Redeployment and unsustainable pressures

This advice guide has information on your rights and your employer's responsibilities if you have been redeployed from your normal working environment.

If you are being redeployed as part of a formal redundancy or reorganisation process, see our redundancy and reorganisation guide.

The RCN Nursing Workforce Standards are designed to support a safe and effective nursing workforce alongside each nation's legislation. They include guidance on workforce planning and rostering.

These are unprecedented times. Nursing staff in almost all settings are facing challenges beyond what were ever expected. Many health and social care professionals will be asked to be flexible in what they do.

It may entail working in unfamiliar surroundings or working in clinical areas outside of your usual practice for the benefit of patients, individuals and the population as a whole.

Due the unsustainable pressures in health care, staff may be redeployed for a number of reasons including:

• the increase in demand for some services because of a surge
• to support areas where staff are off sick
• to support certain areas as elective and routine services return, and to potentially support a back log of work following the pandemic - see NHS England's roadmap to safely bring back routine operations.
• to support with the COVID-19 vaccine programme and winter vaccine programmes.

Redeployment may mean covering wards or clinics or providing support in other areas, for example general practice nurses required to work in different practice settings or even NHS staff covering independent health and care sectors.

There must be an appropriate governance structure during the period of deviation with clear plans to ensure the safety of these temporary models of care, alongside a strategy for returning to standard care delivery.

Further information 

The Critical Care National Network Nurse Leads Forum (CC3N) has some further information specific to redeployment and induction in critical care. 

RCN e-learning critical care guidance for non critical care nurses.

England

• NHS England: Management – confirmed coronavirus (COVID-19)
• NHS England - Joint statement on developing immediate critical care nursing capacity
• NHS England - Discharge

Wales

• Welsh government COVID-19 workforce risk assessment tool
• Welsh government guidance - Keep Wales safe at work

Scotland

• Health Protection Scotland

Northern Ireland

• Guidance for HSC staff, healthcare workers and care providers

There is no mutuality of obligation in a bank arrangement; each placement is individual, and you can choose whether to accept or not.

If you have accepted a bank shift and you are asked to move, there should be a discussion about whether or not you are willing to change the agreement that was originally made. You need to be happy that you are competent to work in the other area. The same considerations apply regarding your environment, your patients and your work.
 
Your bank contract may contain a clause stating that you could be disciplined if you refuse to move, however you can refuse to move if you have reasonable grounds. See our section on refusal within this guide, and discuss your concerns immediately. It is important to also document them to prevent any future action being taken against you.

If you are being redeployed to a different area or workplace, use this ten point checklist to help you:

• assess your situation
• consider if your employer has met their responsibilities
• decide whether any further support is needed.

1. Your personal circumstances and risk

When redeploying staff, we expect employers to undertake appropriate occupational health risk assessment based on the individuals own health and wellbeing. The risk assessments must be relevant to areas of practice and patients, including consideration of personal protective equipment (PPE) requirements. It is important to see our occupational health section below for more information on risks and underlying health conditions.

It is important to see our occupational health section below for more information on risks and underlying health conditions together with our COVID-19 workplace risk assessment toolkit.

Employers also need to consider an individual’s unique experiences and skills before considering where to redeploy them.

2. Your contract and pay

It is important to check that your contract allows you to be moved. Also check any relevant local policies. If your contract does not allow you to be moved, discuss this with your manager and contact us.

If you contract does allow the move, you should not experience any detriment in relation to your pay or  your terms and conditions of employment.  

3. PPE requirements

You must be provided with the appropriate PPE based upon workplace risk assessment and national guidance. Where necessary, you should also receive fit testing and appropriate training, including safe donning and doffing.

4. Security systems and IT

You will need an induction to the relevant security systems, passcodes and a name badge might be required. You will also need an induction to the telephone and alarm systems, along with incident reporting IR1/Datix system and record keeping procedures (see below).

5. Your working time

Your employer must comply with your contract of employment and local policies in addition to meeting the requirements of the Working Time Regulations.

They must also ensure that appropriate arrangements for recording and accruing overtime and TOIL are in place, and any related payments are made. Read more about overtime and TOIL on our COVID-19 FAQs.

6. Your role, responsibilities and team

The specific duties and responsibilities of the role along with your level of competence should be discussed from the outset. You should also know who your line manager will be and who you will be working with.

As part of your induction to the new role you should be given information about the team around you and each team members competencies. It is reasonable to make enquiries about other redeployed staff and their competencies. Any areas of concern should be escalated and reported to senior managers.

You may need more information about:

• essential contacts (for example who is on call)
• senior staff on shift
• supervision and support arrangements.

