Emergency Physicians - Clinical Support Time




ASMOF was made aware that a LHD was advertising and offering contracts/ letters of appointment, particularly for Part Time Emergency Physicians which indicate that there will be no allocated clinical support time (‘CST’), while of course requiring these doctors to carry out their responsibilities for teaching, research, administration, quality assurance etc. This was formally raised in a correspondence and the response from the LHD did not satisfactorily resolve the matter. 

ASMOF therefore took the disputation to the Industrial Relations Commission of NSW (‘IRC’).

The Current Disputation - ASMOF v HNELHD
ASMOF’s Position
Before Commissioner Stanton, ASMOF submitted and argued that the LHD’s job advertisement was misleading and is inconsistent with the following:

(1)    the Staff Specialists (State) Award

(2)    the “key accountabilities” of the position required by the employer and as listed in the position description

(3)    due to the intensity and unrelenting nature of the work environment of Emergency Departments, these essential non-clinical activities are not able to be performed while an emergency physician (‘EP’) is rostered to the clinical area, and

(4)    that these activities are described and recommended by the Australian College of Emergency Medicine (‘ACEM’) in its ‘Statement on Clinical Support Time Allocation’ (Doc No. S17) and ‘Policy on a Quality Framework for Emergency Departments’ (Doc No. P28).

Further ASMOF argued, that:

(a)    EPs ought to have allocated clinical support time (‘CST’) off the floor to attend to, and performed their required non-clinical duties. 

(b)    The LHD should amend its job advertisement.

(c)     The LHD write a letter to ASMOF to the above effect. 

 ASMOF requested Commissioner Stanton make the Recommendations to the above effect (a to c).

The LHD’s Position
Firstly, the LHD rejected ACEM’s policy.  The LHD said that Manning Rural Referral Hospital (‘Manning’) is not an accredited training hospital and therefore the LHD need not comply with ACEM’s policies in relation to EPs at Manning.  In addition, the LHD argued that there is no specific provision in the Award which states that allocated CST must be given, and therefore it will be given during low demand periods.  Essentially the decision-making will be at the discretion of the Director of the Emergency Department at Manning.

The Commission
The Commissioner did not accept ASMOF’s position. The Commissioner agreed with the LHD, including that CST can be given by the Department Head during “low demand periods”.  The Commissioner was not of the view that the statement was misleading or inconsistent. 

What’s Next
ASMOF has sought a further conciliation conference in the IRC, before Commissioner Stanton. The matter has been relisted in the IRC for 2 March 2017.

ASMOF has briefed Counsel to appear in this matter, and a small number of key FACEMs will be conferring with him early next week to ensure that he receives a clear and coherent understanding of all of the issues.  As the issue has attracted the attention of a number of senior EP consultants associated with ACEM, who feel quite passionate about the matter, they will be joining ASMOF and Counsel in the IRC.  ASMOF considers there is great utility for the Commission to hear the impact of the LHD’s position directly from senior EP consultants.