Why I’ve Been Quiet

My apologies for not blogging very much last week, unfortunately my mind was occupied by some rather important things…

It started with one of my station officers handing me an envelope, in it was an appointment to see my immediate boss and a human resources manager to talk about my current level of sickness.

At the time I was on a 'Formal warning', essentially I was ordered not to be sick otherwise I could face disciplinary procedures that could end up with me being fired.

In the letter detailing the appointment it told me that I could bring a union rep (I don't belong to any union as the main one seems about as much good as a chocolate teapot and I refuse to fund them) or a friend, and whatever paperwork I deemed necessary.

I phoned my boss and asked her if the meeting would be a friendly little chat or if I should be worried – I was told that I should bring a union rep along with me and any paperwork.

This led me to worry somewhat about my future with the London Ambulance Service.

So last week was spent either preparing for the meeting, or stretched out on my sofa just plain worrying about it, jotting down logical arguments about why I should keep my job.

I thought that it wouldn't be too hard to fight my corner – in the last eighteen months I'd had four periods of sickness, however two of those were work related. One of which was when I was assaulted by a patient for around half an hour, the other caused by doing CPR in an enclosed space for forty minutes or so.

Then there was apparently a 'back pain' that I couldn't remember and of course my recent epididymitis.

If you were to take out the two work related injuries you'd realise that I'd been sick twice in eighteen months, which in my opinion is pretty good.

On the appointed day I found myself in the office being told that, depending on the meeting, I could end up being sent to Waterloo to have my sickness 'handled' by upper management (which I suspect would have me out looking or another job), I could be kept on the formal warning, or I could be removed from any warning.

The thing that surprised me about the meeting was that the people present seemed to blame me for the assault (I was wrestling with a potentially brain injured patient, and the 'urgent police' we called for didn't turn up), that if I were to be assaulted again I could be further disciplined for that sickness. I assured them that I wasn't planing on being assaulted again.

I explained that an ambulance officer had already told me not to wrestle patients, so the next head injury patient that wants to wander off into traffic can do so.

Then, concerning the other workplace caused sickness, I was asked if it were really necessary for me to undertake an extended CPR in an enclosed space – I explained that the patient was heavy and 'stuck' and so, no, I couldn't move them to a place where it would be easier to do CPR. I continued to remind them that once I start CPR, according to LAS policy, I'm not supposed to stop.

I reassured them that my epididmytis was unlikely to return, and even if it were I'd be able to recognise the grumbling early signs and start on the antibiotics a lot quicker.


I was sent out of the room while they discussed what to do with me.

It didn't take long – I would be kept on a formal warning until December, so all I have to do is not be sick until then. At which point I could well be taken off my disciplinary sanction.

I promised them that even if I were to catch the dreaded swine 'flu I'd still be in for work – at which they said nothing.


I mention this, not to have a dig at the people in the meeting – they have the rules that they have to follow and ultimately they treated me fairly. I mention this just to show the sorts of rules that govern road staff, people who are placed in danger, are often in close proximity to infectious patients and who work long rotating shifts with no break while having to carry heavy patients downstairs.

I mention this because the same rules apply to those in the LAS who work in the offices 9-5 Monday to Friday dealing with paperwork and going to meetings, walking around with clipboards and drawing up policy documents.

I mention it because I've heard that around half of road staff are on an 'informal warning' – and that if this is the case, either there is something wrong with half your staff, or there is something wrong with the sickness policy.


I have a nice little holiday next week – to say that I am really rather looking forward to it would be the understatement of the century. A week in an all inclusive hotel in Egypt doing very little but reading and lazing by the pool. I'm counting down the hours I've left to work before I fly out.


38 thoughts on “Why I’ve Been Quiet”

  1. The idea of these meetings is to have a scare tactic. Like sitting at home worrying whether you are going to have a job or not. ( as in your case )Look back and see how may frontline staff have been sacked for their sickness. Even the ones who make it obvious they are not sick.

    I think the figure will be very near zero.

    Bums on seats to hit call connect is all that counts.

  2. Its the same all over – we have monthly “review” meetings at which our Managers have to tell us our sickness rating. I haven't been off ill in three years – so I have a big fat zero. I know it, he knows it, and yet policy says he has to tell me, every month, that I haven't been sick. In case I hadn't noticed. Seems all big organisations worship at the feet of the great God of Procedures! A friend of mine who is battling cancer is currently waiting for HR to decide what's happening regarding her job. She's had too many days off – maybe she should have asked for Chemo during her lunch hour? Most of these policies have a “manager's discretion” clause but too many managers seem to be afraid to use their discretion, probably in fear of losing their own jobs.