7. Your work area

You will need to have an induction to the clinical area which should cover:

• policies and procedures (see below)
• the infection status of the clinical setting
• access to and appropriate use of any equipment that might be needed in your role
• moving and handling (access to equipment, procedures)
• location of toilets and staff room/lockers/drinking water
• working times, rota and break allocation.

8. Access to policies and procedures

This should be discussed and copies must be readily and easily available. For example, you may wish to check the:

• record keeping policies
• medical teams & referral process including escalation
• medicine safety procedures (including any limitations e.g. IV drugs)
• emergency procedures (for example evacuation and fire safety, violent incident, resuscitation, needlestick/exposure incident)
• infection control procedures.

9. Indemnity cover

Employers must ensure that the appropriate indemnity arrangements are in place for all staff who are required to move to a new work area. Read more about this in our indemnity section below.

10. Career development opportunities and returning to your role

Opportunities
Although temporary redeployment can be unsettling, there could be opportunities to working in a different environment. Both you and your employer could maximise these learning opportunities by setting some key objectives during your redeployment. Consider how you might use the experience and reflect on it for your revalidation.

Your return
When you return to your original place of work you may need a period of reorientation. Employers should consider a further risk assessment to include additional education and training needs, and any support, clinical supervision, or counselling requirements which are available to support  you in your return to your previous role and duties.
 
If you are delayed returning to your substantive role, discuss this with your manager and if you have concerns, contact us.

Your employers’ responsibilities

Your employer is responsible and accountable for ensuring staff have the necessary skills and knowledge to take on work. They should consider staff limitations and competencies carefully when delegating tasks or temporarily moving staff. This is relevant for all members across the health and social care workforce, including those in training (for example student nurses, trainee nursing associates and nurse apprentices).  

Your responsibilities

Registrants are accountable to the NMC Code, and where appropriate the NMC's Standards for competence for midwives. If you are a registered nurse, you must practice in line with the NMC Code at all times and use professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in your professional standards. 

Remember, you must speak out if the move may undermine your ability to follow the NMC Code. You may also find it helpful to read the NMC's guidance produced during COVID-19.

Accountability and delegation

Accountability and delegation principles apply to all members of the nursing team. Read more about accountability and delegation in practice. Our accountability and delegation case studies provide helpful examples of how the decision making process and the principles of accountability and delegation apply in various health and care settings.

Nursing Support Workers (NSWs)

NSWs, must also speak up if they feel they do not have the relevant skills and training to adequately carry out safe and competent practice. Read more about accountability and delegation.

Nursing Associates

Please note this applies to England only.

Nursing associates are deemed competent and confident within their scope of practice at the point of registration with the NMC. If you are asked to undertake any clinical interventions that are outside the scope of your practice knowledge, experience and skills, you should refer to the NMC guidance and local policy to support decision making on how best to proceed. 

If you are  asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance.

For more information about the role of the nursing associate, see our guidance.

If you do not feel competent

Firstly, look at our redeployment checklist to see if further support is needed from your employer. Speak to your manager and if the issues cannot be resolved, follow this up in writing using our model letter. Please also see our section on refusal, along with our advice guide on refusal to treat.

You must speak out if the move may undermine your ability to follow the NMC Code. If you need further support, document your issues and contact us.

Any NHS organisation employing redeployed staff, including any support with the COVID-19 pandemic, has the benefit of the NHS indemnity schemes. NHS indemnity cover applies to all NHS employed staff and those providing their services to the NHS as locums, bank staff and other self-employed roles. Read more about this along with helpful FAQs on NHS Resolution.

For those outside the NHS, the Department of Health and Social Care (DHSC) has made it clear that the employer will provide indemnity cover to anybody working in redeployed or backfilling roles. In the unlikely event that there is a gap in that cover for the pandemic response, the new state-backed Coronavirus indemnity scheme will cover their work.

For further information about indemnity please see information about our indemnity scheme and COVID indemnity page.

If you are asked to move to a new work area or are temporarily moved to work for a different employer, you should not experience any detriment in relation to your pay, or terms and conditions of employment.

If you work in the NHS, and your move is due to COVID-19, a joint working group of the NHS Staff Council Executive has published two FAQs on pay protection relating to COVID-19. The questions cover pay for those who are temporarily redeployed for short periods to help service and patient needs.

See our redeployment checklist within this guide for more information on your rights during redeployment and contact us if your pay has been reduced due to temporary deployment.

An employer is required by law to protect their employees from harm. Assessing risk is just one part of the overall process used to control risks in your workplace. The risk assessment must reflect the established evidence and be based on the individual’s own health and wellbeing.

