2013 Annual Conference Report by NSW Nurses and Midwives' Association

Report to

2013

Annual Conference

Table of Contents President’s Report �� 4 General Secretary Report �� 8 Assistant General Secretary Report �� 13 Overview – Industrial Issues �� 18 NSW Public Health System �� 20 Local Health Districts, Networks, Justice Health and ADHC �� 23 Private Hospitals �� 38 Aged Care Sector �� 41 Other Industry Sectors �� 48 Professional Services �� 50 Communications �� 58 Community Sector �� 61 Conclusion �� 62 Summary of Financial Information �� 65

Report to 2013 Annual Conference Coral Levett, President As President it is my privilege to provide a short report on some of the activities of the Association, particularly those involving the Executive and the Council.

NSWNMA Council Activities Council is made up of 23 democratically elected members including the General Secretary, the Assistant General Secretary and eight executive members. It is vested with the responsibility of managing the affairs of the Association according to our rules. Each year all members of Council face numerous challenges in the carrying out of their duties in order to ensure the Association is in the best possible position –

professionally, financially and industrially – to best serve the interests of our current and future members. There has been just one change to Council in the last year, that is, the resignation of Louise Howell due to competing work and family commitments. I take this opportunity to thank Louise for her contribution and commitment to Council for the duration of her term of office. It is anticipated that this Councillor position will be filled by a delegate at the September Committee of Delegates’ meeting. Leading and managing this organisation continues to be an extremely challenging but important responsibility, and I acknowledge the commitment of the entire Council under Brett Holmes and Judith

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Kiejda’s expert leadership. Brett and Judith continue to do a spectacular job and it is my privilege to have them as our leaders. The workload for our Councillors continues to be extensive with each one attending approximately 120 hours in meetings for Council, Committee of Delegates and other required meetings. As well as this, the Councillors have:

been actively involved in decisions to establish and provide the new Accident Journey and Professional Indemnity Insurance for financial members and continued to oppose the retrograde and unfair changes to the Workers’ Compensation legislation by the O’Farrell government;

authorised the expenditure necessary to complete the Association’s name change to the NSWNMA;

participated in Association industrial campaigns, including the ongoing protection and enhancement of our nurse to patient ratios, including the recent See Red campaign, local MP lobbying and attending the recent National Party Annual Conference;

authorised significant expenditure in relation to the day-to-day finances of the Association as you will see when the Association accounts are presented to you;

attended official functions as required by the Association;

been actively involved in regular committee representation, such as, Lamp Editorial, Professional Issues Committee (PIC), Special Interest Groups, Log of Claims Committees, etc;

authorised donations on behalf of the Association to a variety of groups and charities to the value of around $50,000;

carried hundreds of resolutions to further the interests of our members, this Association and the nursing and midwifery professions; and,

reviewed numerous NSWNMA, ANMF and ACTU policies, guidelines and position statements, of which a number will be presented to this Annual Conference for endorsement as required by the rules.

Other than Brett and Judith, our Councillors are all nurses and/or midwives working directly in our health system, carrying out their Council duties in addition to their usual employment arrangements. Although some of our public sector employed Councillors are afforded paid leave to attend some daytime meetings, most of our private and aged care sector Councillors have no such entitlement. All Councillors are full- or part-time

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Our Councillors are all nurses and/or midwives working directly in our health system, carrying out their Council duties in addition to their usual employment arrangements ... We are very fortunate to have Association Councillors that are prepared to put in the necessary time this role requires of them. employees in a wide variety of public, private and aged care settings across NSW and many of them also hold executive positions at the local branch level. We are very fortunate to have Association Councillors that are prepared to put in the necessary time this role requires of them and I thank the Council for their continued effort and for their professional collective wisdom.

ICN This year in May the quadrennial International Council of Nurses Congress was held in Melbourne. A number of Councillors were afforded the opportunity to attend

Peg Hibbert, Lyn Hopper and Gary Clark represented NSWNMA at the International Council of Nurses Congress.

and represent the interests of our members. This forum was attended by over 4,000 nurses and midwives from over 120 countries and covered important professional, health, education, industrial relations and social justice policy matters of interest and concern to our membership and nurses and midwives throughout Australia. By all wearing our union scrubs, we were easily identified and attracted the interest of many, including the federal health Minister Tanya Plibersek during her presentation.

May Day Parade

Professional Issues Committee The Professional Issues Committee (PIC) has been focused on the review and development of policies, guidelines and position statements for presentation to Annual Conference for endorsement, and has also provided valuable input into the numerous professional issues that present themselves relating to nursing and midwifery. A couple of new policies have also been developed for this year’s conference. Encouragingly this year we have had good attendance from all members of the committee, including our Associate member representatives (undergraduate nursing students). Thank you to all the members of the committee for their contribution and participation and also to the Association staff who support them.

Australian Nursing & Midwifery Federation Activities

Coral Levett and Jillian Thurlow at the 2013 May Day Parade.

It was very exciting this year to participate and win first prize for the ‘Best Union Contingent’ in the inaugural May Day Parade. May Day is an opportunity to celebrate the great things achieved for workers by unions in this country, including securing the right for an eight-hour day (reserving time for eight hours of recreation and eight hours of sleep) and a better work/life balance. NSWNMA chose to theme our float ‘A proud past, a fighting future’. A great day was had by all who participated, and congratulations to NSWNMA Administrative Services Manager Warren Williams and his team for all their preparation and hard work for this important event.

Edith Cavell Trust This year we have allocated financial assistance to 24 members to embark on undergraduate nursing or midwifery studies, or to further their postgraduate professional development through study or research. An amount of $80,000 was allocated this year to further the professional and educational interests of our members. As the Trust scholarships are only available to members and associate members, it is another great reason to encourage non-members to join.

Following the lead of some of our state branches, we have recently changed the name of the Australian Nursing Federation (ANF) to the Australian Nursing and Midwifery Federation (ANMF). As well as being members of the NSW Nurses and Midwives’ Association, we also form the NSW Branch of the ANMF which allows us to exert our influence on professional and industrial matters at the national level. As a Branch of the ANMF, we form a sizable component of a collective of over 240,000 members throughout the nation. We are now the largest union in the country as well as the fastest growing. The ANMF continues to have strong leadership with Lee Thomas and Yvonne Chaperon at the helm We are very excited to have a new Vice President –

We have recently changed the name of the Australian Nursing Federation (ANF) to the Australian Nursing and Midwifery Federation (ANMF) ... As a Branch of the ANMF, we form a sizable component of a collective of over 240,000 members throughout the nation. Report to 2013 Annual Conference — President « Page 6

Some of the attendees at the South Pacific Nurses Forum in November last year in Melbourne.

SallyAnne Jones who has also been the President of the Queensland Nurses Union for a couple of years now. Many of the issues that affect nurses and midwives in NSW are indeed federal matters and affect the professions of nursing and midwifery at a national and international level. For this reason, it is vital that we speak and lobby as a national and united body. I really enjoy my work with Lee, Yvonne and the rest of the ANMF Federal Executive, and on your behalf I look forward to continuing this work into the future.

SPNF ANMF (or ANF at the time) hosted the South Pacific Nurses Forum in November last year in Melbourne. It provided a great opportunity for discussion of issues in common, and a number of NSW delegates were able to attend.

union on the front foot. We have certainly become leaders of the union movement in Australia. As with previous years, I anticipate an active and enthusiastic contribution from the delegates at this conference. As usual, we have some exciting professional questions on the agenda to debate and decide and I am confident you will do this with enthusiasm and wisdom on behalf of the wider membership. I would like to encourage all delegates to actively participate in the proceedings of conference for the next two days. We value your contribution and look forward to an informative, challenging and successful 68th Annual Conference.

Coral Levett

Conclusion In conclusion, I would also like to acknowledge the hard work of the dedicated staff of the Association. This has been another year of extremely high activity and enormous change. My observation is that the team effort is what makes the difference between success and failure. We continue to be a growing strong union with a very proud membership. I congratulate Brett and Judith once again on their exemplary, modern leadership and their ongoing capacity to keep this

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President

Report to 2013 Annual Conference Brett Holmes, General Secretary The 68th Annual Conference theme of Ratios put patient safety first recognises our ongoing campaign for safe patient care and the commitment by the New South Wales Nurses and Midwives’ Association and its members to better outcomes for the community of NSW and our members. The reality for our union and delegates, branch officials and members in all sectors is that we are in what will seem a never-ending campaign. Winning and defending outcomes across all sectors is what we do as a union; we have faced many challenges in the past twelve months and there are many more on the near horizon. A separate report on the Ratios put patient safety first campaign is included in the Conference papers.

The fact that, for the last 68 years, we all attend Annual Conference as part of the democratic structure of this union is a testament to the validity of our existence. We continue to exist, more importantly grow, because we not only provide leadership but also power to our members to achieve real outcomes.

NAME CHANGE As a result of last Annual Conference decision-making, the New South Wales Nurses’ Association transitioned seamlessly to its new name of the New South Wales Nurses and Midwives’ Association. Remarkably, this has not resulted in some members wanting to hold

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onto the past but an acceptance that we are a union prepared to embrace change and recognise the progression of our two professions with more in common than differences. I thank all of the staff involved for their work in this name change. The Australian Nursing Federation is also embarking a name change to the Australian Nursing and Midwifery Federation.

PRIVATISATION The announcement by the O’Farrell Government on 2 May 2013 that the new Northern Beaches Hospital and health services would be designed, built and fully operated by the private sector came without consultation and was presented to the NSW public as a fait accompli. This is a step reminiscent of the failed Port Macquarie Hospital privatisation, however it bodes poorly for the retention of our public health system in public hands. Clearly, operators of such a facility and investment expect a profitable return on their investment as well as taxpayer contribution to the build. Private operators, whether for-profit or non-government organisations, have obligations to shareholders or their benefactors to make a profit or a surplus. We cannot stand idly by when the complete public health services for the Northern Beaches community are delivered on the basis of profit. Committee of Delegates and the Council of the NSWNMA have determined that we should campaign against this privatisation that has become a pattern of conservative state governments in Western Australia, Queensland and now NSW, especially when the federal Liberal /National Party is applauding such privatisation. We aim to ensure commitments from all sides of politics to the retention of our public health system in public hands.

