Do your patient notes in your proper hours Friday 1 March

Work Your Proper Hours Day is the day when the average person who does unpaid overtime finishes the unpaid days they do every year, and starts earning for themselves.

Sixty-nine per cent of physiotherapy staff work unpaid overtime, according to the NHS Staff Survey for England, published earlier this week.

Despite some progress in recent years thanks to the recent CSP Pinpoint the Pressure campaign, workload pressures remain a major ongoing issue for physiotherapy staff.

CSP national health and safety officer Donna Steele said: ‘Members often come under pressure to complete patient notes in a treatment slot that they don’t think is long enough. Or they are doing their notes out of work hours because they run out of time or there wasn’t an available work station when they needed it.

‘Some may find themselves struggling to complete notes on the day that they saw their patient. When the pressure is on the temptation is to leave work incomplete or do unpaid overtime.

‘When this happens you run a number of risks: of disciplinary action or dismissal if you fail to achieve your employer or HCPC’s requirements on record keeping; going off sick through stress and fatigue due to over-work; making a clinical error, caused by fatigue and lack of concentration that could harm a patient.’

The CSP is encouraging members to consult CSP advice and guidance relating to duty of care, role conflict on prioritising work demands and the CSP Quality Assurance Standards, which members can use as a tool to ‘identify whether there are potential or actual gaps in how you and your colleagues are working that undermines safe physiotherapy services,’ said Ms Steele.

‘As health professionals our members need to step up and say “We have an obligation to record keep, we need to relook at the admin time”.’

Personal responsibility but collective solution

Ms Steele stresses that while there are personal professional responsibilities each member needs to consider, collective solutions can be found to the issue.

 ‘When members work as a collective group they are powerful. We believe Work your proper hours day is a real opportunity to highlight why admin time is important.’

In 2017 and 2018 the CSP ran a campaign to tackle workloads and among the improvements members and workplace reps secured in the NHS and in the private sector was additional admin time:

Essex: management agreed to increase from 20 to 30 minutes time for writing up patient notes after a stress survey found ‘very high percentage’ of CSP members reporting an unacceptable high stress levels with the main reasons being too short treatment time and no admin backup staff.

Cheshire: stewards and safety reps did a stress survey of 20 CSP members and found the 30 minutes allocated for new patients, post-operation, was too short. Survey results fed back to members whose suggestion of an increased time slot of 45 minutes was accepted by management.

London: management doubled to one hour a day administration time after a survey by CSP safety reps found 68 per cent of staff reported ‘insufficient to no admin time.’

Southmead: the CSP safety rep surveyed staff about workload and found members were writing up to 20 referral letters a day. More effective admin support and processes were put in place.

South Wales: Staff were given additional admin time at the end of the day, especially in MSK outpatients, after they conducted a Fish Bone Exercise and presented to senior managers.

Dudley: the CSP safety rep and stewards worked together after management cancelled a ‘complimentary’ 15-minute break and ended an allotted quarter hour of administration time for outpatient MSK physios each day. The safety rep said: ‘People were just doing the admin in their own time and frequently staying over by 20 or even 30 minutes every day. 

‘Outpatient staff have a diary that runs the entire working day in 30 minute segments and there was no allocated time to write reports, chase up consultants, check emails and so on.’

However, by presenting management with a copy of their survey, the CSP team managed to persuade senior staff that the admin time was vital to reduce the stress of frontline staff. And not only was the protected admin time reinstated, it was actually extended to half an hour each day. 

The safety rep says the joint working between rep and safety steward was a big help in presenting their case. ‘It’s good for moral support, you don’t feel like you’re on your own, and working it through with someone else can be very valuable,’ he says. ‘And the survey was something solid, so we could sit down with our managers and show them how members felt.’