Health NZ and nurses’ union at odds over safe staffing

Friday, 1 November 2024

Nursing students about to complete their studies are concerned about their job prospects, as Health NZ advises there are 'fewer vacancies' than in previous years

“Patchy” improvements to safe staffing levels risk being undone amid Health NZ - Te Whatu Ora’s financial problems, the nurses’ union is warning, as it works through contract negotiations with the health agency.

The New Zealand Nurses Organisation (NZNO) spent years trying to get hospital bosses to commit to Care Capacity Demand Management (CCDM), a programme that helps to give oversight of how short-staffed wards are and whether there is the right skill mix on shift.

It was implemented at some hospitals in 2018, but has yet to be set up in all hospitals despite the Labour government promising to do so in 2021.

The union says that while the programme does have shortfalls, it is the only benchmark for safety and staffing levels used in hospitals and - where implemented - has led to an increase in patient safety.

The union is concerned now that Health NZ is proposing to “pause” the full-time equivalent calculations as part of the programme, which NZNO described as a “blow” in a leaked email to its members. It described uptake of the programme as “patchy” but noted Health NZ did not have a measure to determine base staffing levels without it.

‘Under discussion’

Health NZ said the calculation was “under discussion as we work to improve the quality of data produced”.

But union delegate Nathan Clark, who works as a nurse, warned patients will be at risk if there was not a scheme ready to replace it. “If you remove the benchmark that you have for your safety and staffing what have you got then?”

The two Health NZ - Te Whatu Ora leaders appeared at Health Select Committee on Wednesday and briefly spoke to media after about the organisation's finances,non-disclosure agreements, and Levy's second job.

“Putting a pause on that is putting a pause on patient safety.”

Health NZ earlier this month released a trove of documents on its financial situation which it said related to increased staffing, especially around nurses. Chief executive Margie Apa said it had “overcorrected” the amount of nurses it needed to hire.

Its commissioner Lester Levy has been tasked with finding $1.4 billion worth of savings.

Health NZ northern chief executive Mark Shepherd said the agency was always seeking to match staff “resources to patient demand to improve care, make optimal use of resources and provide a better working environment for health workers.

“Ensuring we have the right clinical staff on the frontline with the appropriate skills, knowledge and experience is a top priority,” he added.

‘Under-staffing is unsafe’

But Labour’s health spokesperson, Ayesha Verrall, pointed out that under-staffing is associated with an increase in deaths in hospitals, and is unsafe.

“Labour agreed to CCDM in order to have transparency and clear information on where extra staff were needed and how many,” she said.

“It is disappointing to see Health NZ roll back this reporting, it is another way in which the Government is trying to conceal understaffing and underfunding from New Zealanders.”

A number of health and disability commission reports into patient complaints note a shortage of staffing, or having the wrong skill mix on a shift, as contributing factors.

In 2018, after a baby died, another was seriously harmed and a “high rate of complaints” at Hutt Hospital, the then-district health board requested an external review of its women’s health services.

The review found registered nurses were working out of scope as midwives, as well as other “chronic” shortstaffing issues, and urgently recommended CCDM be implemented.