NSW ELECTORAL FUNDING LAWS – HIGH COURT CHALLENGE The Association, along with Unions NSW and other unions (Australian Manufacturing Workers Union, United Services Union, NSW Teachers Federation and Transport Workers Union) have lodged a High Court challenge to provisions of the Electoral Funding, Expenditure and Disclosures Amendment Act 2012. The challenge seeks to strike out provisions of the Act relating to:

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caps on electoral communication expenditure; aggregation of affiliation fees into the expenditure

caps applicable to political parties (e.g. affiliation fees paid by some unions affiliated to the ALP); and,

prohibition of donations to third parties by organisations (e.g. the Association is prohibited from contributing to a campaign run by Unions NSW that involves political expenditure).

It is the Association’s view that the Parliament of New South Wales, while legislating to significantly increase public funding to political parties and parliamentarians, has severely restricted the ability of legally constituted organisations to freely associate and advocate on matters of public importance. This legislation conflicts with the Objects of the Association which recognise the legitimate right of the NSWNMA to lobby politically on behalf of members, and to associate with other organisations to further the industrial interests of members. We believe that the High Court case is an important step in defending the rights of freedom of association and free speech for the NSWNMA and its members.

NSW STATE GOVERNMENT WAGES POLICY The State Government wages policy, which was made law in 2011 and removed the NSW Industrial Relations Commission’s (NSW IRC) arbitration powers, has been brought into force with direct impacts for public sector workers, including nurses in ADHC and nurses and midwives in the public health system. To add further insult, the State Government announced it would deduct the increase of 0.25% in the Superannuation Guarantee Levy from the wages outcome. This was tested in the NSW IRC in front of a Full Bench of the Commission. When the government was defeated by the independent umpire it quickly moved to amend the wages policy law to enforce their position. In an effort to save face the government also intends to appeal the decision of the NSW IRC so as not to appear that the law can be simply changed at whim to suit the government’s position.

It would appear that the O’Farrell Government is prepared to change the law any time it deems it necessary when tackling the public sector workforce.

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This is very ugly for our democracy and the willingness of the government to overturn a decision by judicial officers of the Commission is an appalling indictment on the government’s lack of respect for its workforce and their rights. Unions had little choice but to take the 2.25% wages offer, pending the outcome of the appeal. In any case, it would appear that the O’Farrell Government is prepared to change the law any time it deems it necessary when tackling the public sector workforce. It must be clear to all of our members that if they want to see a change to workers compensation law or to government wages policy then a political solution will be required.

Aged Care Legislation Living Longer. Living Better And The Wages Supplement (Compact) In the last hour of the Gillard Prime Ministership this legislation finally passed through both houses of the federal parliament. The Wages Supplement is the longawaited outcome of our aged care campaigns Because We Care and Aged Care Can’t Wait. Further detail follows in the report but this has opened the way for improved wages outcomes in the aged care sector, providing they are not removed by an Abbott Government should the Liberal/National Party win the upcoming federal election.

Many aged care providers delayed bargaining their new agreements with this additional funding because of the uncertainty of a different government that might be prepared to rip the increased funding out of the mouths of aged care workers. Only time and votes will tell the longterm outcome for aged care.

GOVERNANCE The publicity surrounding the Health Services Union and governance matters resulted in the Federal Government introducing changes to the Fair Work (Registered Organisations) Act 2009 that impose requirements on industrial organisations to insert rules providing for:

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training for responsible officers;

officers’ obligations for disclosure of remuneration and material personal interests; and,

declarations of related-party transactions.

specific duties of the Executive in relation to financial and risk management;

While the NSWNMA is not obliged to incorporate these matters into our Rules, Council has resolved to present a rule change to Annual Conference reflecting those federal requirements. Not only do they consolidate many long-standing Association practices, but they also provide a formal governance framework within our Rules for the future. Additionally, the NSWNMA Councillors have undertaken training courses in financial management

Brett Holmes (second from right) with Minister for Ageing Mark Butler (third from right) at the Aged Care Compact launch.

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and governance, delivered by lecturers from The University of Sydney. To meet legislative requirements of the Fair Work (Registered Organisations) Act 2009, the NSWNMA/ANMF Branch Councillors will also undertake an approved course developed by the ACTU. This year Councillors have also reviewed and updated the current policies that govern Council and introduced three additional governance policies.

MEMBER BENEFIT SCHEMES Accident Journey and Professional Indemnity Insurances These new member benefits were in development at the time of the 2012 Annual Conference and came into effect on 18 September 2012. All members were advised of the details of the scheme and we have received a positive response. It is important to note that the benefits have been accommodated within the 2013 budget without the need to raise additional levies on members. Details of both benefits are on the Association website. The Accident Journey Insurance provides cover for members who are injured on their journey to and from work and who, prior to 19 June 2012, would have been covered by workers compensation. The O’Farrell Government’s changes to workers compensation from 19 June 2012 largely removed journey claims.

The Accident Journey Insurance provides cover for members who are injured on their journey to and from work and who, prior to 19 June 2012, would have been covered by workers compensation. The implementation of this scheme has been challenging and complex, particularly given the continuing uncertainties with the interpretation of the new legislation and the aggressive attitude adopted by some insurance companies; for example, it has been standard practice to deny liability for claims even when they occurred on the employer’s property. While the Association and our insurers are of the view that such claims are covered by workers compensation, the insurers have accepted the claims. At the time of this report, 21 members have received payments under the policy.

WORKERS COMPENSATION The changes to the workers compensation scheme are still becoming apparent and it is clear that when the O’Farrell Government pushed the legislation through parliament in the middle of the night, it had far from determined how the new system would operate. As a result, the NSWNMA has had to institute a significant annual retainer with our law firm, NEW Law. This is to ensure that any member, deemed by the government system not to have a case for an appeal to the insurer’s decisions, is given that coverage where the experts at NEW Law determine a prospect of winning exists. Many of the new provisions are still coming to fruition and victims of workplace injury, who are being assessed for work capacity or have exceeded the allowable timeframes for compensation, will ultimately be cast on the Commonwealth social security system, or the NDIS (now DisabilityCare) when it is rolled out.

FINANCES Finances 2012 The NSWNMA remains in a strong financial position with the audited results for the year to 31 December 2012 showing an Operating Surplus of $2,321,360 before NonOperating Revenue and Expenses, and Total Compre hensive Income Attributable to Members of $8,197,340. Non-Operating Revenue and Expenses included:

profit from the sale of the Camperdown and Wollongong properties of $3,983,891;

reversal in the Provision for Impairment - Waterloo property of $2,097,394;

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loss on the disposal of Financial Assets of ($897,236);

net gain on the revaluation of Financial Assets of $1,364,388; and,

actuarial losses – Defined Benefit Superannuation Fund of ($332,256).

write-down of the Investment in the NEW Law Joint Venture of ($340,201);

The Balance Sheet as at 31 December 2012 recorded Total Accumulated Funds of $31,999,421, an increase of more than 34% on the 2011 total. This was due to three main factors:

Another solid operating result during the year with revenue increasing and costs contained within budget.

The significant profit recorded on the sale of our Camperdown and Wollongong properties.

The revaluation of the Waterloo property which led to a significant reduction in our Provision for Impairment.

The full audited accounts have been placed on the Members Only page of the NSWNMA website and will be presented to Annual Conference by the Association’s Auditors.

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The unaudited accounts to 31 May 2013 recorded a deficit of $762,881 as we have had significant expenditure in the first five months of 2013 on our public health system campaign, including TV and radio advertising. We did however out-perform the budgeted deficit of $1,421,231 for this period. Last year we had a surplus of $1,890,546 to the end of May, but there were much lower campaign costs and the 2012 result included an almost $500,000 surplus on the sale of the Wollongong property.

Key Growth » A net increase in the Public Health System for the year (30/06/2012 to 30/06/2013) - up by 1,362 members (3.67%).

A net increase in Residential Aged Care for the year - up by 345 members (3.72%).

A net increase in Private Hospitals for the year - up by 37 members (0.79%).

Other sectors up by 220 members.

We have had a steady growth in membership which at the end of March exceeded 57,000 financial members. Because we set high membership targets for 2013, total income from Membership Subscriptions lags behind budget by $67,641 after five months. Staffing costs are higher than last year as we have geared up for the public health system campaign although they remain below budget.

Public Health System up by

1,362 members

MEMBERSHIP STATISTICS

Residential Aged Care up by

Membership Statistics

345

The NSWNMA has recorded a net increase of 1,964 financial members in the 12 months to 30 June 2013. This brings the NSWNMA to a financial membership of 57,965 at 30 June 2013, representing a growth of 3.51% for the 12-month period. To obtain this net gain, 7,331 new members were admitted and 5,670 members resigned. The size of the task to recruit is obvious but without an ongoing effort by every member, every branch official and every staff member, we cannot continue this level of growth. In the first half of 2013 Council admitted 4,484 members, the highest number recorded in the past 19 years. As always, there are many more nurses and midwives who could join but have not yet been convinced of the importance of membership. It is the responsibility of all of us to strongly encourage those nurses, midwives and assistants in nursing to join our union.

In the first half of 2013 Council admitted 4,484 members, the highest number recorded in the past 19 years.

members

private hospital up by

other sectors up by

220

members

The number of PRD members has decreased from 9,710 to 8,696 (15.0%).

The number of PRD members has decreased by 1,014 for the year (30/06/2012 to 30/06/2013). This still represents more than $6 million per year or $500,000 per month income, with the obvious need to continue the campaign to remove our dependence on this form of income.

