exist.

1.2

With affect from 01 October 2005, the following guidelines will apply across West Midland Ambulance Service NHS Trust, incorporating Shropshire Ambulance Service, hereinafter known as the Trust.

1.3

The aim of this document is to provide an agreed understanding of how rest/meal breaks should be managed by the Service

1.4

The Policy also enables Operational staff to be pro-active in requesting breaks.

1.5

This policy applies to all groups of staff on Agenda for Change contracts, except where group or individual arrangements are already established, as detailed in Appendix 1.

2

OBJECTIVES

2.1

The main objective is to try and ensure that all staff as in paragraph 1.5 receive an uninterrupted unpaid rest/meal break within a specified time frame or window and that interrupted rest/meal breaks are kept to an absolute minimum.

2.2

To ensure that the health and safety risks to employees of the Trust are reduced to their lowest practicable level as a result of not having an appropriate rest/meal break when carrying out their duties.

2.3

To make provision for:

2.3.1

Periodic risk assessments and for action to be taken as a result of those assessments.

2.3.2

Further risk assessments to be undertaken as a result of any change to this policy.

Page 2 of 8 Pages

Voluntary arrangements 2.3.3

3

Operational staff may volunteer to be available, during the rest/meal break, subject to the criteria and arrangements set out in this document.

REST/MEAL BREAK ENTITLEMENTS

3.1

All staff as described in paragraph 1.5 will be entitled to the following unpaid rest/meal breaks. Shift Length

Rest/Meal Break

12 Hours

1 X 45 Minutes unpaid

10 Hours

1 X 37.5 Minutes unpaid

8 Hours

1 X 30 Minute unpaid

3.2

In addition to the above, any staff required to use a PC continually will receive additional ‘paid’ breaks appropriate to the shift length being worked, to comply with the Display Screen Equipment Health and Safety regulations.

3.3

These additional concessionary breaks will however be subject to being disturbed without attracting any compensatory payment. These additional breaks will only ever be disturbed to meet the call demand.

3.4

Due to the additional break allocations stated in 3.2 above, Operations Centre staff on 12 and 10 hour shifts will receive their uninterruptible break allocation over two break periods, ensuring that a minimum 30 minute primary break is observed.

3.5

The following rest/meal break windows will apply to operational road staff.

3.5.1

12-Hour Shift Break, to start between the 4th and 8th hour. E.g. 0700-1900 shift – break to start between 1100 and 1500.

3.5.2

10-Hour Shift Break, to start between the 4th and 7th hour. E.g. 1000-2000 shift – Break to start between 1400 and 1700.

3.5.3

8-Hour Shift Break to start between the 3rd and 5th hour E.g. 0600-1400 shift – Break to start between 0900 and 1100.

3.6

Where two staff are crewed together, but are working different shift patterns (e.g. 0800 and 1000 starts) it will be the responsibility of the Operations Centre to ensure an appropriate rest/meal break window is allocated. Whenever

Page 3 of 8 Pages

Voluntary arrangements operationally possible this should coincide with the rest/meal break of the crew member with the earliest start. This should avoid excessive working without a break for that individual. 3.7

4

The Operations Centre shall determine when staff will be stood down for a rest/meal break within the agreed time windows set out in 3.5. However, the intention is to ensure, where operationally possible, that crews take their rest/meal break at the earliest opportunity following the start of their rest/meal break window.

INTERRUPTED REST/MEAL BREAKS

4.1

Only those staff who have voluntarily made themselves available, upon request at the start of the initial break, will be disturbed.

4.2

Rest/meal breaks will only be interrupted when an emergency occurs that requires an immediate response and no other resource is available or appropriate to attend within an acceptable time frame for the case. This will only be for category ‘A’ “Immediately Life Threatening calls”, category ‘B’ “Serious but not immediately Life Threatening calls” and “Doctors’ immediate or ‘blue light’ requests”.

4.3

Leading up to rest/meal breaks it is the responsibility of the EOC to manage the distribution of the available WMAS resources to try and ensure that appropriate cover is maintained during rest/meal breaks, thereby minimising the potential for breaks to be disturbed.

4.4

When more than one crew on station is on a rest/meal break the crew who have been on rest/meal break for the shortest period will be activated to an emergency call if required. This will always be subject to the deployment of the most appropriate skill levels required to meet the presenting condition of the patient.

