There is a set, legally required process for making redundancies. Normally this will need your employer to notify you several weeks in advance that redundancies are being considered (depending on the number of redundancies) and which roles/services are under consideration.
Start planning as soon as you receive notice of the process via briefing/email/newsletter.
- contact your union eg RCN, UNISON to alert them to the change in service
- contact your supporting organisation/charity eg MS Trust, Parkinson's UK, Epilepsy Action , Epilepsy Society etc. Check whether they are aware of the situation and talk through what support you want now and what you might want in the future
- identify anyone else affected
- attend every meeting you can
- start gathering evidence to support your case
- make your case following the steps below, remembering these rules:
Rules for making your case
- prepare brief factual evidence that supports your case including your case load, key responsibilities etc.
- avoid personal terms such as I, we, me, us or our and steer clear of emotional statements or responses. Always refer to 'the service'
- paint a realistic picture of the new service. With redundancy, the specialist nursing service for your condition will be reduced or even disappear; ensure patients and service users are aware of the potential for a reduced service in future, not that you can continue to provide everything as you do now
- remember the 'bigger picture' and the risks for your employer, because it will help shape your response appropriately
- think about making joint submissions eg with other condition-specific neurology nurses
- ensure your submission stands out. Management will be receiving lots of reports from specialist nurses – what makes yours different?
- offer an alternative scenario only if this is suitable for the service and the team eg reduced hours in condition specific nursing and some hours offering a general neurology nurse specialist service
- talk to your national patient organisation at all stages of the process
- listen to advice and support
Analysing the threat: materials to support your response
This step is all about getting the evidence together. Think of it as putting all the right pieces of paper in your portfolio. How you use them to make your case is covered in step B.
Spell out the likely results of a reduction in service in terms of what it might mean for patients – what will happen to them and where will they go if your current service is unavailable?
Spell out what this will mean for your employer, the risk assessment completed at step 3 should help you here.
If you are unsure of what to do at this stage, contact your supporting national patient organisation. We can look at the evidence you have and help pull the words together to describe what happens if your service is cut or disappears.
Describe the threat and its driversWhy is redundancy being offered or threatened? Is it voluntary or compulsory redundancy?
- reduced number of clinics
- reduced telephone support
- cuts to home visits
- does this put pressure on other neurology services?
- are patients in the service more likely to:
- contract UTIs
- fail to comply with medication
- be at higher risk of serious adverse incidents eg SUDEP (sudden unexplained death in epilepsy) etc
- pressure on waiting times for neurology outpatients
- higher risk of admissions/bounceback
- very delayed discharge
- increased mortality etc
Summarise the argumentsList what you have found in point 4 in up to 10 key bullet points, eg Include any direct financial consequences you know will result, eg: increase in emergency admissions/readmissions, loss of income from nurse-led clinics etc
- reduction in staff = reduction in specialisation
- greater pressure on neurology registrars and consultant neurologists
- potentially greater waiting times for patients, risk of breaching 18 week referral to treatment targets
- potential for more emergency admissions and readmissions
- increase in delayed discharge
- risk of higher mortality etc
Craft an executive summaryIn 200 words or less, create an upfront statement about the likely effect on your service of the bullet points found in point 5, for example
"We recommend retaining the role of MS specialist nurse in its current form. Making the MS specialist nurse role redundant will have an adverse impact on safe, high quality patient care, creating longer waiting lists for neurologists and for out patient appointments, risking breaches of the 18 week referral to treatment target. It will increase the risk of emergency admissions by 20% and raise the risk of emergency readmissions within 28 days by 50%. Without an MS specialist nurse service, all annual reviews and monitoring will have to be undertaken by neurologists, whose caseload will prevent them from offering annual reviews in clinic. Therefore all symptom management and medication reviews will pass to primary care where there is no specialist knowledge. This may create an increase in complications such as avoidable UTIs and falls, leading to a rise in avoidable admissions. Since the specialist nurse will no longer be able to offer support to inpatients, many of whom have limited mobility and may present with pressure ulcers – requiring intensive nursing and therapy input - a risk of increased readmissions within 28 days and significantly delayed discharges, as well as poorer medication adherence is anticipated."
Creating your response, using materials from analysing the threat
Cut and paste all the answers from section A into a coherent document.
Check whether your management requires a particular format for the document, in which case you will have to follow that.
In all other cases, write a business case as follows:
- executive summary – cut and paste from section 6 above
- describe the situation – cut and paste from section 1 above. Exclude drivers if these are known but unhelpful, eg a personality conflict with management
- list your key arguments in bullet points – cut and paste from section 5 above
- describe your service– cut and paste section 2 above
- describe the risks – cut and paste section 3 above
- describe the consequences– cut and paste section 4 above
Ask an external party to read it
Ask your supporting charity to read the final document. Sometimes a fresh pair of eyes can spot things you've missed that can help support your case.
Submit your document
Ensure you know who should receive this, eg local management, senior management, commissioners etc. Discuss with your national patient organisation if you are unsure.