Other Statistics » Number of branches: 446 – up from 407 in 2012 » New branches formed: 13 » Branches reformed: 18 » Delegates: 633 » Branch Officials: 1,531

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Report to 2013 Annual Conference Judith Kiejda, Assistant General Secretary PUBLIC SERVICES INTERNATIONAL (PSI) The NSWNMA is now in its fifth year of affiliation with the Global Union Federation PSI. The battle for the protection and retention of quality public services across the globe has shifted up several gears as the effects of austerity measures bite deep into public services, and NSW is not immune. We have seen drastic measures taken by the current state government into winding back public services including in our own Local Health Districts. Conservative governments internationally have

insisted the only way to rein in budget deficits is to curtail public spending, despite recent admissions by the International Monetary Fund (IMF) that these drastic public sector cuts in the name of austerity may have gone too far. The story is simple: if governments take away people’s public sector jobs, not only do they delete the quality and quantity of public services – the measure of any decent society – but they also negatively impact the economy because those people cannot spend money they no longer earn. PSI is dedicated to the retention and improvement of quality public services worldwide and this union is proud to be part of that movement. Tax reform is the only way to ensure enough resources to adequately

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fund important public services such as health and aged care. The NSWNMA continues its push to make governments of all persuasions understand the need to pursue tax reforms such as the introduction of a financial transaction tax on the speculative economy.

leadership and the need to yet develop that framework our usual annual Health Services Taskforce meeting was not held this year and consequently there was no international nurses meeting at PSI.

PSI held its World Congress in Durban, South Africa in November 2012 – an event that only occurs every five years. The NSWNMA was represented by Lead Organiser Shirley Lee on migration matters, Organiser Paul Collier was our youth representative and I was pleased to represent the Association in my capacity as the PSI Health Coordinator of the Asia Pacific Region. It was a privilege to speak on the floor in front of 1200 global representatives supporting resolutions on ratios for safe patient care and the importance of tax reform to fund quality public services. I was also very honoured to be asked to present the NSWNMA’s innovative approach to supporting the Your Rights at Work Campaign.

GLOBAL NURSES UNITED (GNU) Given the current difficulties in progressing the nursing agenda within PSI, the nurse affiliates and some other international nurses unions gathered in San Francisco at the end of June to ascertain the possibility of forming an international nurses union – in line with the 2008 Annual Conference resolution – that could work alongside PSI initiatives.

This convention was historic in that it elected the first woman as General Secretary. Rosa Pavanelli was elected to succeed Peter Waldorff’s single term in office – also an historic event. There is already evidence that the shift in leadership has produced positive results on the global stage as the campaign for quality public services intensifies.

I am excited to announce that the 14 countries present - Argentina, Australia, Brazil, Canada, Costa Rica, the Dominican Republic, Guatemala, Honduras, Ireland, Israel, the Philippines, South Africa, South Korea, and the United States – agreed to form this international nurses union called Global Nurses United. GNU is aimed primarily at campaigning against the worldwide move to increase the privatisation of health, to further our agenda of ratios to provide safe care in ALL health care delivery settings, and the vitally important need to reform tax systems to ensure adequate funding of public services.

Rosa Pavanelli is supportive of nurses having a lead role in PSI and we are working toward a facilitative framework to ensure that occurs. Given the new

This union of nurses will conduct its business in the first instance primarily by electronic means and will have its first face-to-face gathering in September

From left: Judith Kiejda, Paul Collier and Shirley Lee representing NSWNMA at the PSI World Congress in Durban, South Africa in November 2012; Judith Kiejda amongst the international nurses union representatives at the formation of Global Nurses United (GNU) in San Fransisco; the NSWNMA hosted the Board of the Canadian Federation of Nurses Unions (CFNU) prior to their attendance at the International Council of Nurses (ICN) Convention held in Melbourne in May 2013; Shirley Ross-Shuley spoke at the Sydney Alliance.

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2014. GNU’s first global activity will be held on 17 September this year on an issue that is important to each participating country. The NSWNMA hosted the Executive Board of the Canadian Federation of Nurses Unions (CFNU) prior to their attendance at the International Council of Nurses (ICN) Congress held in Melbourne in May 2013. This was a very productive meeting day where we shared our ratio story and is another example of the growing connection between international nurses unions.

ASIA PACIFIC REGIONAL ACTIVITIES The NSWNMA attended the annual sub-regional meeting held in Auckland in March 2013. The NSWNMA presented on the topics of tax reform and health activities in the Asia Pacific region and facilitated a workshop on critiquing the work to date on our migration project: a pre-decision kit in the form of an information booklet. The booklet will help aspiring nurse and midwifery migrants to Australia to understand exactly what is required of them professionally and personally in migrating to this country. The NSWNMA will participate later this year in PSI workshops in the Asia Pacific Region where we will launch the completed pre-decision kit booklet. It is anticipated that this booklet, once introduced, will be a template that could be used by a number of unions in a number of industries. I extend my thanks for the hard work of a small NSWNMA team in bringing this project to fruition.

THE SYDNEY ALLIANCE The Alliance has been growing in reach across Sydney, building new districts, running and winning successful campaigns, and increasing the number and commitment of diverse people, groups and organisations in local community action. The Association has been involved in numerous Alliance actions and activities throughout the year. As the Assistant General Secretary of the NSWNMA, I have taken up a position on the Sydney Alliance Board, contributing to its governance and leadership. Officers and members are taking active leadership roles in districts and research action teams, as well as in assisting with training and planning activities to build leaders within the Alliance. The following are some highlights of NSWNMA participation in just some of the Alliance activities held over the past year.

Take the Time campaign In late 2012 the Alliance won a great victory for this campaign when the NSW Government reversed its decision to make Boxing Day a normal retail trading day, impacting on the family and community time of up to 90,000 retail workers and their families. This win

In late 2012 the Alliance won a great victory when the NSW Government reversed its decision to make Boxing Day a normal retail trading day.

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NSWNMA President Coral Levett (middle, standing) with NSWNMA members at the Sydney Alliance Assembly in October 2012.

A negotiation was held between Mirvac and the Alliance to commit to apprenticeships in local building projects for young men in the Glebe-Redfern district ... providing pathways for young men who have faced barriers to accessing skilled work. was achieved by a delegation from the Alliance showing the strength of a non-partisan coalition of unions, faith-based organisations and community groups. The government reversed their decision on realising that the issue was widely and deeply felt, affecting people across a range of experiences and interests.

May 2013 Assembly in Glebe A delegation from NSWNMA, including community nurses from Marrickville, took part in the May Assembly with a focus on an exciting project in the Glebe area. A negotiation was held between Mirvac and the Alliance to commit to apprenticeships in local building projects for young men in the Glebe-Redfern district. This is now underway, providing pathways for young men who have faced barriers to accessing skilled work. The Assembly also heard from each of the ten Sydney Alliance districts and their plans for local change. Attendees from across Sydney signed up to become involved in community issues through their

local District. The presence of community nurses was instrumental in reinvigorating the Inner West District which has since been meeting regularly.

Parramatta District Members of the Parramatta District have supported the Community Support and Health team to continue its work in improving access to community support and health services for people from culturally and linguistically diverse backgrounds. After an extensive community listening campaign, a series of research meetings and a survey of fourteen Alliance partner organisations, a proposal was developed to design an audit tool that organisations can use to make their workplaces more culturally friendly. The NSWNMA has had a leading role in this work and has built strong partnerships with a range of organisations in the process. Although an application for a small grant to Parramatta City Council in early 2013 was unsuccessful, the group was approached soon after by WentWest Medicare

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Local in Blacktown with a desire to fund a pilot project. This has resulted in an exciting partnership between the Alliance and Western Sydney Community Forum to commence in the second half of 2013.

Planning for the 2015 State Election The Alliance has started planning well ahead to consider its role leading up to the NSW State election, to develop a well-considered plan, focused on fostering strength in local communities and building the impact of the Alliance on state-wide issues for the common good. The Alliance is a non-partisan organisation, working in a climate where this election is unlikely to be strongly contested. Each partner organisation conducted an internal planning meeting during June/July 2013 to feed into the Alliance so that a strategy can be developed. A large Assembly in March 2014 will mark one year until the next state election and the NSWNMA is planning a delegation of up to 200 members.

Building new Districts The current phase of building districts is underway, and there is excellent potential for nurses and midwives to become involved. New districts are being built on the North Shore, Canterbury/Bankstown, Blacktown/ Mount Druitt and the St George/Sutherland Shire, and members can help shape the work of their local community through joining a district. One example is a current campaign to research transport accessibility and parking around Westmead Hospital, and design proposals to address this through the Alliance.

A large Assembly in March 2014 will mark one year until the next state election and the NSWNMA is planning a delegation of up to 200 members.

THE LAMP The Assistant General Secretary’s office is responsible for overseeing the production of the The Lamp. We publish 11 issues per year and I believe we produce a very professional and contemporary magazine. It is the one communication channel that each member receives every month. Brett and I see this vehicle as one of our most important opportunities to inform our members, not only about current industrial matters in each of our sectors, but also that the membership has the necessary information on extended health matters that keeps them informed. I would like to thank all the members, staff and production crew who work together to ensure our members are up to date on all issues of importance to the membership. THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION

VOLUME 70 No.6 JULY 2013

Print Post Approved: PP241437/00033

AUSTRALIAN COUNCIL OF TRADE UNIONS (ACTU) EXECUTIVE As a state-registered affiliate of the ACTU, Brett and I sit on the Executive and represent our members at three meetings per year. In this last year I was elected to the position of Vice-President (Junior) and in that role have had the privilege of meeting with the Prime Minister and Cabinet on a quarterly basis. This is a new opportunity for the NSWNMA and gives your union a voice at peak federal government level.

Judith Kiejda Assistant General Secretary

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Overview – Industrial Issues NIGHT DUTY STUDY The Nurses and Midwives Nightwork Study Report was released in mid-December 2012 by the Sydney Nursing School, The University of Sydney. Following are the study’s substantive terms of reference and findings:

1. Risk – frequency and duration of night shift work

In September 2009 the NSW IRC identified a risk of the development of a number of diseases from the performance of night shift work where such work was undertaken for a particular frequency and duration. The following table summarises the IRC’s findings in relation to these risks.

