Full details of the Dorset mealbreak policy can be viewed here.    The "westcountry" meal break policy can be viewed here.  The London policy is available here

Most people knew it from the very early days of the introduction of the Agenda For Change — When it comes a meal breaks and the Ambulance Services, there is going to be a problem…

 During a long and complicated process over several years, UNISON fought hard to try and ensure that the Agenda For Change brought improvements and uniformity to pay and conditions for its members across the NHS. One of these improvements was to guarantee staff a meal break during their working shift, by making sure it is outside the paid working day. Standard working hours were set to 37.5 hours a week, not including time spent on a meal break.

 This is quite workable in most areas of the Health  Service, but instantly created difficulties for ambulance trusts, who have to maintain emergency cover at all times with limited funding, and yet are obliged to try and ensure staff take a break. Further complication is caused by ambulance staff who want to work 12 hour shift patterns, creating the need for 2 breaks during a shift, and an uneven number of hours in a set period. This has led to a difficult situation nationally across all ambulance trusts, and work is underway with UNISON to secure a national solution. Meanwhile, individual trusts are left to make their own arrangements.

 UNISON members in the former West country areas of the trust are  trialling the re-introduction of 12 hour shifts. Yet over in the Dorset area, where 12 hour rotas are already in place, the meal break problems are  perhaps most clear. Here, from the beginning of this month, staff working 12 hours are stepped down to a 37.5 hour week, exclusive of meal breaks. This does not mean that they will see any actual drop in pay, but it does mean that they will have to continue to attend work for a 39 hour week, and one meal break from each shift will be taken outside of the working day.

 This raises concern over emergency cover, and so there are suggestions for a payment in the event of  meal break interruption if staff agree to be available for category A calls during their unpaid break. Similar arrangements are already in place in some other Ambulance trusts.

 A vote was promised and UNISON representatives met with both members and then management earlier this year, putting forward a set of suggested requirements and conditions  surrounding the meal break issue.

 Many members in Dorset were concerned about an email-ballot at the end of September, asking for a yes vote. Necessary small print seemed to be missing, raising many vital questions, and the break which did not attract the interruption payment was set as the one during the busiest part of the shift, not allowing any financial incentive for management to ensure that staff received their break during the busiest time.

 Urgent meetings were arranged on Tuesday 26th September and Friday 29th September 2006 between senior UNISON officials and senior management to try and negotiate a solution. A new vote was then put to staff in Dorset - who voted for "option one" - to have one meal break paid, and the other unpaid, but with staff remaining available. This break would be interruptible for a "life threatening emergency", with a consolation payment of £15.00. Staff in other areas continue to work a system of two unpaid, un-interruptible meal breaks.

Currently, Staff in all areas are encountering problems with both ways of working.

The Dorset policy will is due for review at the end of December 2006, whilst we await a national guidance from the National Ambulance Forum, expected in March 2007.

The debate rages on. Some argue that on busy stations, it is simply unacceptable to be expected to work 12 hours with the potential of not having an allocated break. Others do not feel morally comfortable being unavailable for their meal break periods, whilst many resent the half hour meal break periods being taken out of the working day and then having to be worked as "time owed" because of the shortfall in hours that this creates.

Pressure grew for a national solution, with The London Ambulance Service introducing their  policy and the national press in January 2007 reporting a claim that lives have been lost as a result of nearest available crews being on meal breaks.

Consultation papers have been posted to all members of the South Western Ambulance Branch of UNISON, and elsewhere  nationally, to ask for opinions on the issue of meal breaks. As you are probably well aware, the meal break debate has continued to rage on since the introduction of meal breaks outside of the working day, brought about by the full implementation of the Agenda For Change working conditions. (see “The meal break Issue” at www.swamb.com for more detail). It was left up to local arrangements to try and come up with a solution. 

Now a whole range of various ways of working are in place across ambulance services in the UK, and hardly any of them are without problems, some of which have even made the national press in recent months. In the end, it has been shown that ambulance Services have been unable to apply exclusive break arrangements without compromising patient care.

The National Ambulance Sector of UNISON has been working to collate the different methods being applied across the country, and to come up with a recommended solution for all trusts in England and Wales. This is why all UNSION members have been asked their opinion.

The information provided by UNISON accompanying the consultation paper outlines a suggested return to inclusive meal breaks, on the basis of section 10.1 of agenda for change conditions, which allow for meal breaks to be included in the working day as an exception where emergency cover is required. UNSION is recommending that shifts should preferably be taken at base station, with a first meal break of 45 minutes duration and a second break of 30 minutes for a shift of 10-12 hours duration, and believes an appropriate time for implementation would be no later than 1st October 2007. The National Ambulance Sector believes that this change can be accurately costed that any additional costs should be met by the Department Of Health. 

Full details of the current Dorset mealbreak policy can be viewed here.

The current "westcountry" meal break policy can be viewed here.

The London Ambulance Service policy is available here

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