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An announcement is expected soon about the funding and priorities for nurse postgraduate study in 2014 – and possibly, change is afoot.

In recent years, the funding pool available for nurses wanting to pursue postgraduate study has stayed static at around $12 million a year and training priorities have continued to be aged care, rehabilitation, and mental health and addiction.

For the past two years, Health Workforce New Zealand (HWNZ, which has administered postgraduate training funding since 2011) has indicated in advance that the status quo would continue for funding and training priorities for the following year.

But when Nursing Review asked in mid-August this year whether the same funding and focus were likely to continue in 2014, an HWNZ spokesperson said postgraduate nurse funding for 2014 had not yet been approved and the HWNZ board had also yet to agree on postgraduate training priorities for 2014, including nursing.

“But HWNZ would expect to continue to support nurses seeking to undertake postgraduate study,” the spokesperson said.

When HWNZ was asked further whether any major restructuring or changes to postgraduate nursing funding were being considered for 2014, it declined to answer. Last year, the former director of HWNZ, Brenda Wraight, said HWNZ was to carry out a full review of postgraduate nursing funding in 2013, but no review is known to have taken place.

Ring-fence ‘stick’ on its way?

In January this year, HWNZ chair Des Gorman indicated a “financial stick” could be used from next year if district health boards did not start providing ring-fenced jobs for nursing new graduates.

HWNZ administers the funding for the new graduate NETP programmes, as well as postgraduate training, and Gorman first mooted ring-fencing new graduate ‘intern’ places in 2010, when new graduate nurse unemployment started to emerge as a problem. The call was taken up by Ministry of Health Chief Nurse Jane O’Malley in 2011, but few DHBs have made the full shift to ring-fenced 12-month contracts for new grads.

Gorman told Nursing Review that HWNZ had been clear since it set up regional training hubs that DHBs needed to provide ‘proper internships’ for nurses, including ring-fenced jobs, and training money could be at risk if they didn’t.

“The money is a dry run this year. But in the financial year 2013-14, there will be money at risk. In the financial year 2014-15, it won’t just be money at risk, it will be the entire funding at risk,” he said

Sue Hayward, head of the Nursing Education Advisory Team (NEAT), said in mid-August that she had yet to hear anything about postgraduate funding changes for 2014.

“I had assumed it would stay at the same level. We are all hoping the requests we have made to allow a little more flexibility around the areas we can focus on will be supported by HWNZ,” said Hayward, who is also director of nursing and midwifery for Waikato District Health Board.

“I think HWNZ would look at the success of both the funding levels and the processes for allocation and see there is nothing to be gained from a workforce development prospective if changes were made, especially with no dialogue with the sector,” said Hayward.

Kathy Holloway, chair of nurse educator group NETS, said she was unaware of any proposals to change funding for 2014. She recently attended a HWNZ central regional training hub meeting with the region’s directors of nursing as an education representative.

“There is support in the group for a regional approach to workforce development and a commitment to meet collectively more often but no specific actions as yet,” said Holloway.

Skills Matter, the training funding arm of mental health workforce agency Te Pou, has been advised that it will continue to manage HWNZ training funding targeted for the mental health and addiction workforce.

Fiona Hamilton, the Skills Matter programme lead, said actual HWNZ funding levels for programmes like its clinical leadership in nursing practice programme were yet to be confirmed, but the organisation hoped to maintain the same level of funded places.

Support for new role training

Hayward said one area where DHBs were experiencing barriers was using their HWNZ funding to support the clinical training for new expanded practice roles like registered nurse first surgical assistant (RNFSA) and nurse colposcopists.

“In expanded practice, there’s a requirement not only for postgraduate study but also for having those nurses taken off the roster to spend time working alongside a nurse already qualified in the field or a consultant.

“DHBs are saying they don’t have the FTE capacity to fund supernumerary time while that nursing is learning a different scope,” said Hayward.

“We are wanting to know whether we can negotiate with HWNZ to use our existing funding in a different way.”

HWNZ said it did propose to provide support for new roles for nursing, including RNFSA, “and other roles that contribute directly to addressing government priorities and health targets”