Disease

Frequency

Duration

Cardiovascular morbidity/mortality

At least three For six years night shifts/month or more

Colorectal, Endometrial, Prostate cancer

At least three night shifts/ month

For 15 years or more

Breast Cancer

At least three night shifts/ month

For 20 years or more

The Nightwork report found high frequency and duration levels of night shift worked by public health system nurses. Of the nurses surveyed,

Overview – Industrial Issues « Page 18

In September 2009 the NSW IRC identified a risk of the development of a number of diseases from the performance of night shift work where such work was undertaken for a particular frequency and duration ... The Nightwork report found high frequency and duration levels of night shift worked by public health system nurses.

70.2% worked six years or more

38.0%

70.2% worked six years or more; 38.0% worked 15 years or more, and 25.7% worked 20 years or more where such years included working three or more night shifts per month.

2. Ascertain the extent to which nurses and midwives are able to have input into their work arrangements The report makes clear that nurses and midwives in the public health system feel that they have little control over whether they can avoid working night shifts. Inflexible shift arrangements are believed to be a part of public sector nursing.

3. Remuneration and preparedness to work night shift The executive summary describes these results as “not conclusive”. One table indicates that for 60.7% of rotating roster nurses and midwives sampled, an unspecified increase in the night shift allowance would not change their preferences for working night shifts. On the other hand, another table shows that just over 20% of rotating roster nurses sampled were likely to work more night shifts with such an increase.

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worked 15 years or more

25.7% worked 20 years or more

4. Reasonable and practicable risk mitigation and amelioration strategies The proposed strategies were imprecise and included solutions such as investigating the provision of suitable sleeping spaces for shift workers on completion of their shifts. Other more organisational strategies included provision of senior staff on night shifts.

The new industrial relations environment and night shifts The changes that the O’Farrell Government has wrought on the NSW industrial relations jurisdiction since the Nightwork report was first commissioned have been profound. In that context, the Commission is now unable to arbitrate to increase night penalty rates unless it extracted conditions from another part of the public health system award. The only real path to dealing with the issues raised in the report is through continued negotiations with the Ministry.

NSW Public Health System NSW MINISTRY OF HEALTH Multiple Assignments Dispute » What is a Multiple Assignment? Around May 2011 the NSW Ministry of Health commenced the implementation of a new payroll system known as StaffLink. The implementation of the StaffLink system caused the Ministry to consider how it would classify and remunerate employees who have two or more positions within the public health system. The Ministry uses the term ‘multiple assignment’ in reference to employees who have more than one position.

» Background The NSWNMA was actively involved in a considerable number of meetings with the Ministry regarding its

approach to multiple assignments. Over time the Ministry developed the Multiple Assignments in StaffLink: A Guide for LHD HR and HSS Service Centre Staff (the StaffLink Guide). It has been incorrectly claimed that the Association agreed to the content of the StaffLink Guide, and throughout an extensive period of negotiation the NSWNMA repeatedly voiced its opposition to various parts of the StaffLink Guide. In particular, the Association’s principal concerns were that: 1. the Ministry refused to provide employees on multiple assignments with single pools of leave and, as a result, employees were unable to access leave entitlements across different positions; 2. the Ministry refused to provide employees on multiple assignments, who work 38-hours or more per week, with ADOs, and

NSW Public Health System « Page 20

The Ministry claimed its position was justified on the basis that employees on multiple assignments have two or more distinct contracts of employment. The NSWNMA believes this is a fundamental misinterpretation of the award ... if basic entitlements could be avoided in this way, multiple assignments could then be used as a vehicle to severely undermine the award. 3. the Ministry regularly required employees on multiple assignments to work 40-hours per week and not pay overtime penalty rates for the two additional hours beyond 38-hours. The Ministry claimed its position was justified on the basis that employees on multiple assignments have two or more distinct contracts of employment. For example, they alleged that employees with two contracts working 38-hours per week are not entitled to ADOs because each contract is a separate and distinct part-time contract. The NSWNMA believes this is a fundamental misinterpretation of the award. Further, the Association is concerned that if basic entitlements could be avoided in this way, multiple assignments could then be used as a vehicle to severely undermine the award.

1. The Ministry will treat employees with multiple assignments within a single public health organisation as if they had a single assignment. This will then entitle them to:

access leave across each of their assignments, e.g. an employee who has accrued leave in one assignment will be able to access that leave in another assignment;

have all of their service counted for the purposes of accessing maternity, adoption and parental leave;

six weeks annual leave if they work on a sevenday basis across multiple assignments;

ADOs if they work full-time hours across multiple assignments; and,

overtime in accordance with clause 25(ii)(a) of the award if they work full-time hours across multiple assignments.

» The Dispute In August 2012, the Association notified the NSW IRC of an industrial dispute regarding multiple assignments. The matter was listed for two Compulsory Conferences during which all attempts to conciliate failed. The Association then filed an Application for a Declaration under Section 154 in the Industrial Court of NSW. This is a more complex and serious proceeding in which declarations were sought to apply throughout the public health system. The matter was heard on 26 and 27 March 2013. During proceedings the Court recommended as follows; In light of the evidence received by the Court to date, I strongly encourage the parties to discuss further the relief being sought by the applicant in this matter. There are instances in the evidence of Mr Craft where the result of having employees on multiple assignments has led the respondent to exercise a discretion when questions of equity and fairness have arisen. The Ministry subsequently offered to resolve the matter and, following lengthy and detailed negotiations, an in-principle agreement has been reached.

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Current employees affected by this will be notified accordingly. 2. The Ministry will continue to treat employees with multiple assignments in different public health organisations as if they had separate contracts of employment, however:

at the time an employee commences a second assignment in a different public health organisation, their accrued leave will be apportioned across those assignments (unless the employee elects otherwise);

current employees with multiple assignments will be able to elect to apportion their leave across assignments;

service in all assignments will be recognised for the purposes of long service leave and eligibility for maternity, adoption and parental leave; and,

where one assignment is terminated, the employee’s remaining leave credits will be transferred to their other assignment.

3. A new Multiple Assignments clause has been inserted into the award. 4. Where a change of boundaries causes an employee to have assignments across different public health organisations, Point One shall continue to apply until one of the assignments is terminated.

HEALTHSHARE NSW At the end of June 2013, the StaffLink payroll system has been instituted in the majority of NSW public hospitals. It is anticipated that StaffLink will be introduced to Nepean and Blue Mountains LHD in early August 2013 with the Ambulance Service and HealthShare expected to be on line before the end of 2013. The introduction of the new system has seen some glitches, mostly related to incorrect data input and HealthShare NSW, responsible for implementing StaffLink, met with NSWNMA representatives regularly to discuss the problems as they arose. StaffLink’s Time In Lieu of Overtime Module has been temporarily switched off pending rectification of a system error and managers have been advised to maintain manual records. All Local Health Districts have been advised to produce electronic payslips within six months of going live with StaffLink, and objections raised by the Association in relation to availability of email addresses, printers and security have been addressed.

NSW MINISTRY OF HEALTH: POLICY REVIEW Policy reviews have been significantly slowed by a reduction in the Ministry’s resources and changes to protocols for policy development and review. A revised version of the Work Health and Safety Better Practice Procedures (PD2013_005) was released in February 2013, a revision that significantly lifts the standards for Local Health Districts. The Protecting People and Property Manual has also undergone a major review and is available on the NSW Health website. Finalisation of the surgical smoke plume policy was still awaited. An important policy entitled Physical Assaults Involving Staff: collection of data (PD2012_043) released in July 2012 requires health services to report physically violent incidents to the Ministry of Health. Despite some reported difficulties with standardising definitions and fields for data collection, it is vitally important that members report all violent incidents on IIMS as a WHS incident to ensure that the data is captured in a central database.

NSW Health Draft Managing Potential Misconduct Policy Directive The Association, Australian Salaried Medical Officers Federation (ASMOF) and the Health Services Union (HSU) are currently in discussions with NSW Health in relation to the final draft of the Managing Potential Misconduct Policy which will replace the current Policy Directive 2005_225: A Framework for Managing the Disciplinary Process in NSW Health. The Health Legislation Bill 2013 was recently passed by both houses of the NSW Parliament which included an amendment to the Health Services Act 1997 enabling NSW Health to suspend employees without pay in specified circumstances. NSW Health has yet to develop guidelines around suspension without pay and has agreed to consult with all stakeholders, including the health unions, before incorporating the provisions into the draft Managing Potential Misconduct Policy. The health unions have provided their preliminary submissions on the issue and await further consultation with the Ministry.

NSW Health has yet to develop guidelines around suspension without pay and has agreed to consult with all stakeholders, including the health unions, before incorporating the provisions into the draft Managing Potential Misconduct Policy. Uniforms contract The roll out of the new public health system uniforms has commenced with a planned completion around the end of July 2013. To date, the main concerns for members relate to the design of the overly-long female tops with pockets that are not compatible with all types of personal duress alarm units used in the public health system. Some LHDs are taking the opportunity to change their uniform and dress policy and a number of nurses and midwives have been told that they are no longer required to wear a uniform, thus cutting costs for the health service. The NSWNMA understands that HealthShare NSW intends to carry out a survey in September/October 2013, and that the NSWNMA will be consulted on the survey questions.

NSW Public Health System « Page 22

Local Health Districts, Networks, Justice Health and ADHC CENTRAL COAST LOCAL HEALTH DISTRICT Local Health District Matters Âť Restructures: Mental Health As a result of the devolution from the former Northern Sydney/Central Coast Area Health Service, a review and proposed restructure of the Central Coast Mental Health Service was undertaken. Following a number of revisions, the branch accepted a restructure offer, succeeding with a NUM2 position instead of a NUM1 for the PECC. In addition, a Nurse Manager 2 position

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was secured for the Acute Community Manager role, along with a CNE for community mental health.