4.5

The objective is to achieve at least an uninterrupted break of 20 minutes. Therefore on occasions when a meal break has been disturbed, a further rest/meal break will be allocated. This will be the unexpired balance of the break or 20 minutes, whichever is the greater, and may only be interrupted for Category A calls.

4.6

More than one interruption to the break should be a very infrequent event and allowing for this acts as a “safety net” for patients and the organisation. Every effort will be made to minimise these interruptions.

4.6.1

Examples; 45 minute break with 15 minutes taken, balance = 30 minutes 37.5 minute break with 20 minutes taken, balance = 20 minutes

Page 4 of 8 Pages

Voluntary arrangements 30 minute break with 19 minutes taken, balance = 20 minutes

5

COMPENSATORY PAYMENT

5.1

Once a rest/meal break has been allocated, only those staff who have volunteered to be available may be disturbed.

5.2

When any rest/meal break is interrupted, staff will be entitled to claim a compensatory payment of £20. The crew will then be allocated their rest/meal break following completion of the incident.

5.3

Compensatory payment will be payable for each interruption which occurs. This would normally be expected to be once only per person per shift.

5.4

When the rest/meal break window expires any crew who have been unable to take their rest/meal break within 60 minutes of the agreed times or window will be allocated a rest/meal break as a matter of priority. In this situation, staff will also automatically become eligible to claim the compensatory payment. The additional 60 minutes is a trigger point for payment, not to be treated as an extension to the break window.

5.5

Occasions will inevitably occur when a crew will be required to attend a call and will be unable to complete their rest/meal break during the stated rest/meal break windows. Personnel must clearly understand that one of their main duties is to ensure that the needs of all patients are met without delay.

5.6

On occasions when it has not been possible to provide a break, staff are entitled to claim the compensatory payment in addition to overtime payment for the period of the rest/meal break not taken.

6

LOCATION OF REST/MEAL BREAKS & REIMBURSEMENT PAYMENT

6.1

This section applies to all staff as in paragraph 1.5.

6.2

All staff must be available at their designated place of work promptly at shift start and finish times.

6.3

In an attempt to provide staff with the best opportunity for an uninterrupted rest/meal break, breaks may not always be allocated at the base station for any given vehicle. The Control may wish for the Crew to take their break away from their station at any of the recognised ‘ Social Response Posts’ (standby points) agreed with the staff and pre designated by the Trust. A definition and list of the current ‘Social Response Posts’ are at Appendix 2 although these will be continually reviewed and updated in partnership with staff representatives.

6.4

Breaks allocated ‘Off Base’ will be entitled to claim a £5 reimbursement payment to cover the cost of purchasing additional food. If the crew are

Page 5 of 8 Pages

Voluntary arrangements subsequently disturbed whilst at an ‘Off Base’ location, they will also become eligible to claim a £20 compensatory payment in 5.1 above. 6.5

Crews may initiate a request to take their break at another location other than their ‘Base Station’. Requests should be made known to the controller at the earliest opportunity. In these circumstances no claim for reimbursement can be made however if their break is interrupted from their chosen location, they will be entitled to the £20 compensatory payment.

6.6

Staff who choose to be uninterrupted and leave Trust premises for the duration of their break are responsible for ensuring that they return promptly for duty on the expiry of the break period. Please also refer to paragraph 7.2.

6.7

Operations Centre staff will only become eligible to a reimbursement payment if they are tasked to attend an alternative control location during their established shift and before any primary break has been taken.

7

MONITORING

7.1

The Trust will ensure that monitoring arrangements are in place to provide evidence of compliance with the above guidelines. Records of occasions when rest/meal breaks are interrupted will be published on a monthly basis for the information of all Staff.

7.2

The Trust’s Command & Control Software will record all the meal break events associated with a crew. It will therefore form the basis for determining the actual time taken for each break period. The Command & Control system clock will be the only time source used to record meal break allocations; any discrepancies will be referenced against this time record only.

8

RISK ASSESSMENTS

8.1

Risk assessments referred to in paragraph 2.3 will be recorded on standard WMAS forms and will be returned to the Environmental, Safety & Security Manager’s office.

8.2

Managers or competent persons who have received training in such tasks should carry out the assessments. Additional advice may be obtained via the Staff Environmental, Safety & Security Manager.

9

RESPONSIBILITIES

9.1

The Human Resources Director will have overall responsibility for the interpretation of Terms & Conditions and the Working Time Directive Policy.

9.2

The Director of Corporate Development has the overall responsibility for the implementation of health and safety matters within this policy. The Director will also be responsible for the development and delivery of training courses in health and safety and for the review of procedures relating to the subject.

