Disillusioned kindly posted comments 'bout Day Hospital but then interestingly mentioned how staff sickness meant that the work didn't get done.
This got me thinking.
If a Consultant Psychiatrist is off sick for a short time (a few day), any routine work isn't done but any urgent work is covered by colleagues, being absorbed in to their working week. If off for any length of time, a locum is brought in to fill the post and do the work. Although I've not had a day off sick this year, nor have others I work with, I think that it's understandable that if I am off sick, 'phoning in that morning to say I'm on my death bed, then the clinic list for that day would have to be cancelled. Given that the work isn't done by anyone else then has to be done when I return to work, on top of everything else, it's usually easier to soldier on and do the work rather than take time out one week then have 2 weeks' work to do the next. But anyway, short term sickness will occasionally occur and will occasionally impact on appointments.
For nursing staff, the story's the same for short term sickness too. If colleagues are off for a short time then urgent stuff is dealt with and some it's understood that appointments for that day may need to be cancelled. Going through all activity since April 2008, we've actually not had to do this terribly often, since either other CPNs* or I have done the visits instead. Thus, we can count on one hand the number of patients who've had cancellations through sickness. We don't like to mess patients around so if we can sort it out we rather would do, then we're up to date and the patient's had the input we'd all felt was needed.
Long term sickness is different, though. I've little sympathy or understanding for why long term sickness should affect patient visits and support at all, since it's long term (so plans can be made to address this).
Disillusioned said that staff off long term do have impact on support. Needs identified and planned for within the Care Programme Approach (CPA) should, obviously, be met. The whole point of it is that you're looking at needs and planning medical, social and nursing care to address these needs.
For a service to have folk, with CPA evidencing the service provision nececssary for their health, to then fail to deliver, seems wholly inexcusable. Okay, if through short term sickness I'd concede as above that the odd visit may not happen, but for people to just do nothing is unbelievable. It's embarrassing.
In what other area could someone be off work, have patients in need of support, and still no support is given and no work gets done?
* Apologies to anyone who's a Integrated Developed Independent Outreach Team (IDIOT) nurse and not a CPN, but I can't get my head around new jargon for new jargon's sake ;-)