  3. I should think they would want to inquire about your health and ask what they might do to help keep a valued public servant healthy and satisfied. British have this wonderful word: gormless.

  4. To be fair they did – and reminded me of all the different support groups that exist should I feel stressed out or something. And that if I felt like going sick I should talk to human resources to see if they could help me out.Last time I was referred to the occupational health department who told me to 'eat well, exercise and sleep'.

  5. Even the Romans didn't treat their slaves like this. At least their slaves could one day win their freedom. This negative motivation is reminiscent of the 1950s when the 'floggings will continue till moral improves' attitude' prevailed. Really it's down to unimaginative management who haven't a clue about leadership.The attitudes expressed here are not restricted to the LAS, they're rife throughout British industry, both private and public where management and staff have no respect for each other.In his autobiography, Colin Powell recounts his style of leadership where his troops were positively motivated and produced results far better than expected. This is the sort of leadership Britain needs – but will never have.

  6. The very nature of the job exposes staff to a variety of health risks. I can relate to this post, as I recall a flu epidemic laid low a lot of the front line staff. Somehow, we managed to keep the motors on the road with a lot of staff putting in extra hours.Conversely, I managed to injure my shoulder during a rescue. Was the result a summons to HR. Well, No. I got a visit from my boss who asked about my health and family. Then, on his way out he gave his personal telephone number so I could call if I needed something, then arranged for the delivery of a hamper.

    So why the draconian measures being employed by the LAS? It's simple really. The vast majority of the population would be of on long-term sick leave after being exposed to a tiny fraction of your experiences. Once again another snapshot of just how far we have fallen as a society.

    Keep on rocking-an-blogging.

  7. I am really shocked by this. It is the reverse of what you would expect from a service that exists to help the sick. When my father had terminal cancer some 30 years ago I very much appreciated that he was paid sickness benefit and got free treatment from the NHS – it seemed so much more humane than the private system that my relatives in the US lived under (where he would probably have been bankrupt by the hospital charges alone and had to sell the house making his children homeless and causing more stress and pain) Now it seems although there is still the remnants of an NHS it is trying as hard as possilbe to take on all the worst traits of pure capitalism. I feel disgusted by your management.

  8. The key point that NHS management seem to miss is that we're around sick patients with infectious illnesses all day. Even the best BSI precautions won't stop you catching said illnesses, and you're immune system can only be so good. Add to that all the bad manual handling procedures and terrible working conditions that you have to put up with, not only ethically for the patient's sake but also by your protocols, and it's no wonder that half the staff have sickness issues. But ignore all that – it's the targets that matter! *shakes head*Try and avoid catching anything in Egypt then…

  9. Ditto… I have had my second meeting re: sickness leave, ripped off a shred but not doubting my illnesses were genuine.. told that I can't have any more time off sick until October or face disciplinary action which made me very stressed which in turn affects my asthma one of the reasons I was off sick… then got told the University needs to see a return on it's investment..The last straw as far as I was concerned.. me and my experience are hitting the road, the house is up for sale and nearly packed all my worldly goods.. I am off to Cornwall, to pastures new and hopefully someone who might appreciate me more than my current employer life is too short to be treated so shabbily and I for one want some respect.

  10. I was in a similar situation myself once, I didn't like the way the displicinary was handled and so I walked out, taking further time off for stress to cover my notice period. The anxiety leading up to it has really messed with my head to be honest, and I'm so scared I'll be out on my backside without any warning in my current job- irrational but not my fault. Maybe I should sue them for emotional abuse? Anyway I think you should start showing the signs of swine flu, just to see what happens- how good are you at acting?

  11. It just totally wrong. You do not choose to be sick. The LAS and other such forces that have the same policy need to realise the crews are a precious resource, not something they can dump because they get ill.This makes me mad!

  12. Really sorry to hear this, it sounds like an absolute nightmare.Why are the LAS putting the general public as well as their own staff at risk in this way? Surely any ambulance officer with symptoms of infectious disease will be much more tempted to come in to work anyway, under this regime?