Page 6 of 8 Pages

Voluntary arrangements He/she will be responsible for the review of items related to Health & Safety related to this policy and the control of forms used in conjunction with it. 9.3

The Directors and Managers have responsibility for ensuring that matters within the policy that are within their sphere of operations within the Trust are managed.

9.4

The Staff Environmental, Safety and Security Manager will have responsibility for providing advice and assistance in respect of risk assessments.

This Agreement has been developed in partnership, endorsed by the Staff Side of the Joint Executive Committee, and ratified by the Agenda for Change Project Board.

Signed:

Date:

…………………………

………………………………

Mr B M Johns Chief Executive

Mr H Reaney Staff Side Chair

21st October 2005

Page 7 of 8 Pages

Voluntary arrangements APPENDIX 1 All Staff on Agenda for Change Contracts Application of this Policy

For clarity, the foregoing policy is applied (or not) to each department/staff group listed as described below: Department/group AES ! movements within 5 miles of base? Air Ambulance Appeals Airport Paramedics Capacity Management & Communications Clinical Support Team Corporate Development Education & Professional Development Emergency Control Centre(s) Emergency & Urgent Operations Estates Finance FCP Unit Human Resources Information IT Management Development Operations Management Press & Communications Patient Transport Services Porter/Drivers

Purchasing Shropshire EOC Shropshire Operations Uniform Department

Application of Meal Breaks Policy No foreseeable reason for staff to have interrupted breaks, although policy would apply where essential. Subsistence would apply > 5 miles away from base. Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Policy applies. Policy applies. Self management of unpaid breaks well established Self management of unpaid breaks well established Policy applies. Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Self management of unpaid breaks well established Policy applies. No foreseeable reason for staff to have interrupted breaks, although policy would apply where essential. Subsistence would apply > 5 miles away from base. Self management of unpaid breaks well established Policy applies in principle, except will require local agreement for cover arrangements. Policy applies, except that break times reduced to take account of 39 hour/week rotas. Self management of unpaid breaks well established

Page 8 of 8 Pages

COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST MEAL BREAK POLICY 1.

Policy Statement This Policy and Procedure has been created to ensure the fair and consistent management of daily meal breaks within the Service. The primary aim is to ensure, as far as reasonably practicable, all relevant staff obtain a daily meal break.

2.

Scope This Policy and Procedure applies to all Staff within Coventry and Warwickshire Ambulance NHS Trust. The payments apply to those staff on Agenda for Change Terms and Conditions.

3.

Principles This Policy has been produced on the following principles: • • •

• • • • • •

4.

The National Terms and Conditions Document for Agenda for Change should be followed at all times; Operational managers with devolved responsibility should agree a “Break Window” for all staff within the staff group, in partnership with staff side; Staff would be given the option as to whether they wish to have an undisturbed meal break or they wish to be available for duty. Those staff who work as an Operational crew must either make themselves available to work, or not making themselves available to work on a crew basis. The Working Time Directive will be followed, in all circumstances; Staff should be re-imbursed when they have a meal break interrupted by management, this will be an flat rate sum that buys out any on call, overtime payments for the period. This will be called an interrupted meal break payment; The Trust believe that all staff should take their meal breaks at their base station / department. Where this is not possible, a break will be allocated at another facility with equivalent facilities; When operational staff covering an operational shift are allocated a break outside the employees region, i.e. for a long distance transfer, they will receive an additional payment; Reasonable efforts will be made to reimburse staff time lost in their meal break being interrupted; Should no meal break be facilitated, staff will automatically qualify for the interrupted meal break payment. Definitions Break window – A period of time where the meal break will begin. Break windows are agreed as follows For shifts between 7 and 8 hours – between the 3rd and 5th hour For shifts over 8 but not above 10 hours – between the 4th and 7th hour

Issue Date: April 05 Revision: April 06 VERSION 5

Issued By: Director of Human Resources Authority: Director of Human Resources

Document No: HR 21 Page No: 1

COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST MEAL BREAK POLICY For shifts above 10 hours

– between the 4th and 7th hour

Meal Break – A period of time allocated for staff to refresh and revitalise themselves away from their daily work. Meal break length For 8 hour shifts, i.e. 7 ½ hours operational - 30 minutes For 10 hour shifts, i.e. 9 ½ hours operational – 30 minutes For 12 hour shifts, i.e. 11 ½ hours operational – 30 minutes 5.

