By Anusha Bradley for RNZ
A budget-blowing restructure of the way ACC manages claims has left staff with "overwhelming caseloads" and so stressed they're "dropping like flies", a Public Service Association (PSA) union survey has found.
ACC spent $74 million to move to what it calls "Next Generation Case Management" in order to increase productivity and make ACC more "client centric", but union members say it's having the opposite effect.
Case managers now have "overwhelming caseloads", staff face "huge backlogs" of work and rising stress and job dissatisfaction is seeing staff "dropping like flies," ACC staff reported when surveyed last month.
The comments, collected by union delegates from staff around the country, paint a grim picture. One union delegate said frontline staff in her branch were "regularly crying in the stairwells due to the increased workload, increased stress and decreased client satisfaction".
Other staff were taking "stress leave, at breaking point or resigning with or without a job to go to," another union delegate said.
"Case management has become very disorganised, disjointed and dysfunctional. There is definitely a big reduction in work satisfaction," one delegate reported.
Photo / RNZ, Vinay Ranchhod
The 2019 restructure resulted in ACC managing claims nationally. Under the new system clients are allocated to one of three different streams according to their needs.
Clients with complex needs have a personal case manager, which ACC now calls a recovery partner. Those needing some assistance are assigned a personal recovery co-ordinator, and those needing little help are managed by teams of up to 20 recovery assistants who carry out more administrative tasks.
The new system, which was completed in September 2020, was supposed to cost between $38 to $58 million but the budget blew out by $16m as its scope widened.
The system - the first change in 20 years to the way the corporation manages claims - was designed to improve productivity by freeing up time for case managers to spend on more complex cases.
PSA organiser Brodie Croucher, however, said it hasn't worked and some case managers were now struggling with caseloads of 150 clients.
"They've tried to break up the necessary work into small tasks, and then push those tasks out to a potentially lower-paid workforce," he said.
But a lot of these small tasks ended up requiring a lot of work and union members warned the restructure would not work as ACC predicted when it was first mooted in 2018, Brodie said.
There were no longer any branch reception staff so these duties had to be picked up by other workers and frontline staff had to take on at least two "overflow calls" a day to manage a backlog, adding to their duties.
As a result, stress and sick leave among union members was rising and morale was at an all-time low, but ACC management had failed to act, Brodie said.
"Unfortunately, they often put it back on our members and say, 'You need to manage your stress differently,' which isn't helpful at all. Historically, they were saying, 'Oh, it's just the system bedding in and we have to get things organised'. But that excuse is kind of wearing thin now."
An ACC staff member, who RNZ has agreed not to name, says the new system actually creates more work, and some staff are doing unpaid hours at home just to clear the backlog.
"They lost a huge amount of very qualified people… and then they recruited a whole pile of people who didn't know anything about ACC and put them all in assisted recovery, and tried to teach them effectively two years worth of stuff in two months. And they can't do it," they told RNZ.
Photo / RNZ, Vinay Ranchhod
Privacy concerns and the lack of training some staff had when dealing with sensitive claims were also issues highlighted in the PSA survey.
"Staff have made several comments expressing discomfort with the level of access they have to sensitive claims when the work they do may be tangentially related at best. They simply don't want this access and do not have the training to work on such claims," a delegate wrote.
The union members were also overwhelmingly negative about the impact the changes were having on clients. While one member believed there had been "huge improvements" in the management of sensitive claims since the restructure, the majority of staff surveyed said the new system hadn't worked as promised.
"Clients feel unsupported, providers are unable to speak to 'a person,' which frustrates them, and staff around the country are overworked," one said.
Some staff believed new IT tools were helpful and access to clinical advice had improved. Others, however, expressed frustration that call centre staff and case managers used different IT systems, which meant "the left hand cannot see what the right hand is doing".
Complaints to management were fruitless, the survey found.
"ACC leadership has made it known to all staff that the model and new way of working isn't going to change, so if staff don't like it, they know where the door is," one person said.
Another wrote, "Staff are told that there is nothing wrong with the model and it's the staff 'mindset' that needs to change."
Photo / RNZ, Vinay Ranchhod
ACC's own staff survey, obtained by RNZ under the Official Information Act, showed that in October-November 51 per cent of employees were either "not engaged or actively disengaged" from their job.