    It's absolutely criminal.

    Have a good holiday – you've well and truly earned it!

  13. This makes me so angry, can't they see that you deal with the sick and then put two and two together when you yourself get sick? My partner is a doctor and, while he seems to be immune to all the bugs, he passes everything he comes into contact with along to me so I get everything that's going. Luckily my bosses seem to be more understanding than LAS management and I'm not even in the health service. Keep your chin up Tom, maybe management doesn't appreciate you but we do…

  14. Oh dear here we go again.Well I'm glad you're not being take up to SE1 and fingers crossed with the pig flu.

    Obviously I can't talk about the figures on your complex but on mine at any given time there are about 5% of staff on Informal warnings. Yup just five out of 100 road staff, who treat the same illnesses and tend to carry the same number of heavy patients.

    I don't doubt the genuine nature of your sicknesses but statistically you're quite a way off average, yes you've been very unlucky and assuming that you bad luck spell is now over then there is little to worry about.

    I just feel that when comparisons to Roman slavery are being made then its time for a more balanced perspective.

    The policy is not exactly draconian and frankly a sickness policy is required to be able to still respond to emergencies.

    I think as ever you make some very good points about the policy being applied to staff without direct patient contact and hopefully that as well as swine flu will be part of the current review.

    In parting, and without knowing you, it seems to me that you have 2 full time jobs (and you seem very good and passionate at both) however this is bound to make you more vulnerable to illness.

    Still all the best


  15. DSO, you don't mention what you see as the other full time job. If you mean the stress of being treated like a commodity by the people who control your pay, then yes, indeed.I've been in that situation in a very different, physically less demanding field. I can talk about the endless angry monologues running in your head, the sick feeling in your stomach, the mountains of timewasting paperwork, the insomnia, the exhaustion, the effort of maintaining a good professional attitude on the job in the face of it all.

    But I have a horrible feeling you're talking about Tom's blogging. I suppose something along the lines of “if you didn't waste time on this silliness, you could eat well and sleep, which is, of course, known to prevent all illness.” If it really is this second point, then you need to get more, DSO.

  16. It's just disgusting the way they treat you ~ you should refuse to treat anyone that you feel might be infectious or cause you injury – get some of the pen pushers out to deal with them instead and see how their sikness rating goes.Enjoy your holiday

  17. Hello Tom – I'm still here, just been lurking for far too long :)I'm in a similar situation, sort of. My employer also uses the Bradford Factor, almost exclusively it seems, and sticks to it like it is the absolute end all in sickness management. I am currently off the company sickpay scheme, receiving only statatory, because my sickness over the past few months has been 'abysmal'.

    This might have some small part to do with the Appendectomy I had in January.

    Of course, an emergency operation is voluntary, I had a choice! Woe betide those who impact on Company time with their petty lifesaving operations, How Dare I!!?

    Rambling I know, but my point being, you're not alone. Petty minded corporate coin counters exist in any industry you care to mention, and it seems to be more and more a fact of life that we have to accept the pantomime that surrounds most HR departments. The only way to get on seems to be to play the game strictly by the rules set out, and document every tedious little thing, as you never know when you will be called to justify something seemingly trivial.

    One day i'll find an employer with some sense….until then there is always beer and the national lottery… 🙂

  18. I had to read this twice to make sure it was as ridiculous the second time!Words fail me!

    Enjoy your hols

    Baldock has its annual Beer festival Bank Holiday week end if you need to drowned your sorrows!

  19. I've been thinking about this all evening – it makes my blood boil! Would it be worth dropping them a letter, asking them to confirm, on LAS headed paper, the points that were covered in the meeting: i.e. that if you were to contract swine flu, in order to avoid disciplinary procedures, you are required to still come in to work and treat seriously ill people; if you attend any patient which you suspect of being in any way violent (this will, of course, include post-ictal patients), you will not treat them until the police arrive, even if this takes four hours; etc. etc.That way you would at least have some nice ammunition to take to the Press if you should end up being disciplined for ending up off sick due to assault / swine flu etc – I can see the Sun headlines now “Ambos ordered to stay at work whilst suffering from Deadly Swine Flu!”

  20. DSO made some points that I would like to comment on;If you have a 'sickness policy' it must be viable and applicable to your staff. Since leaving the service, I have not had to carry morbidly obese charecters down several flight of steps, nor have I had to scramble about in overturned cars, amidst broken glass, and a strong smell of fuel.

