2 Objectives and scope The objective of this report is to reflect the outcomes of the work undertaken by HWA during 2012-13 to identify opportunities for nationally co-ordinated action that will generate improvement in the retention of nurses in the profession, and boost productivity. The has been on identifying actions that federal, state and territory Health Ministers can take collectively. It is clear from consultation with key stakeholders that a wide array of innovations and initiatives are being pursued (see Attachment 1 for consultation process). The aim of this report is to put forward recommended changes in the system that will further enable and encourage diffusion of innovation in the workplace, recognising there are often many paths to achieving an outcome at the local level. are many areas that will improve nursing workforce sustainability that are not specifically addressed in this report. Some of these include the education and training pipeline, recruitment, workforce distribution in specific areas and settings, retention across the career span (for example strategies for older nurses or temporary exits due to parenting) and immigration. Some of these issues are being addressed in other HWA work (see Attachment 2). Further investigation into other areas may be warranted in future work. there are recommended actions in this report that relate to education and training capacity for the nursing workforce, the principal objective of these and the overall suite of recommendations is to improve nursing workforce retention and productivity. Midwives are not included in this report. The midwifery workforce will be examined in future HWA work, within the development of maternity services planning. The identification and formulation of the recommendations for action set out in this report were guided by the following principles: Orientated towards enabling outcomes Reflective of consultations, research and the evidence Realistic given current fiscal context Manageable in number Amenable to action by Ministers collectively Focused on ensuring national workforce sustainability The advice and feedback from all phases of the consultation process, together with the literature evidence, has been considered during the development of this report. There are important and persistent issues relating to the distribution of the nursing workforce across geographical areas, sectors (Aboriginal and Torres Strait Islander,
Support and Assistant Models New South Wales Health has introduced 500 ward-based Clinical Support Officers to assist nurses with their administrative load. The National Health Service (NHS) in the United Kingdom (UK) is trialling a similar role of Personal Administrators to take on the administrative load of ward leaders. Bendigo Health and Austin Health in Victoria trialled health AINs across different wards and found improvements in patient and staff satisfaction, staff retention, decreased agency costs and overall increases in efficiency. HWA has recently analysed the assistant and support workforce, including those related to the nursing profession and practice. The analysis considered the scope of practice and models of care for their contribution and their fit to the healthcare team. Assistants have always been an important part of the health workforce. Their roles have often been initiated on an ad hoc basis in the absence of national guidance and support on how to get the best value from this workforce. They are therefore often under-utilised and their value not sufficiently recognised. Health Ministers have recently agreed to the establishment of negative licensing arrangements that include Assistants in Nursing. The Australian Nursing and Midwifery Federation has stated that if assistants in nursing are to be widely implemented in the acute sector then they must have nationally mandated minimum educational preparation, be licensed using existing models and have a regulatory framework in place that contains scope of practice. The concern of other stakeholders is to ensure that the operational context for the assistant and support workforce remain appropriately flexible and agile and enable it to be sufficiently responsive in meeting the specific care and service needs of individual organisations. The essential element for uptake of roles is generation and dissemination of evidence from successful models. The recent UK Cavendish Review of healthcare assistance and support workers in NHS and social care comments, “These workforces are set to grow. There is an urgent need to acknowledge them, support them, and plan for them”. Effective planning means using an evidence base to determine local staffing needs incorporating the key requirements for the workplace context, including an enabling industrial environment, continuous support and ongoing evaluation. Barriers and enablers of productivity and innovation Australia now has a national registration and accreditation scheme in place providing scope for boosting flexibility and deployment of skilled workers to meet the needs of communities and employers. This is a significant national reform, which in time can enable and support progressive workforce reform.