Improvements to patient safety and better working conditions for NSW nurses and midwives are a step closer, following today’s announcement by NSW Labor to overhaul the current staffing system in public hospitals.

The NSW Nurses and Midwives’ Association (NSWNMA) has welcomed the move as step in the right direction but is determined to continue campaigning until all areas of their 2022 Award Claim are adopted.

NSW Opposition Leader, Chris Minns, confirmed a Labor government, if elected, would scrap the current outdated rostering system and replace it with an enforceable, minimum shift by shift staffing model, with improvements to dedicated specialty areas, such as emergency departments, from mid-2023.

The model is an enforceable shift by shift minimum staffing system for nurses and midwives. This is exactly what ratios are: they guarantee there is a minimum number of nurses or midwives on each shift in relation to the number of patients.

Responding to the policy, NSWNMA General Secretary, Shaye Candish, welcomed efforts by NSW Labor to lay the foundations for significant reform of the health workforce and for listening to the issues raised statewide by nurses and midwives.

“Our public health system is in desperate need of serious reform and addressing the systemic issues impacting the nursing and midwifery workforce is central to that,” said Ms Candish.

“What NSW Labor has put on the table would go a long way towards repairing the broken staffing system we have in NSW, and towards tackling the overwork and fatigue being experienced by the majority of nurses and midwives who are keeping our public hospitals functioning.”

“There are a number of specialties we have no commitments for. We will continue our ratios campaign until we get reform across our whole health system.”

NSWNMA Assistant General Secretary, Michael Whaites, said the commitment from NSW Labor signals a significant injection of hope to nurses and midwives across the state, but acknowledged it wasn’t the full nurse-to-patient ratios claim the union had been campaigning on.

“NSW Labor’s safe staffing levels proposal will help to address the widespread workforce problems in the health system, and it’s certainly a lot closer to what’s needed compared to anything the NSW government has offered to date,” said Mr Whaites.

“For too long, nurses and midwives’ professional and clinical perspectives have been ignored by the NSW government. They have continually been asked to do more, with less, to the point that we now have a nursing and midwifery retention problem in NSW.

“With the right interventions, we can turn these staffing issues around and restore confidence back into the health system, which will also help attract future nurses and midwives to work in a NSW hospital.

“We welcome NSW Labor’s announcement however, the NSW government could act on the staffing crisis today.

“We will continue to pursue every political party to support a transparent and enforceable, shift by shift minimum staffing ratios system in NSW for as long as it takes.”

NSW Labor Minimum Safe Staffing plan – The details

If elected next year, NSW Labor has proposed to scrap the current outdated Nursing Hours Per Patient Day (NHPPD) rostering system and replace it with an enforceable, minimum shift by shift staffing model.

All existing NHPPD wards will convert to a shift by shift system
For those at 6 NHPPD, in example, a minimum nurse-to-patient ratio of 1:4 (morning shift), 1:4 (afternoon), 1:7 (night) enforceable on every shift will apply – with an additional nurse designated as ‘in charge of shift’ / Clinical Coordinator on at least two shifts. Assistants in Nursing additional to the minimum ratio.

Emergency Departments
A shift by shift minimum of 1:3 + triage; 1:1 in resus; 1:3 in EMUs and 1:4 in MAUs. A Clinical Initiative Nurse (however named) and Assistants in Nursing are to be additional to the minimum staffing ratios in EDs.

Maternity
A full review of the current staffing model, Birthrate Plus® in consultation with NSWNMA. A shift by shift minimum of 1:3 in postnatal wards. Midwifery Group Practice / midwifery-led models of care will continue.

Intensive Care Units
ICUs will be staffed to the latest Professional Standards outlined by the Australian College of Critical Care Nurses as relevant to the department.

Multi-Purpose Services with Lvl2 ED open 24/7
A shift by shift minimum of three nurses, two of whom must be registered nurses and two must be FLECC or ENECC trained.

This commitment is to adopt ratios-based principles to reform the Public Health System Nurses’ & Midwives’ (State) Award, in a phased approach. Which means, like the Greens and Shooters, Fishers and Farmers parties, NSW Labor support a mandated safe staffing ratios-based system. All eyes are now on the NSW government to respond.

NSW Labor’s plan is a promising start towards much needed reforms to the public health system but there are areas that still need to be addressed. The NSWNMA will continue to campaign to achieve the meaningful changes all public sector nurses and midwives need.

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