Nurses to help shape ‘safe’ staffing rules in NSW emergency departments

The state government has tasked the nurses’ union and health bureaucrats with jointly devising a plan to deliver so-called safe staffing levels in NSW hospitals, ending a long-running industrial campaign centred on legislated ratios.

The first task of the new safe staffing working group will be to ensure there is one nurse for every three patients in emergency departments, with intensive care units and maternity wards to follow.

Safe staffing levels in hospitals were one of Labor’s first major election commitments, despite not reflecting the long-held demands of nurses who wanted staff ratios cemented in legislation, as in Victoria and Queensland.

About 5000 nurses and midwives demonstrated on Macquarie Street last year.Credit: Louise Kennerley

Nurse-to-patient ratios, along with increased pay, were central to the NSW Nurses and Midwives’ Association demands of the previous Coalition government and resulted in multiple strikes across the state in 2022.

NSW Labor took a staff ratio policy for nurses to two state elections but decided last year not to support an upper house inquiry recommendation to mandate increased staffing levels.

Instead, it settled on what it calls safe staffing levels, which will convert the existing nursing hours per patient day staffing requirement into minimum staffing levels enforceable under the employment award.

The new working group, made up of union representatives and NSW Health, will plan and drive the implementation of safe staffing levels across the public health system. It will begin with emergency departments but will be rolled out more broadly.

The group will look at the diverse workforce needs of facilities, varying patient needs and nursing workforce planning and supply. It will report to NSW Health secretary Susan Pearce, who will provide regular updates to Minister for Health and Regional Health Ryan Park.

As part of its election commitment, Labor also promised to recruit an extra 1200 nurses and midwives to the public health system within the next four years, in a bid to ease the workload on existing staff and stop the exodus of healthcare workers to other states.

Premier Chris Minns said the government was committed to boosting the number of nurses and midwives in NSW hospitals, beginning with emergency departments.

“This is the first step to safe staffing in hospitals – ensuring there’s one nurse for every three patients in ED. It was one of the very first election commitments we made,” Minns said.

“Safe staffing levels will see more health staff retained, working in areas that need them the most, and it means better outcomes for patients and the level of care they will receive in NSW. It is critical we have government and representatives for our health staff working together towards this important reform.”

NSW Health introduced the patient ratio system of nursing hours per patient day following industrial action under the previous Labor government in 2010. The current system assesses staffing levels over a weekly period, not shift by shift.

Victoria legislated a minimum of one nurse to four patients in 2001. In 2016, the Queensland government endorsed a minimum of one nurse to four patients for morning and afternoon shifts and one nurse for seven patients for night shifts in the state’s public health services.

The Morning Edition newsletter is our guide to the day’s most important and interesting stories, analysis and insights. Sign up here.