    The spectrum of potential injury to emeregency service workers cannot be factored, or compared to my nice and comfortable existance working at a desk. Given we are now a service providing 'economy', I suspect that we are mostly 'desk jockeys' of some discription,

    wholly protected from nasties like Australian antigen, hypothermia, a smack in the gob from a drunk etc.

    With regard to the second job question, once again I have to disagree. When I joined the service, a second job was the only way to keep the family in scooby snacks and nappies (sic). I now appreciate that current front-line staff are better paid, but essentially the job is the same. Your arse is on the line. Fortunately, Tom does not have to lob drunks out at chuck out time. I did.

    Keep going Tom, and enjoy your holiday.

  21. I understand your feelings towards the “normal” union. However, it might be worth joining a general union. You don't need to pay in to their political fund if you don't want to.A trained union representative would probably have been able to help you through this process – and may well have set your mind at rest about an number of issues.

    I know a lot of people feel uncomfortable about joining a union. However, your employer has a lot more lawyers than you do – it evens up the fight to have a team on your side who can tell you what your employer is and isn't allowed to get away with.

    Get well soon!


  22. Ah yes – the Bradford Score…I have a sickness record that is certainly far better than average, and in my last position I reacted with incredulity to this (I was a staff representative). I pointed out that people don't choose when to be ill, and surely the real problem is people dishonestly claiming to be sick – I therefore cited the Bradford Scale has having little to offer our or any other organisation…

    The following year I had three seperate days sick. and in my appraisal the Bradford score was mentioned. I told them to have evidence that I had acted dishonestly before ever mentioning the Bradford Scale to me again.

    Silly policies like this are a (admittedly small) part of the reason that, when presented with an alternative opportunity, I jumped.


  23. This is the single reason why I remain a union member. Regardless of the political aspect (My contribution goes to the 'general' fund, they assure me), a Union rep could be the only ally you have in a situation like this.If the NHS management structure focused less on 'keeping 'em down', and more on common sense, then I could save my fifteen quid a month!

    Mind you, if common sense was all it took, us plebs at the coalface would be able to run things ourselves, and that would never do, now would it?

  24. Sorry to hear you've had such a tough time Tom, it really doesn't seem fair. However, as poacher turned gamekeeper (former union rep turned manager!) I have seen why these increasingly draconian policies are creeping in.Having worked in 3 different public/voluntary/charity sector organisations over the past 6-7 years I have experienced each one in turn introducing more restrictive 'absence management' policies. Each time this has been in response to those colleagues (and I'm sure we've all worked with them) who seem to think that sick leave is to be used to extend their weekends or other leave entitlements. These people tend to make me sick as they have no respect for the organisation, the job they're doing or their colleagues who are left to pick up the slack.

    It's harsh that these policies result in punishing people who are genuinely sick and I'll always use my discretion, looking at patterns and sickness overall before making a decision about how and when to apply the policy – I encourage all my other managers to exercise the same common sense approach to try and ensure the right balance is reached.

    Kick back and enjoy your holiday – it's well deserved.

  25. Hey, this is quite off-topic but I've been back-reading your blog over my lunch break for a few weeks now and a post back in 2005 has caught my eye – namely your wish to do a webcomic.I'm wondering if you'd still be interested? I can't promise something long running like megatokyo for certain, but if you had any short stories (I'm thinking 10 pages or less..) I'd be happy to collaborate with you over the summer. You can see a fairly bizarre selection of my artwork at http://www.tintreas.deviantart.com.

  26. I used to work in a hospital, in a technical support capacity. I went into clinical areas, but didn't have patient contact.Now I don't work there I am so much healthier! I'm sure it's a combination of not being so stressed, not sharing germs on the train commute, and not being in the same building as lots of sick people.

    It must be yet another step up for you – with the shiftwork, direct patient contact, and manual handling issues to add into the mix. I don't see how you can be held to the same standards of sickness absence as an office-based worker, even one in the NHS.

    I hope you manage to stay healthy for a bit!


  27. Two full time jobs? I take it you mean blogging?Blogging which has made me a better practitioner, which is a huge stress relief and which brings me loads of joy?

    I don't have a girlfriend or wife, I have no children, I have no social life to talk of. Any of those would be more like a job than sitting at a computer for half an hour a day.