You can see our COVID-19 workplace risk assessment toolkit for more advice on risk assessment. Public Health England's (PHE) report COVID-19: review of disparities in risks and outcomes for more information identifies a number of risk factors that any risk assessment will need to consider, including;

• ethnicity
• age, gender and location
• underlying health conditions and other factors, such as BMI
• pregnancy - read more below
• individual staff members’ domestic living arrangements (for example if they are living with someone who is particularly vulnerable or have additional caring responsibilities) mean they need to be able to take further precautions
• you can also see our COVID-19 and individual risk assessment guidance for risk factors and model letters. 

Ethnicity, race or national origin

Ethnicity needs to be explicitly considered. Black, Asian and Minority (BAME) staff face an increased risk of both contracting COVID-19 and dying from the disease as noted in COVID-19: review of disparities in risks and outcomes.  Also see our COVID-19 and individual risk assessments guidance.

Staff with underlying health needs

If individuals have a disability or an underlying medical condition, for example immunodeficiency, which means they may face a risk to their health or wellbeing if they move to an unfamiliar or new working environment, they should inform their line manager or an appropriate person and/or seek advice from their local occupational health service before agreeing to move. A risk assessment would be needed before any further decision is made. You can find more information in our COVID-19 and individual risk assessments guidance.

If you work in the NHS, see NHS employers guidance on risk assessments for staff.

If you have concerns, discuss these with your manager and if the situation is not resolved, contact us.

Pregnant women

Read more about pregnant workers on our COVID-19 FAQ.  You can find more information, including a template letter, in our COVID-19 and individual risk assessments guidance. 

Information from the Royal College of Midwives can be found here, along with their advice for pregnant healthcare workers.

If you have concerns, contact us.

Further information

NHS Employer guidance - Risk assessments for staff
NHS Health and Wellbeing guidance
Health and Safety Executive: Coronavirus (COVID-19) – Advice for workplaces

Organisations must have effective procedures in place to allow nursing staff and their representatives to raise any concerns in relation to equipment, policies and processes at the earliest opportunity.

Nursing staff should feel able to raise their concerns without detriment and should receive timely feedback on their concerns.

If you are being asked to work in another area/speciality and have concerns about your competence, please use our model letter to raise this with your employer in the first instance. If you have any other concerns about your redeployment, speak to your line manager and see our raising concerns guidance. You might also find the following information useful:

PPE and COVID-19
Refusal to treat guide
NMC Code.

If the issue is still not resolved, please contact us.

If you are facing redeployment as part of a formal redundancy or reorganisation process, please see our advice guide on redundancy and reorganisation and our 121-meeting checklist.

Your employer can usually request that you work somewhere other than your normal environment as a temporary measure, but they must be sure about your competence level. In most cases your employer can redeploy you to other areas, but it is important that you check your contract and local policies. Temporary deployment is generally a voluntary choice; staff should not be forced to move. Please see the checklist above for more information on this. You may be able to refuse if you have reasonable grounds, for example because a medical condition cannot be supported or if you are pregnant and the necessary measures cannot be put in place.

You are also within your rights to refuse to do something if you are not competent to do so, but you cannot refuse to learn how to do something if it is a requirement for patient care or safety.

Before refusing

If you are being asked to work in another area/speciality and have concerns about your competence, please see our guide below on refusal to treat and discuss your concerns with your employer.

You can use our model letter to raise your concerns about this with your employer. Please contact us if the situation is not resolved.

NMC code

There is a general expectation within the NMC Code that nursing staff should support redeployment in emergency situations, performing as competently and safely as they can and providing the appropriate safeguards, including relevant PPE, are in place. If you have concerns about your competency, please see our competency section above.

Remember, you must speak out if the move may undermine your ability to follow the NMC Code 

Further information

• Refusal to treat advice guide
• Refusal to treat guide (lack of PPE)
• Raising concerns guide
• NMC Code

If there are any issues with returning to your substantive post at the end of your redeployment period, discuss this with your manager and ask for the reasons in writing.

If you have any concerns about this, contact us for further advice.

Employers can usually ask specialist nurses to work on wards, however if the specialist nurse has any doubt about their competence they must decline and give reasons why. For example, they may state that they have not worked on a ward for over 10 years so are not up to date, or that they would be working outside their professional Code.

If you are a specialist nurse who does not feel competent to work in a new area, you should discuss your concerns with your employer, document what you have discussed and contact us if the matter is not resolved. 

If you agree to the move, you should start to collate evidence of how the move will impact on your own area of work. You may need this evidence to show that this way of managing staffing problems will only have a knock on effect in other areas.

Please see our student advice guide. If you need further support, contact us.