The first major deadline for delivering on the Safer Staffing Accord is drawing close and will be met, says DHBs spokesperson Jim Green.

Green is the CEO spokesperson for the 20 DHBs which are one of the three signatories to the July 30 Accord, along with the New Zealand Nurses Organisation and the Ministry of Health, which commits the parties to ensure there are sufficient nurses and midwives in public hospitals for both nurses’ and their patients’ safety.

He said he had seen an update yesterday on the first deliverable of the Accord – due at the end of November – which is a report looking at the feasibility of employing all nursing and midwifery graduates.  “I know we will be able to report back to the Minister within that timeframe next week.”

Jane Bodkin, acting Chief Nursing Officer at the Ministry of Health said the Accord group continued to meet weekly and agreed it was making good progress toward meeting the first deadline of providing the Minister with options for employing and training all New Zealand nursing and midwifery graduates.

Green, when asked whether it was possible that full employment could be implemented from next year, said he hadn’t seen the final proposal so was unclear when it was hoped to implement it by.  “But I have heard that DHBs are looking at where graduate nurses can be utilised more within their DHBs as part of looking at solutions around expanding the workforce.”

Update on $38m short-term staffing relief fund

That included looking at how DHBs would utilise the $38m fund allocated by the Government to provide immediate short term relief of nursing and midwifery workload pressures across the 20 DHBs while the long-term solution, the safe staffing Care Capacity Demand Management (CCDM) system* was being fully implemented.

The DHBs were required to submit ‘brief plans’ to the Ministry of Health’s Chief Nursing Officer on ‘why, where, who and how’ workforce capacity would be increased at their DHB through the fund. To receive their funding share the plans have to be first signed off by each DHB’s joint union-DHB CCDM Council, or equivalent, and then approved by the joint DHB-NZNO Safe Staffing Healthy Workplace (SSHW) governance group.

At the beginning of November just 10 of the 20 DHBs had submitted plans and eight had been approved.  Bodkin said the Chief Nursing Office had now (November 23) received plans from 18 DHBs of which 15 had been approved.

Jim Green, who is CEO of Tairawhiti DHB and himself a former registered nurse, said he was aware that his own DHB’s plan had not yet been signed off by SSHW but it had employed the extra staff anyway – and more than its allocated fund share.

Bodkin said the numbers actually employed were not yet known but the approved plans would translate to approximately 397.14 extra staff being employed. She said DHBs with approved plans had started formal recruitment process but some DHBs which had yet to submit plans had called for expressions of interest in employment.

The fund – which is roughly equivalent to employing 500 fulltime equivalent (FTE) mid-career registered nurses (RNs) – does not have to be used to employ RNs. It can be used to employ the nursing skill mix agreed to by each DHB including additional registered nurses, health care assistants, enrolled nurses or midwives – but it can’t be used to fill existing vacancies or to staff planned new services.

Green said Tairawhiti – as a result of its workforce calculations had employed an extra 9 FTE staff – its allocated share was 5.4 FTE and the staff taken on was a mix of senior nurses, registered nurses and health care assistants.

He said all DHBs had committed, prior to the NZNO ratifying the MECA in early August, that they would carry on in good faith to work on employing extra staff to relieve immediate pressures in anticipation of receiving their fund share.

*CCDM three core components

  1. Mix and Match Staffing (i.e. using patient acuity data analysis to calculate the safe FTE base staffing required for a ward or unit to meet patient demand patterns)
  2. Variance Response Management (i.e. capacity at a glance screen (CAG) and ‘traffic light’ system to alert when ward is in immediate need and systems of how to respond)
  3. Core data set (Using high-quality data to review and respond to safe staffing needs)


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