The survey defined the 44 per cent not engaged as employees "less likely to put high energy and passion into their work and are less loyal and productive". The 7 per cent "actively disengaged" were "emotionally against the organisation; they are not loyal and are likely to undermine the efforts of others".
While the majority of union members were saying the new model wasn't working, ACC's acting chief executive Mike Tully was telling the workforce and education select committee that Next Generation Case Management had been a success.
"While the model is still embedding, we can see green shoots of progress. Client satisfaction is higher and our rehabilitation rates are starting to improve," he told MPs on July 7.
National Party ACC spokesman Simon Watts, who sits on the committee, said Tully's assurances that all was well raised serious questions because this was not what he was hearing.
"I'm having conversations with a number of ACC providers who have been dealing with this new system. Many of them have noted to me that they are finding it complex and difficult to work with them."
ACC figures show nearly a quarter of calls to the organisation in April and May were being abandoned because they can't get through, Watts said.
"The acting CEO and officials had nothing but praise for the system - they assured me that it was being implemented well and was supported by staff and clients and that obviously doesn't correlate. The cost blow-out is also concerning."
"The minister needs to come forward and state what is the situation here? Because clearly, they both can't be right."
Tully told the committee it has since hired an additional 74 call centre staff to improve call response times.
Former ACC lawyer Warren Forster said this would only add to the cost of the restructure. In 2018 he warned the new model would not work.
"This isn't a client centric system, this doesn't put the person at the centre of it, it's done in a way that really centralises ACC… it's trying to put in a system where ACC has more control."
One of the key problems was that ACC had taken away the discretion that staff had to make decisions on cases, he said.
"They put it all now in a big computer system and literally the computer says no, and no one can overcome that problem. What they need to do is to take away that control and give it to people. Give it to treatment providers and trust them. Give it to the staff and trust them."
Tully told RNZ workloads had increased and staff turnover was higher than he would like, but 183 additional people had been hired to ease the pressure.
This was on top of the 74 call centre staff hired in May. ACC would also soon be "advance hiring" 217 more staff in its next recruiting round in anticipation of more staff leaving, he said.
The restructure had still been a success, Tully said, but extra workloads were due to more people having accidents than it anticipated. ACC had planned for 4 per cent claims growth but had experienced 10.8 per cent since the national Covid-19 lockdown was lifted.
"That was occurring right at the time when we were doing the final transition of some of this work. That's created an extra workforce pressure. And so for us to clear through that we need to bring on the resources, which is what we have been doing."
ACC staff had been doing an "absolutely tremendous job" coping with the workload and the organisation's own staff surveys showed improvements, Tully said.
"The feedback we've been receiving from our staff from engagements quarter upon quarter are improving. So the actions we're putting in place are certainly making a positive difference.
"We've still got some way to go, I don't deny that."
Concerns raised by staff in the PSA survey that some had inappropriate access to sensitive claim files had not been raised with him, Tully said.
"The access to sensitive claims information is restricted to ACC people that need them to support a client."
ACC staff who worked in call centres, claims, payments as well as clinician advisors all had access to sensitive claims information in order to help the claimant, he said.
"So the people that have access, are the right people to have access. People don't look at the whole of the claim, they're really looking at the information that they need. Staff here don't have the luxury to sit and read claim after claim after claim ... they've got enough to do," Tully said.
ACC Minister Carmel Sepuloni said she was happy with how the organisation's transformation was going but she would be meeting ACC executives this week to discuss the findings in the PSA survey.
"The customer feedback from clients is improvement but we just want to make sure our staff are also having positive experiences of the changes as well."
"ACC is very cognisant of the fact the organisation's culture is very dependent on ensuring our staff enjoy the work they are undertaking and that they don't have unreasonable pressures on them."
The total cost of ACC's Next Generation Case Management increased $16m to $74m due to it involving "a wider scope of value-adding change than originally planned", a spokesperson said.
Its overall transformation project, however, is now forecast to cost $619m, which is $50m less than planned - and will bring $300m in benefits by 2030.
As of April 2021, ACC had 3748 fulltime staff of which 850 were PSA members.