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Nursing demand for a share of the $13 million postgraduate study funding pool for nurses appears undiminished. Detailed national statistics on what qualifications and specialties that the money is spent on are not readily available*, but from next year a new contract framework will be asking how the funding leads to Kiwis being better off. Nursing Review reports.

It’s now coming up eight years since the last national statistics were published on what qualifications* and in what specialties* nurses were studying – and passing – using grants from the initially $12.5 million (now $12.9 million) postgraduate funding pool. It is also not clear how many of the 2,000-plus nurses whose study is subsidised each year work in the district health board, primary health care or residential aged care sectors.

This information is gathered by the 20 district health boards that distribute the nursing funding on behalf of Health Workforce New Zealand (HWNZ), say Sue Hayward, head of the national Nursing Education Advisory Team (NEAT) and Kathy Holloway, chair of Nursing Education in the Tertiary Sector (NETS). But the pair say that while much of that national data was reported by the former Clinical Training Agency, this hasn’t been the case under HWNZ.

In response to a Nursing Review request HWNZ provided some additional statistics* (supplied after print article went to press and included only in this online version of the article) which showed  that about 56 per cent of the HWNZ nursing postgraduate funding pool was spent on funding papers towards a postgraduate certificate, 24 per cent to postgraduate diploma papers and 20 per cent to Master of Nursing papers. Specific information on nurses' practice areas were not available but HWNZ said about 31 per cent of postgraduate papers funded were coded towards primary care (including aged care) qualifications and about six per cent towards rural health papers. 

Meanwhile, in line with government policy, HWNZ is moving to a new framework for evaluating the impact of spending on postgraduate training.

Holloway, the new head of nursing at Victoria University, says perhaps the new results-based accountability (RBA) framework will include some of that statistical data.

The Ministry of Health on its website describes RBA as “a simple, practical way” of using publicly available data and provider data to track the impact of a programme (or in this case, funding nurse postgraduate study) on the wellbeing of a population.

Hayward, director of nursing for Waikato DHB, says nursing will be the first cab off the rank to have its funding evaluated using RBA and a working group of skilled nurses from across the country has been set up in partnership with HWNZ to assess what measures should be adopted.

“It is something we have all put our hats on and thought, ‘What should we measure to show that having postgraduate education funded by HWNZ has made a difference to the retention of nurses, the skill and knowledge base of nurses, the experience of patients and maybe even the outcomes of patient care?’,” says Hayward.

Paul Watson, acting strategy and relationships manager for HWNZ, says the measures decided on will focus on answering the questions ‘How much did we do?’ and ‘How well did we do it?’, and ‘Is anyone better off?’

HWNZ plans to introduce the RBA reporting framework for the 2017 postgraduate funding contract. Watson says RBA is unlikely to affect the total funding for postgraduate nursing education but “may help direct the funding” to education in areas achieving the desired outcomes.

Nursing spends all of its thin slice of the pie

Despite national data not being released on how or where postgraduate funding is spent, nursing leaders report that they have been told they aren’t spending all of their allocated pot.

“Professor Des Gorman [the HWNZ executive chair] keeps announcing that the postgraduate nursing fund has been underspent,” says College of Nurses executive director Professor Jenny Carryer. She says that bothers her seriously as she couldn’t find evidence either way and she consistently meets nurses in her postgraduate classes who are self-funding.

Kathy Holloway says her impression is there’s no underspend, but “without the actual hard data it’s hard to either agree or disagree”. Likewise, Sue Hayward says she finds it “interesting” that she’s been told that nursing is not spending all its money if HWNZ is not able to share how the funding is actually spent. Hilary Graham-Smith, associate professional services manager for the New Zealand Nurses Organisation, says any underspend may also be being used as a “flawed argument” against nursing consistently calling for a fairer slice of the postgraduate funding pie.

Hayward says DHBs experience strong demand for nurse postgraduate funding and underspend can only occur if HWNZ isn’t flexible in allowing funding ring-fenced for a nursing workforce with low demand to areas with over-demand. She says NEAT has been talking to HWNZ about the need for flexibility with funding to meet demand for expanded role training like the new postgraduate diploma for registered nurse prescribing available next year.

Nursing Review asked HWNZ for clarification about underspending and was told that there was a “small underspend” of postgraduate nursing funding in 2014–15 but HWNZ encouraged DHBs to work regionally to ensure funding was fully utilised and this had resulted in no underspend of the $12.9 million allocated in the 2015–16 year.

Funding for the 2016–17 year is yet to be announced but is anticipated to be similar to this year’s $12.9 million.

HWNZ also confirmed that there will be additional funding once again next year for nurse practitioner training following this year’s $846,000 allocated for 20 places in the country’s first dedicated NP training scheme. See more in the online story at: www.nursingreview.co.nz/news-feed/2016/np-training-scheme-gets-funding-for-another-year .

HWNZ postgraduate funding is available to registered nurses working for a government-funded health service such as a district health board, rest home or primary health care provider. To find out more about funding priorities and eligibility, nurses can contact their local DHB’s postgraduate nursing education coordinator.

*Some additional statistics were provided by HWNZ after Nursing Review's print edition went to press in July 2016. These statistics were added to the online version of the article on September 27 2016