Staff Group Definitions

5.1

Accident and Emergency Staff This staff group will comprise Emergency Care Practitioners, Paramedics, Technicians , Trainee Paramedics, Trainee Technicians and staff who work on the Alternative Response Vehicle.

5.2

Non Emergency Operational Staff This staff group will comprise Patient Transport Service Staff, Patient Car Service staff, Logistical Medical Service staff and Out of Hours Drivers.

5.3

Operations Centre Staff This staff group will comprise Operations Officer, Senior Operations Assistants and Operations Assistants.

5.4

Support and Managerial staff This staff group will comprise Admin and Clerical Staff, Station Managers not working an Operational Shift, Middle Managers, Senior Managers, Clinical Supervisors etc.

6

PROCEDURE

6.1

Accident & Emergency Staff All staff at the beginning of their shift will liaise with the Operations Centre regarding their break. The crew will inform the Operations Centre at the start of their shift, if they are willing to be disturbed during their meal break, or if they wish their break to be uninterrupted. Staff will be allocated a break as per the agreed windows in Section 4 above.

Issue Date: April 05 Revision: April 06 VERSION 5

Issued By: Director of Human Resources Authority: Director of Human Resources

Document No: HR 21 Page No: 2

COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST MEAL BREAK POLICY If the crew do not make themselves available to work through a meal break, they will be allocated a meal break. If the crew make themselves available, they will remain available for operational duties. If they are used during this period, they will receive a one off payment. This payment is stated at Appendix 1. Operational Procedures outline which calls can constitute disturbance from a meal break. If staff make themselves available, but are not used, they will receive no additional payment. Should staff be allocated a break away from their base station, when they had food at station to consume, they will qualify for a further payment, detailed at Appendix 1, to compensate for additional expenditure. This payment figure will be reviewed at appropriate intervals. The Operations Centre will maintain a monthly report for payroll purposes of those staff who are eligible for the Missed Meal break payment. 6.2

Non Emergency Staff Non Emergency staff will be planned an unpaid meal break within their daily duties. If staff are unable to take a break at this time, the Operations Centre will allocate a meal break to staff at the next possible opportunity. This will be allocated within a reasonable timeframe. If a member of staff agrees to work through a meal break, they qualify for an additional payment. This payment is detailed at Appendix 1. Should the member of staff wish to take a meal break, this will be facilitated. The Operations Centre will maintain monthly report for payroll purposes of those staff who are eligible for the missed meal break payment.

6.3

Operations Centre staff Operations staff use the same procedure as Accident and Emergency Road staff.

6.4

Support and Managerial staff Support staff from non-operational Directorates and non-road Operational management have the responsibility to arrange their lunch break within their staff group.

7.

Recording Operations Centre staff must maintain accurate records for payroll purposes.

Issue Date: April 05 Revision: April 06 VERSION 5

Issued By: Director of Human Resources Authority: Director of Human Resources

Document No: HR 21 Page No: 3

COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST MEAL BREAK POLICY All employees must record their time clearly on any appropriate time recording or payment record as appropriate. 8. Monitoring This Policy will be monitored by Service managers to ensure fairness and consistency of practice. Feedback from either management or staff side representatives will be given to the Director of Human Resources for purposes of Policy review. 9. Review This Policy will be reviewed 12 months from the date on agreement through the Joint Consultation and Negotiation Committee (JCNC) Policy and Procedure Sub Group, or any other group as agreed by management and staff side representatives. It will be the role of this working group to make recommendations to the Executive Team and the JCNC.

This agreement applies from the point of assimilation for staff groups onto Agenda for Change Terms and Conditions.

Chief Executive:

………………………………….

Date:

…………………………………..

Staff Side Chair:

…………………………………..

Date:

…………………………………..

Issue Date: April 05 Revision: April 06 VERSION 5

Issued By: Director of Human Resources Authority: Director of Human Resources

Document No: HR 21 Page No: 4

COVENTRY & WARWICKSHIRE AMBULANCE NHS TRUST MEAL BREAK POLICY

APPENDIX 1 Meal Break Payments The following Meal Break payments were agreed with effect from 1 June 2005, to be reviewed December 2005. A&E Staff: Non Emergency Staff:

£20 £13

All other allowances as per Agenda fore Change Terms and Conditions

Issue Date: April 05 Revision: April 06 VERSION 5

Issued By: Director of Human Resources Authority: Director of Human Resources

Document No: HR 21 Page No: 5