A boost to workforce funding to “immediately alleviate” the stress of current nursing workloads is amongst the safe staffing recommendations made by the Independent Panel.
The Independent Panel, set up to try and resolve the pay impasse without a winter strike released a series of recommendations yesterday on pay and safe staffing to the New Zealand Nurses Organisation and the 20 district health boards. The pay rise recommendations have fallen short of nurses and NZNO’s expectations but NZNO said it was pleased to see “a significant number of recommendations that reflect their concerns about the immediate staffing crisis”.
The panel report noted the lack of recognition by DHBs of the impact on nursing workloads of the “significant increases” in patient acuity over the past decade due to both the ageing population and the number of patients with multiple co-morbidities.
“This has increased the complexity of nursing care in hospitals and related settings, requiring a more skilled, knowledgeable and experienced workforce,” said the panel. It said the lack of recognition of these changes had led to “a sense of grievance that underlies both workloads and remuneration”. It added that the panel recommendations reflected that the “fundamental workload issues” could not be addressed through remuneration alone.
The recommendations include the 20 DHBs – on ratification of a new NZNO DHB agreement – receiving funding equal to two per cent of the total national cost of the DHB employed nursing and midwifery workforce for DHBS to ensure it has enough nursing staff to “deliver the required patient services”.
Cee Payne, the NZNO’s industrial advisor said this was a “significant recommendation” that had not been previously seen for nursing and midwifery.
The panel also noted that DHB representatives were aware of the need to address the workload issues but “resource constraints” meant that measuring nurse workloads was not a priority for many DHBs.
“This is even though the instruments and mechanism to accurately assess patient acuity and staffing required has been available to DHBs through a validated patient acuity tool and the Care Capacity Demand Management (CCDM) programme for many years.”
The panel recommended that “high-level commitment needs to be made to improving the nurse workforce planning strategy, and to ensuring compliance with commitments agreed in the MECA” including implementing CCDM across all DHBs”.
Ensuring that nurses felt they had a “voice” within the workplace was also seen as important and the parties agreed to a national framework requiring DHB chief executives to “review how the nursing perspective can, and does, influence clinical and business decisions within their DHB, initially focusing on nursing workloads, escalation pathways and incident reporting”.