Workplace Matters Branches across the LHD were active in ensuring safe patient care and the appropriate staffing levels in their wards and units. The Gosford Mental Health Unit branch had been concerned that sick leave was not being replaced when inpatient beds were vacant in the unit. Members considered this was an unsafe practice as the unit had insufficient staff to perform a timely takedown which placed both staff and other patients at risk. The branch successfully presented a case, based

on historical evidence, that they required a minimum of six staff on each shift. Similarly, an announcement was made that two wards at the Long Jetty Healthcare Centre were to be closed for refurbishment, leaving only one RN, one EN and one AiN rostered for night duty. The branch was able to use the facility’s own fire management policy, staff WHS policy and safe patient care issues to ensure that two RNs were on duty each evening during the refurbishment.

FAR WEST LOCAL HEALTH DISTRICT Broken Hill Base Hospital A restructure was proposed for palliative care, oncology, haematology and community health. The LHD DoNM has made assurances that the NSWNMA will be consulted about the proposed restructure.

HUNTER NEW ENGLAND LOCAL HEALTH DISTRICT Local Health District Matters » Implementation of NHPPD/Ratios A total of 186.42 additional FTE nursing positions were employed across the LHD between 2011 and 2013 resulting from the implementation of NHPPD in the 2010 award. The number of nurses employed by headcount was believed to exceed 200. Difficulties remain with the provision of data for spot checks and the enforcement of like-for-like replacement, although these are not widespread issues. Operating theatres across the LHD are not implementing the 2008 standards as formulated by the Australian College of Operating Room Nurses

A total of 186.42 additional FTE nursing positions were employed across the LHD between 2011 and 2013 resulting from the implementation of NHPPD in the 2010 award. The number of nurses employed by headcount was believed to exceed 200.

(ACORN) while many local managers working within peri-operative services are frustrated that they are yet to reach the ACORN 2002 standards.

» Introduction of AiNs across Mental Health The LHD has commenced consultation with the Morriset Hospital branch on the proposal to introduce AiNs onto the casual pool and within the existing staff profile to cover EN vacancies. The LHD states they have had significant recruitment difficulties and for over two years have been unable to recruit to some EN positions. The branch has nominated representatives from each hospital unit to participate in the USCC and will develop draft business rules and seek agreement from management in the form of an MoU. The LHD has also indicated that it will seek to introduce AiNs across the LHD and will contact the NSWNMA mental health branches to commence consultation locally.

» Introduction of centralised booking system and privatisation of Non-Emergency Patient Transport (NEPT) HNELHD has been trialling a centralised booking system for NSW Health for NEPT that will see the roll out of a new software called Optima Net and each patient transport vehicle fitted with Mobile Data Terminals to manage all NEPT requests. The centralised system will be able to manage the booking of all NEPT requests for HNELHD transport fleets and ambulance service ‘green’ fleet. Once booked, the system will also coordinate dispatch of the NEPT fleet. The NSWNMA has participated in staff information sessions provided by the HNELHD NEPT project team. Two main booking hubs will be established: one at Regents Park in Western Sydney to manage metropolitan bookings, and one in Newcastle to manage regional bookings. There is potential for three other regional satellite booking hubs. July 2013 is the ‘go live’ date for the Optima Net scheduling system and Mobile Data Terminals in transport vehicles. Following the user-testing trial in HNELHD, the Ministry has indicated that it will introduce the centralised system across all LHDs from May 2014. Currently, South Eastern Sydney LHD does not have an NEPT service and they utilise the NSW Ambulance Service for non-emergency patient transport. A private tender has been sought for the provision of NEPT in South Eastern Sydney LHD and a contract was executed for this service to commence in June 2014. NSW Health has indicated that future NEPT services across the state may go out to private tender, following the trend by the NSW State Government to privatise essential services.

» Overtime and Sick Leave Management in Mental Health In December 2012, the LHD issued a memorandum to nurses stating that “any staff member who is absent

Local Health Districts, Networks, Justice Health and ADHC « Page 24

Some mental health branches across the LHD reported the withdrawal of the memo had not been adequately communicated to nursing and workforce managers who were continuing to deny overtime to nurses who had recently taken sick leave. from work on sick leave will not be offered overtime for the remainder of the current pay period and the next pay period following their return to work to allow them to effectively recover from their illness”. NSWNMA branches disputed the memo on the grounds that:

it was discriminatory by penalising nurses seeking overtime due to their illness;

the memo created a disincentive to take sick leave when nurses are sick;

management were arbitrarily determining a nurse’s need for recovery without medical evidence; and,

excessive sick leave should be managed in accordance with the Ministry of Health policy.

Following a number of meetings between the NSWNMA and the LHD Mental Health Service executive, it was resolved that the memo would be withdrawn with the statement that “the overtime restriction following periods of sick leave will no longer apply”. Some mental health branches across the LHD reported the withdrawal of the memo had not been adequately communicated to nursing and workforce managers who were continuing to deny overtime to nurses who had recently taken sick leave. An undertaking had been provided by the Mental Health Service Manager to distribute a new memo retracting the original.

» Transfer of Rural and Primary Health Services to the Hunter Medicare Local On 24 June 2013, the LHD advised the NSWNMA that the Hunter Medicare Local would take over the following services:

Psychology service at Karuah;

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Aboriginal-specific health promotion programs of drug and alcohol Aboriginal Health Education Officer at Cessnock, and generalist services Aboriginal Health Education Officer at Muswellbrook;

Dietetics delivered at Muswellbrook, Scone, Denman, Merriwa and Murrurundi;

Falls prevention programs at Karuah and Tilligerry Peninsula; and,

Mental health community education and health programs in Karuah.

The LHD advises it is currently consulting with affected nurses where they do not hold a substantive position within the LHD. Hunter Medicare Local however, in what appears to be a complete contradiction, has advised they will be contracting back to HNELHD some clinical services for a period of six months:

Primary health nursing to Karuah and Tilligerry Peninsula region;

Community dietetics to Dungog, Gresford, Gloucester, Bulahdelah and Hawks Nest communities;

Podiatry services to Muswellbrook and Scone communities; and,

Community mental health nursing services for Karuah, Dungog, Gresford and Vacy communities.

At the expiry of this six-month contract, Hunter Medicare Local will review the provision of these clinical services and determine which services it intends to manage or contract out to other private providers.

» Transfer of Rural and Primary Health Services to New England Medicare Local As a result of changes to funding arrangements for service delivery to small rural and remote communities, the Commonwealth Department of Health and Ageing will redirect funding from the LHD to the New England Medicare Local. The impact of this change on LHD employees is that 13 nursing positions will be lost across the New England within the Rural Primary Health Service. The New England Medicare Local is under no obligation to offer employment to LHD nurses affected by this change in funding arrangements. The LHD advised this change in early May and stated the majority of nursing positions affected are for primary health and community nurses employed on fixed-term contracts which expired on 30 June 2013 to coincide with the transfer of clinical services to the New England Medicare Local. The LHD advises the majority of nurses involved have substantive positions within the LHD to which they will return. Nurses and midwives who do not hold substantive positions would be managed in accordance with the NSW Ministry of Health policy.

Nurses, ambulance officers, and some community members have their say about the inadequate current level of staffing at Muswellbrook Hospital.

Workplace Matters » Buladelah Hospital A long-running community campaign has not persuaded the NSW State Government and HNELHD to reverse its decision to close Bulahdelah Hospital. The recent State Government budget announcement confirmed the hospital’s clinical services will be downgraded to a GP clinic, open 16-hours daily, where nurses can treat patients with minor injuries. The hospital will no longer have an ED or any inpatient services. Patients presenting with more serious and lifethreatening conditions would be assessed and transferred to an acute hospital, such as John Hunter or Manning Base. It is difficult to reconcile the closure of Bulahdelah Hospital with the often-stated mantra from the Minister for Health of “no cuts to frontline services”.

» Calvary Mater Newcastle Earlier this year the branch was successful in lobbying for extra staff in the operating theatres. Members identified that staffing was significantly behind ACORN 2002 standards; the matter was pursued through the Reasonable Workload Committee where members were successful in gaining an additional eight FTE, including one FTE Clinical NUM and a 0.6 CNE, all of which had now been recruited.

» John Hunter Hospital Ongoing confusion about agreed staffing levels within the operating theatres and whether staffing is in accordance with the ACORN Standards has resulted in continued calls by nurses for the reconvening of a USCC, unilaterally disbanded by management at the end of last year. The hospital is yet to recruit the 7.0 FTE nursing positions due to commence on 31 March 2013 as part of the staffing enhancement from the 2010 award negotiations. Following a number of exchanges between members, the NSWNMA and John Hunter Hospital executive, it was agreed to reconvene the USCC in July 2013.

» Muswellbrook District Hospital The hospital received funding from the Resources for Regions grants from the 2012-2013 NSW State Budget to redevelop the ED on the aged care facility site. The Little Company of Mary successfully tendered for the aged care facility. In order for construction of the ED to commence, it is necessary for the remaining aged care residents to be relocated to the general ward. This move will require some renovations to the current ward area, and will result in a loss of one third of the general ward beds available to the local community, causing some concern for the Muswellbrook community as well as hospital staff.

Local Health Districts, Networks, Justice Health and ADHC « Page 26

The branch has been vocal in their opposition to this plan and has gained community support. Currently there is no high level care aged care facility in the Muswellbrook Shire and it will be some years before a new one is built. Both the branch and community members are urging their local MP to consider holding the funds allocated for the redevelopment of the ED until such time as an adequate high care aged care facility for the Muswellbrook community is available. Additionally, the branch continues to work with the LHD to reach suitable staffing arrangements within the ED and is currently trialling a new model of care.