    As for the post itself, it was meant more as a description of what I've been up to than as any political comment. Although the thought that I could be disciplined for being assaulted does strike me as rather harsh.

  28. That is ridiculous. If youre sick youre sick. Theyd be shooting themselves in the foot to fire you because of sickness (especially when some of that sickness was caused by your job). The people who make up these rules have no idea what its like on the front line. Whats worse, they probably get paid three times what you do to come up with these stupid systems.

  29. isn't the point of an “average” that there are some people quite a bit below it, and then some people quite a bit above it?I agree that some sort of sickness policy is required in order to be able to plan for staffing and so on.

    I don't agree that “be average or be unemployed” is an appropriate policy, because people aren't average.

    Verifying all periods of sickness – certainly.

    Offering OT for recurring problems – absolutely, I should hope so too.

    Saying that even if you are sick, even if you are injured, even if you have acquired this sickness or injury in the course of your work, you must attend work regardless of the effect on your health and that of your patients… no. No way.

    You say you've got just five out of 100 road staff on informal warnings, as if the other 95 are fit and healthy examples of humanity.

    What that says to me is that you've got at least 50 road staff who come to work when they probably shouldn't, when they're infectious, when they're impaired by illness or medication and can't drive as safely as they otherwise would, when they're making existing injuries worse by 'working through the pain', and so on.

    It says to me that patients are being put at risk because staff are too scared of disciplinary action if they do the responsible thing and say “I shouldn't be at work today”.

    Personally, I'd like to feel confident that the person driving on blue lights and sirens through the city centre isn't functioning solely on Lemsip, Nurofen, Red Bull and fear of unemployment.

  30. Know the feeling I was sick (work related back inj) for 3 mths 11mths after I was back got bout of the skits at start of night shift went home came back too quick, off again. result absence control hearing,not bad after 25 years. It doesn't only happen in LAS. I'm now on 2 absences one for op on arm probably caused by work and then abscess on gum now can't be ill/injured for next year. By the way reading the book only difference up here in Scotland I work in a more rural area, but still get the jakies, drunks, fighters etc . got my first infant death a few weeks ago, no counselling straight out to next call. control don't give a sh**

  31. As usual the DSO is talking management talk, basically utter crap !!! The LAS MAP was introduced to weed out people using sick as a means for extra days off and basically taking the pi*s. Management have the 'discretion' to over rule any period of absence i.e. a genuine period of sick covered by a GP's cert or surgery, work related injury.Unfortunately the MAP is just being used as a bullying and harassment tool by a FAILING service (managements fault again) to get bums on seats, even if they are sick.

    As of the 4th of August 2009, staff exposed to Swine Flu and have absence due to said flu will also face possible action as the LAS have taken steps to include this as unreasonable absence.

    I wonder if all the staff being treated unfairly under the Management of Absence Policy should fill out the approriate 'Bullying and Harassment' document against Middle/Upper management.

    The LAS seems to have very blinkered views on sickness. It's struggling in lots of areas and all mamagement (P Bradley) seems to do is throw more junior staff at the problem, by recruiting.

    Over 200-300 new Student Paramedics are being recruited into London, but existing EMT 3's are being told there is up to a 2 year wait to start training as a Paramedic.

    Yet again the service Morale is at an all time low, Bradley has his travelling circus approaching, where absolutely no action or plans will be taken on roadstaff suggestions.

    It's sadly not the job most of us joined for, it's become about money and ORCON times and no longer about patient welfare and training existing staff.

    LAS FARCE !!

  32. This sounds awful! You work so hard, doing a very difficult job which requires so much committment, energy, patience, skill, and yet you can be 'disciplined' for being genuinely ill on a couple of occasions? It makes my blood boil.Surely it's better for a person to take a few days off to recover than to try to do his/her job while under the weather? Surely there it is also dangerous for some patients to be treated/in contact with a person who is ill?

    I really hope that you can have a really decent, relaxing holiday, and put such tedious regulations out of your mind.

  33. People cannot help being sick, and the chances of ambulance staff being injured, picking up a bug from an ill patient or suffering from the stress of the job must be high. And it would be totally mad to pressure a worker with swine flu to come into work in a critical service.I find the idea that ambulance staff are being put under stress from this warning system for being sick wrong and stupid. Personally I could not work in such an environment, so how the ambulance staff manage is amazing.

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