Workforce planning looks to the future

1 March 2012

BRENDA WRAIGHT of Health Workforce New Zealand and chief nurse JANE O’MALLEY share their overview of nursing workforce strategies past and into the future.

Nursing is well positioned to meet the demands for care into future – thanks to work that stretches back nearly four decades.

There have been a wealth of changes to undergraduate education in the 1970s and 1980s and continuous review by the profession in its widest sense –including employers, the professional bodies, the regulator, policy-shapers, and educators.

The changes to registered nurses undergraduate education and recent changes to the enrolled nurse education and scope have resulted in a nursing workforce that is well prepared and flexible.

As an example, the 1998 Report of the Ministerial Taskforce on Nursing had a central focus on realising the potential of nursing. The professional development framework proposed by that report laid the foundation for postgraduate registered nurse training that is still relevant today and continues to inform health workforce funding.

Nurses before the 1990s largely self-funded any professional development involving tertiary study. But since the ‘unbundling’ of clinical training, that has changed. Since the 1990s, government funding (firstly through the Clinical Training Agency, and more recently, through Health Workforce New Zealand or HWNZ) of postgraduate nursing education has built on the foundation of undergraduate education. It has enabled those nurses who have undertaken higher education to contribute even more through advanced and extended scopes of practice and nurse practitioner roles. These are crucial attributes in a world of rapid change, and are especially valuable attributes for the nursing workforce that, by virtue of its scope and size, must be central in any broader health workforce strategy.

The impact of two key pieces of legislation will assist the pace of change; the proposed Medicines Amendment Bill will herald new classes of prescribers. And the proposed Health Practitioners (Statutory References) Bill will address legislative barriers enabling suitably qualified nurses and other relevant health practitioners to perform activities that formerly could only be legally carried out by medical practitioners. These legislative changes will enable the work being done around developing new models of care and service integration.

Lessons from six years of nurse practitioner prescribing, as well as the recent diabetes nurse specialist prescribing initiative, will assist the sector, the profession, and employers to develop sustainable credentialing and professional practice models to better support the workforce growth we need. These developments will inform decisions around future HWNZ funding and nursing career pathway infrastructure, with the ultimate objective being increased access to quality services to meet the needs of the population.

So what of the year ahead?

A major focus of the Chief Nurse Business Unit (CNBU) will be reconnaissance around a range of workforce issues and workforce planning activities. Nursing is the largest regulated health workforce, has responsibility for supporting much of the unregulated workforce, and works collegially with much of the remainder of the regulated health workforce.

Thus nursing is a vital component of the total health workforce and central in any health workforce strategic thinking, planning, and implementation. Careful attention to the detail of nursing workforce supply and demand is essential.

While this work is best led by the nursing profession, nursing workforce planning must be fully integrated with broader health workforce strategic planning. Consequently, the CNBU has a close and crucial relationship with HWNZ.

This year, an ‘environmental scan’ is to be carried out, in partnership with the sector, to review and map out the nursing workforce strategies and processes that already exist, work well and should be retained and enhanced. It will also identify gaps and weaknesses and how to address these.

That work will be completed by June so that a draft framework for supply and retention of nurses can be agreed and a nursing workforce plan put in place for development in the 2012/13 year?

Jane O’Malley Chief Nurse, Ministry of Health | Brenda Wraight, Director HWNZ