Hospital; additionally, a General Manager will oversee Shellharbour and Kiama Hospitals. The introduction of a General Manager will see the following downgrading of positions:

• current DoN/Nurse Manager 7 to become a Nurse Manager 6 • current DDoN/Nurse Manager 5 to become a Nurse Manager 4

• current DDoN/Nurse Manager 3 to remain as is however combining DDoN with the current NUM role

» Restructures The ED at Bulli District Hospital reverted to an Urgent Primary Care Centre in March this year. The facility is currently staffed by one RN overnight and a review of the Centre is due in August 2013. The LHD is proposing to discontinue the current District-wide Nurse Manager level 7 position for Women’s and Children’s Health. Under the proposal, the Nurse Manager will be at level 4 and will only be responsible for services at Wollongong Hospital. This position is currently vacant. There is also a proposal for a management restructure across the LHD whereby a General Manager will be located at Shoalhaven District Memorial Hospital and will oversee Shoalhaven as well as Milton-Ulladulla

at Shellharbour Hospital • current DoN/Nurse Manager 7 to become a Nurse Manager 6

» Implementation of NHPPD/Ratios Implementation continues across the LHD and while some wards have converted smoothly, other hospitals such as Shellharbour, Port Kembla and Bulli District have notified that they will struggle with the numbers required. Education of staff around the award provision continues.

at Milton-Ulladulla Hospital • current DoN/Nurse Manager 5 to become a Nurse Manager 4

ILLAWARRA SHOALHAVEN LOCAL HEALTH DISTRICT Local Health District Matters

at Shoalhaven District Memorial Hospital

• current DDoN/Nurse Manager 5 to become a Nurse Manager 4

at Kiama • there will be a DDoN/NUM1

The DoN and DDoN at Shoalhaven and Shellharbour will also be responsible for mental health at their respective sites. The NSWNMA has written to the LHD DoNM outlining concerns around this proposal.

Mental Health The LHD is planning to implement a State Mental Health Telephone Access Line (SMHTAL) which, until recently, shared the incoming calls with South Eastern Sydney LHD. A consultation paper has been released and members have raised various concerns surrounding an Illawarra Shoalhaven service, including a request to establish a USCC, that have been forwarded to the A/Director Mental Health.

Workplace Matters With continuing significant workload issues within the LHD, disputation and review is ongoing at Wollongong Hospital operating theatres and Illawarra Shoalhaven Mental Health Acute Assertive Treatment Team at Port Kembla.

Some of the 600 locals who came for a meeting about the Bulli District Hospital ED in July 2012.

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Reasonable Workload Committees have been established at Coledale, Port Kembla, Bulli, Wollongong, Shellharbour, Shoalhaven District Memorial, Milton Ulladulla and Illawarra Shoalhaven Mental Health facilities. Following reasonable workload negotiations on staffing in Wollongong Hospital operating theatres, the LHD has approved 9.0 FTE positions, including 4.4 FTE nursing positions for a designated clinical products nurse and a holding bay nurse.

MID-NORTH COAST LOCAL HEALTH DISTRICT Workplace Matters Despite considerable branch activity in achieving reasonable workloads agreements in both inpatient units and community mental health services, management has not followed through with the agreed outcome. After a long period, members working in the Palliative Care Service in Kempsey achieved additional weekend staffing that was assisted by an annual donation from an anonymous benefactor.

MURRUMBIDGEE LOCAL HEALTH DISTRICT Local Health District Matters » Introduction of AiNs The NSWNMA received reports that a number of facilities in the LHD had been backfilling EENs with AiNs, which appears to have occurred due to incorrect instruction on staffing profile. The NSWNMA is continuing investigations as well as providing ongoing education.

» Recency of Practice The NSWNMA met with the LHD DoNM and the LHD Senior Nurse Manager for Mental Health and Drug and Alcohol (MHDA) to discuss concerns related to ensuring that nurses are able to meet the requirements of AHPRA for recency of practice and that nursing positions are preserved. The Senior Nurse Manager MHDA committed to reviewing the position descriptions of nurses in community mental health to meet registration requirements within those positions and to provide outlines of the nursing structures for the LHD MHDA, particularly professional reporting lines for all nurses in the sector.

Restructures » Albury-Wodonga Health Service Albury-Wodonga Health Service local management is proposing an executive restructure purportedly aimed at minimising duplication across the service which, while ostensibly a single health service, is governed and funded by both states of NSW and Victoria. At this stage the proposed restructure appears generic and entirely unsuitable for either facility in the service, including a proposal for a single DoN across both facilities which is being opposed by both the NSWNMA and ANF Victorian branch.

» Boorowa MPS and Murrumburrah-Harden District Hospital Following protracted delays and repeated requests, the NSWNMA finally received in mid-November 2012 a concrete proposal for the management restructure

for Boorowa MPS and Murrumburrah-Harden District Hospital. The proposal included all features previously agreed, except a full-time Clinical Services Officer is now reduced to 0.6 FTE. Members agreed to the restructure, but expressed disappointment at the retraction of the LHD from the original agreement and cautioned that any workload issues would be addressed.

» Wagga Wagga Health Service Wagga Wagga Health Service’s executive restructure was finalised late in 2012 following successful resolution of concerns raised by the branch, particularly the inclusion of the Community Nurse Manager on the executive and appropriate advertising and recruitment to the position of WWHS DoNM. The executive positions of General Manager, Medical Director and Business Manager have also now been permanently appointed. This is the first time in some years the facility has had a permanent executive in place.

Workplace Matters » Gundagai MPS The new MPS was officially opened on 11 October 2012 with increased capacity, particularly in the number of aged care residents requiring additional staffing. The LHD executive developed a new staffing profile that was discussed with staff earlier in the year but is yet to receive final approval. With particular staffing concerns on the night shift, management provided an additional AiN although the branch members believe increased RN assistance at night is required. Following the hospital’s expansion, the NSWNMA has been informed that staffing is now at an appropriate level.

» Hay Health Service The LHD Director of Clinical Operations provided guidelines to the branch for the operation of Critical Operations Standing Operating Procedures (COSOPs) which are specific to the facility. Following the actions of the branch and their attempts to resolve a number of issues, the LHD provided an interim facility manager to implement appropriate procedures and processes, to ensure rostering and that first line emergency care (FLEC)-trained staff were rostered to the ED.

» Leeton District Hospital The facility has continued to work on safety improvements to the ED and implementation of the NSWNMA safety action plan following an Association WHS inspection. A meeting of management, branch and NSWNMA repre sentatives was held on 12 September 2012 to discuss the branch’s main concerns, a key element of which was the lack of staff on evening and night shift. A number of out comes were achieved, including immediate employment of an AiN to assist in the ED and ensure that the RN would not be working alone on the evening and night shifts. A position description specific to this role has been developed in consultation with the branch and NSWNMA.

Local Health Districts, Networks, Justice Health and ADHC « Page 28

» Wagga Wagga Base Hospital Hospital management has been reviewing the onsite parking arrangements as demand for parking far exceeds availability. Management had also proposed the introduction of paid visitor parking and designated fleet vehicle parking. Because this proposed model had the potential to disadvantage staff, the branch raised their concerns with management who, in consultation with staff, have put forward more practical options. Improvements have been gained and the branch continues to work with management towards a final solution.

NEPEAN BLUE MOUNTAINS LOCAL HEALTH DISTRICT Local Health District Matters » Restructures Consultation continues on a number of restructures that have been proposed across mental health and community health. Blue Mountains and Penrith community nurses branches have each nominated a representative to participate in their negotiations. The Divisional restructure at Nepean Hospital is ongoing.

Mental Health The duress alarm in the Pialla Unit at Nepean Hospital failed to activate when a staff member was assaulted; it was found that even after servicing, the duress system did not function. The branch called an extraordinary meeting and carried a resolution that it would close the unit to new admissions unless 24-hour security was provided and other interim safety measures implemented. Two security officers were provided 24-hours/day until the duress system was again operational.

Workplace Matters » Nepean Hospital The maternity service at Nepean Hospital was found to be understaffed following a miscalculation of the BirthRate Plus® roll out where non-direct midwifery staff were included in the staffing numbers. Following

The maternity service at Nepean Hospital was found to be understaffed following a miscalculation of the BirthRate Plus® roll out where non-direct midwifery staff were included in the staffing numbers. Page 29 » Local Health Districts, Networks, Justice Health and ADHC

resolutions carried by the branch that called for capping new low risk antenatal presentations and a threatened stop-work action, management agreed to increase the staffing profile in the following areas:

» » » » »

Midwifery in the home: 0.62 FTE Caseload midwifery: 2 FTE Delivery suite: 6.89 FTE Post natal ward: 11.45 FTE Maternity outpatients: 2.31 FTE

A working party has been established to consider any ongoing issues with the maternity service. The branch has also taken to the Reasonable Workload Committee the issue of NHPPD/ratios wards being compelled to special within staffing numbers. The issue was taken to dispute where hospital management proposed a draft policy on specials that is currently being reviewed.

» Lithgow Hospital Branch The branch identified that inadequate staffing and skill mix were significant issues for the ED. The branch met with hospital management and a working party has been developed to explore staffing and rostering issues.

NORTHERN NSW LOCAL HEALTH DISTRICT Local Health District Matters The LHD has closed the Campbell Hospital at Coraki and has progressed towards establishing a HealthOne service on the site.

Mental Health A review of staffing of the mental health service has been undertaken and negotiations continue with the LHD on its intention to reduce staffing levels.

Workplace Matters The Reasonable Workload Committees in both inpatient units and community health are working to ensure that the appropriate number of nurses are rostered to meet patient need. Each committee reviews the staffing FTE, monitors vacancies, and works to fill vacancies and coverage for annual leave relief.

NORTHERN SYDNEY LOCAL HEALTH DISTRICT Local Health District Matters » Northern Beaches Health Service Redevelopment The NSW State Government announced on 2 May 2013 that it would be proceeding with the development, design, build and operation of the new Northern Beaches Hospital as a private hospital with publicly-funded beds.

Regardless of promises the State Government gives the current employees, the fact remains that they will be employees of the private owner and subject to the Fair Work Act 2009 in whatever form it takes in 2018 when the new health service begins operation. According to Minister Skinner’s media release: The 423-bed NBH will provide both public and private services. The successful tenderer will be a private or not-for-profit hospital operator with a proven record. The operator will enter into a long term contract with the NSW Government to deliver public services and the hospital will remain part of the clinical network of the Northern Sydney Local Health District. The NBH will see acute services relocated from Mona Vale Hospital and the ageing Manly Hospital. Mona Vale Hospital will be redeveloped to provide complementary health services, including urgent care, sub-acute care and palliative care. Manly Hospital will close when the NBH opens. Staff of the current services have been advised that the new operator will have a need for significant numbers of experienced staff and it is expected that most current employees will be offered employment by the operator. Unsuccessful staff will be managed in accordance with NSW Ministry of Health policy with a preference for redeployment. An information sheet and a FAQ was provided to staff following the announcement and health unions were briefed just prior to the public announcement by the Minister. The government is insisting on the conditions of transfer as set out below. Transferring employees will be employed on the same terms and conditions as applied to them immediately before the finalisation of the appointment of the hospital operator:

continuity of entitlements, including superannuation arrangements, recognition of continuous service for calculation of future leave accruals, parental leave and redundancy benefits;

transfer or cashing out of accrued annual and long service leave;

» » »

transfer of all sick leave entitlements; employment guarantee for transferring employees, and transfer payment depending upon length of service.

» Introduction of AiNs into Mental Health In September 2012 management commenced advertising for AiNs to be introduced to the roster on mental health units. Mental health branches rejected this action as they believed employing AiNs in mental health units posed risks for staff and patient safety. The branches proposed that AiNs required specialised training to prepare them for working in a volatile working environment and that the number of AiNs on each shift should be capped to ensure an appropriate skill mix was maintained. During the last nine months management has been developing a 36-week transition and orientation program for AiNs working in mental health. A MoU is being finalised which outlines the number of AiNs that can work on any shift (i.e. one) and that there must be at least two RNs per shift before an AiN can be rostered. The MoU also outlines regular review periods to reassess the education program and whether the introduction of AiNs has had any adverse impact on safe patient care or staff safety.

» Restructures The Northern Sydney and Central Coast Area Health Service was finally devolved this year and both LHDs have undergone multiple restructures as a result. Central Coast LHD restructures have been finalised for tier one, two and three and mental health, while Northern Sydney LHD has amalgamated Manly, Mona Vale and Hornsby with one General Manager and Service Directors across all three sites. With the new Northern Beaches Hospital to be built in 2018, a review is now being undertaken of all CNC positions and maternity services. Royal North Shore and Ryde Hospitals have historically been managed by one General Manager; following a review, a new general manager position has been created.

Mental Health » Manly Hospital The NSWNMA acted on behalf of members working in the east wing at Manly Hospital who were asked to sign a waiver for 10-hour breaks between shifts. After investigation, it was discovered that nurses were not being provided with a 10-hour break between double and overtime shifts and their next rostered shift.

Local Health Districts, Networks, Justice Health and ADHC « Page 30

Following disputation, nurses were able to claim back pay underpayment for this breach of the award over six years, and collectively they received $600,000. As a result of this outcome many LHDs, including Northern Sydney and Central Coast, have reissued an election form where staff members are required to nominate either a 10-hour or eight hour break between shifts. The NSWNMA has recommended that staff elect a 10-hour break.

Workplace Matters » Hornsby Hospital Hornsby Hospital has commissioned a new mental health unit that will contain the current 25 beds from the Lindsay Madew Unit, and an additional ten acute adult beds, as well as accommodate twelve child and adolescent beds. Once the unit is operational, the former Lindsay Madew Unit will be used to re-house other departments to allow construction on the three new surgical wards and an operating theatre complex.

» Royal North Shore Hospital In December 2012 RNSH decommissioned the former hospital and moved a new, fully operational hospital to the new acute services site. Several wards were amalgamated, new wards were created and existing wards were enlarged from 25 to 30 bed units. Since moving to the new building the presentations in the ED have increased by 20% and the branch and hospital management are addressing the resultant workload issues.

» Ryde Hospital The new 64-bed Graythwaite rehabilitation unit is due to be commissioned in September 2013 and will accommodate the current Ryde rehabilitation ward and 24-beds from the Royal rehabilitation unit. All nurses from the Royal rehabilitation unit have been offered positions at Graythwaite and will be able to transfer their entitlements. The Royal rehabilitation unit will be commissioning their new spinal and brain injury wards in September 2013. With the loss of 24 funded rehabilitation beds to Graythwaite, management is seeking to operate a private rehabilitation hospital with the 24 nowunfunded beds.

SOUTH EASTERN SYDNEY LOCAL HEALTH DISTRICT Local Health District Matters » Implementation of NHPPD/ratios All units eligible across the LHD have converted to NHPPD/ratios. The Kiloh Mental Health Unit at Prince of Wales Hospital is still recruiting to fill all required positions, and management has agreed that additional beds will only be opened once staffed. Sutherland Hospital management attempted to reduce staffing in the Killara acute aged care unit through implementation of NHPPD/ratios which would have seen the reduction of staffing by 32 hours/four shifts per week. Members raised concerns around patient safety and through negotiation with local and LHD management, it was agreed that current staffing would be maintained until the completion of a new, purpose-built unit.

» LHD budget shortfall LHD management has informed the NSWNMA of a predicted significant budget shortfall due to overexpenditure in the last financial year. As a result, Prince of Wales Hospital has been forced to close beds ostensibly due to the introduction of activitybased funding. Exact figures from the facility were not made available to the NSWNMA however the estimate provided was that bed occupancy is currently at around 90%. The DoN advised this was due to improved length of stay rather than reduced activity. While no staff members were affected by job losses, by early July the facility has seen the closure of 19 beds.

» Reasonable Workloads All sites in the LHD are receiving ongoing education, training and support to establish reasonable workload committees. Reports received from members across the LHD indicate widespread skill mix difficulties, and all members have been encouraged to identify and record data using the reasonable workload process. The newly built Royal North Shore Hospital.

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» Restructures An attempt was made to restructure the St Vincent’s Public Hospital executive and to remove the position of DoN. Following member opposition, the proposal was abandoned and the position of on-site DoN retained. Prince of Wales Hospital and the Royal Hospital for Women amalgamated their operating theatres and staff have been reallocated to the Prince of Wales theatre complex.

SOUTH WESTERN SYDNEY LOCAL HEALTH DISTRICT Local Health District Matters The NSWNMA is in ongoing consultation with the LHD executives for both South Western Sydney and Sydney Local Health Districts on proposals for the separation of their remaining shared services. These services include:

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Breast Screen Child Protection Services Community Health Customer Service and Revenue Mental Health Services Non-Emergency Patient Transport Services Oral Health Services Payroll Support Centre for Education and Workforce Development Information Management

nursing staff and management on amalgamation of the two services. Prairiewood Community Health Centre has been identified by the LHD as the preferred site for consolidation of the two nursing teams and the NSWNMA will be working with the branch, and members involved, through this process.

Mental Health The Waratah and Burunji units at Macarthur Mental Health converted to NHPPD/ratios on 31 March 2013, with significant increases in staff - 11.22 FTE and 4.43 FTE respectively. Some implementation issues are being addressed, with the branch’s involvement, to ensure appropriate skill mix is retained for the units and that LHD management meets the award requirements for staffing in these units.

Workplace Matters » Campbelltown Hospital The NSWNMA has collaborated with the branch executive, members and management on a bed configuration program for Campbelltown Hospital. The proposal sees a separation and realignment of medical specialties to improve outlier managements and overall care. There will be no net loss of beds or staff, and all nursing staff involved were offered the opportunity to put forward their preferences for the move. The branch executive compiled a list of questions and issues for consideration by management prior to the move during July 2013.

» Community Health

Drug Health Services

A number of issues related to workload have been reported across multiple sites, including:

Population Health

leave not being backfilled with subsequent increases in workload for nurses;

Over the next few months the LHDs will be developing and implementing separate organisational structures and stand-alone services which will be better placed to meet the needs of their own populations.

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vacancies that have not been replaced;

some staff being compelled to work weekends.

» Corporate Orientation

These issues will be addressed via the reasonable workloads process.

Interpreter Services and the Recruitment unit.

The LHD and Centre for Education and Workforce Development (CEWD) provided the Association with a proposal to move the two-day corporate orientation from a face-to-face to an online program. The NSWNMA has negotiated with the CEWD and the LHD executive to ensure that the facility orientation component (i.e. the third day) remains face-to-face with the ability for the NSWNMA to attend and present to staff. Concerns that have been raised by the NSWNMA, regarding a proposal for some compulsory components of the orientation program to be completed by new employees in their own time prior to commencing work, are currently under review.

» Restructures SWSLHD community health is proposing consultations with Cabramatta and Prairiewood community health

staff being asked to work at other centres to fill gaps leaving their main place of work short, and

» Fairfield Hospital Members protested against management’s persistent opening and closing of eight surge beds, which resulted in a compromise solution following the involvement of the LHD Chief Executive. Agreement was reached that four of the eight surge beds would remain permanently open and staffed accordingly, and the other four beds would open and close as per current LHD practice. A working party consisting of hospital management and branch representatives would determine a process for managing the four ‘as required’ surge beds.

» Liverpool Hospital From the beginning of 2013, a gradual process of bed configuration, similar to that at Campbelltown, has

Local Health Districts, Networks, Justice Health and ADHC « Page 32

Nurses at two South Coast hospitals worked together to successfully prevent dangerous staff cuts at Bega Hospital.

occurred at Liverpool Hospital and included the opening of new wards and a more than 60-bed enhancement. Liverpool Hospital commenced a practice of admitting over-census patients from the ED against expected patient discharges: by moving the patient identified as an expected discharge to the patient lounge or waiting area on the ward, the ED patient was able to be admitted onto the ward. The process unravelled as soon as a delay occurred in discharge of the patient from the ward. Members raised their concerns about the safety of this practice with the branch successfully requesting a review and establishment of clear criteria for admitting a patient to the ward above the funded bed base. Issues have been raised by NUMs and members regarding NHPPD/ratios and the use of Health Service Assistants (HSA) and AiN specials, and current award provisions relating to specialling within numbers. HSAs are not undergraduate AiNs and are of such variable qualification and skill level, that the facility had limited their scope to the extent where they are almost ineffective on many units, although they are being included in the NHPPD/ratios. The branch endorsed a resolution seeking clarification from the DoN of the skill level of the HSAs, and whether they are being allocated to wards from the casual pool/agency in accordance with the award and the Ministry’s mandatory policy directive on the employment of AiNs. The issue was clarified and guidelines for the appropriate use of AiNs were developed by the DoN; however, some issues persist which are being managed via the reasonable workloads process.

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SOUTHERN NSW LOCAL HEALTH DISTRICT Local Health District Matters » Introduction of AiNs to Mental Health The LHD planned to introduce AiNs into the acute mental health units at Goulburn, with inadequate consultation. The branch resisted this introduction and demanded that all AiNs were employed as supernumerary only until the required consultation and training occurred.

Workplace Matters » Bega and Pambula Hospitals Management of Bega and Pambula Hospitals notified staff that 56-hours of frontline nursing would be removed from Bega due to implementation of NHPPD/ ratios. Members resisted these changes and commenced a community campaign, including a rally. This issue was also raised in the NSW IRC, which found that management was using the required five NHPPD as a maximum rather than minimum staffing arrangement. A new model of care was proposed by the management of Bega and Pambula Hospitals to open post natal beds in Pambula with no midwifery coverage or additional staffing. It was proposed that these beds would be for low risk post natal mothers discharged from the Bega obstetrics service with Bega outreach service visiting these patients daily. The branch opposed many aspects of this model including a potential breach of the award as NHPPD/ratios hours

A new model of care was proposed by the management of Bega and Pambula Hospitals to open post natal beds in Pambula with no midwifery coverage or additional staffing ... these beds would be for low risk post natal mothers discharged from the Bega obstetrics service with Bega outreach service visiting these patients daily. for the medical ward would be used to care for the post natal patients. Due to the unresolved industrial issue this care model has not yet been actioned.

» Moruya District Hospital Operating theatre staff were being rostered on-call on their days off which had an effect on full-time staff, and was in breach of the award. In consultation with the LHD, local management initially sought to address this issue by introducing a seven-day roster. This was opposed as the theatre service is not sufficiently utilised on weekends to warrant coverage. The branch and the LHD agreed to seek a formal arrangement between the LHD and NSWNMA to allow continuation of the current rostering practices without breaching the award.

SYDNEY CHILDREN’S HOSPITAL NETWORK Network Nurse Education A restructure of the service has been proposed across the Network however there are concerns that some positions may be affected. The NSWNMA will continue to work with both Randwick and Westmead branches until a satisfactory outcome is reached.

Randwick Campus In February 2013, the Network DoN advised the NSWNMA of a proposal to amalgamate a number of wards that would affect four NUMs. After considerable consultation, the matter was resolved successfully and all NUMs retained positions without being directed to the Westmead Campus.

SYDNEY LOCAL HEALTH DISTRICT Relocation of The Bridge Dementia Service The NSWNMA has been working with members and management regarding the relocation of this service from Bridge Road Glebe to Concord’s Dame Edith Walker House. A joint WHS inspection has been attended and improvements agreed.

Restructures Consultation has occurred on a number of restructures following the devolution of the Area Health Service into the Local Health District. These include primary and community health and the CEWD.

WESTERN NSW LOCAL HEALTH DISTRICT Local Health District Matters The LHD believes that the implementation of activitybased funding will deliver efficiencies, although the LHD will also be required to find an additional 3% to 4% efficiency within current nursing structures which implies that positions will be deleted. This situation is to be monitored, particularly in light of the July 2013 release of the Strategic Health Care Services Plan.

Mental Health A new Involuntary Drug and Alcohol (IDAT) unit has been established and based at Bloomfield Hospital. State-wide funding has been secured for 12 beds, with eight at Bloomfield and the remaining four beds located at St Leonards. The unit is fully staffed although not all beds have been opened. Following an initial inspection, it will be necessary for all beds to be opened before determining any staffing problems. The restructure of management services across the Orange campus will have an impact on positions in mental health, such as the Child and Adolescent Mental Health Service (CAMHS) after-hours managers at Orange Base and Bloomfield Hospitals, as well as implementation of the agreed managers in the community mental health structure. Several new units are being commissioned at Bloomfield with advice that no nursing positions are being deleted:

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Statewide Open Care Rehabilitation Unit Statewide Medium Secure Rehabilitation Unit Mental Health Rural Outreach Project The Forensic Unit has funding to increase beds, from the original five up to 20 beds. This is being actioned gradually with staff being recruited from the UK, although current staff who fit the profile are also being recruited. The long-term proposal for the Mind Body Recovery

Local Health Districts, Networks, Justice Health and ADHC « Page 34

Centre is a review at the end of 2013 when the Bloomfield Hospital governance of this voluntary community-based unit concludes.

Restructures » Orange and Bathurst Primary and Community Health This restructure has been completed, with the deletion of the remaining nursing designated Nurse Manager 3 position, and its conversion to a dual-graded position. While this was not the preferred position of the branch, it was agreed on the basis that a nurse recruited into the position can elect to be paid under the nurses’ award to maintain their professional status.

» Primary Health Care Program for Rural Communities Western NSW had the largest program across the state, but with many communities under the population threshold of 5,000, the Commonwealth funding that the LHD would have received has now been transferred to Medicare Local.

Workplace Matters » Cobar Health Service A long-running issue of poor staffing levels at Cobar has been resolved. An initial loss of nursing hours at the site resulted in members becoming involved in a campaign to regain those hours. While some hours were regained, members remained concerned about

their ability to escalate staffing levels during peaks in activity or acuity. Members had previously closed beds and eventually the matter came before the NSW IRC. Management and local nurses have now agreed on a revised escalation plan that clearly sets out when additional staff are to be called in to work. Members are satisfied with the outcome and will continue to monitor their workloads and the provision of safe patient care.

» Orange Base and Bathurst Base Hospitals The NSWNMA assisted members at both Orange and Bathurst Base Hospitals following announcements of bed closures at both sites. The NSWNMA was given two weeks’ notice that beds would be closed on the surgical ward at Bathurst Base Hospital and, as a result, approximately five FTE would be transferred to vacancies in other wards/units. Nurses were informed of the ward to which they had been allocated and given 24-hours to make a decision. Members were angry that there was no consultation regarding placement and were very concerned about the impact of the bed closures on the ED and the resultant reduction in theatre times. The NSWNMA was given mixed reasons for the bed closures with local management blaming budget overruns, and the NSW Health Minister stating that the closures were due to an improved length-of-stay process. Staff and the community were given 24-hours notice that the palliative care ward at Orange Base

Cobar nurses went public and won strong public support for their actions

Page 35 » Local Health Districts, Networks, Justice Health and ADHC

RUNNING OUT OF PATIENCE: NSWNMA Bathurst branch members Lyn Sloane and Tatiana Muller (front) and their nursing colleagues are fighting planned cuts at Bathurst Base Hospital.

PHOTO CHRIS SEABROOK

Hospital would be closing and the ten palliative and rehabilitation beds would be moved to surrounding facilities at Molong, Canowindra and Blayney. There was no discussion with the community or the Association and, as with Bathurst Base Hospital, the reduction in FTE was being absorbed by current vacancies. In both cases, the Association worked with members and involved the local community and state MPs. Although the bed closures could not be avoided, consultation processes have been improved and affected nurses were given a greater choice of placement. It will be important that all sites concerned have their workloads monitored closely and that as issues arise the branches respond accordingly.

WESTERN SYDNEY LOCAL HEALTH DISTRICT Workplace Matters » Blacktown and Mount Druitt Hospitals While consultation continues on a proposal to introduce AiNs across Blacktown and Mount Druitt Hospitals, no agreement has been reached to date and members are ensuring compliance with the agreed policy.

» Blacktown Hospital Progress has been made by all parties to improve the treatment for mental health patients in the ED, including a safer room for triaging, assessment and the holding of patients until transfer. The branch continues to monitor the situation closely.

During the past year, several proposals have come forward which affect all staff, two of which were the proposed closure of the staff cafeteria and an increase to car parking fees. The NSW Ministry of Health policy on hospital car parking fees for staff clearly sets out the agreed pricing and the branches will not agree to the proposed increases as they have been tabled. These matters are progressing through the appropriate channels.

» Bungarribee House This unit attracted another 11.75 FTE of nursing positions through the implementation of NHPPD/ratios. The increased staff has improved the outcomes for patient care delivery and allowed the opening of the six-bed short-stay unit.

» Westmead Hospital The new Divisional restructure was agreed by both the hospital and Nurse Managers’ branch with the newlycreated operational positions to be dual-graded. There is no net loss of any senior nursing positions. With the increase in births climbing from around 4,200 to 5,400 in twelve months, a review conducted by the Ministry of Health in November 2012 identified the need for the recruitment of a further 17 FTE midwives. This recruitment drive has commenced resulting in an increase of over 30 FTE in the past year. The proposal to restructure the staffing of the operating theatres has been placed on hold until the DoN position has been recruited. There is no plan to delete any NUM positions, rather to restructure the roles and responsibilities of the current NUM FTE positions.

Local Health Districts, Networks, Justice Health and ADHC « Page 36

JUSTICE health & FORENSIC MENTAL HEALTH network

members. A part of the agreement is the introduction of a new position classification of Nurse Team Leader which is set for further discussion.

Cessnock Correctional Centre

ADHC branches voted to accept the offer and the award was varied on Friday 28 June 2013 in the NSW IRC. While ADHC branches have determined their acceptance of this offer, they will continue the Association’s ongoing campaign for parity with the public health system.

A new Maximum Remand Centre opened in February 2013 housing 804 inmates. The old facility no longer processes the reception of inmates however still accommodates inmates of a minimum classification. With ongoing issues related to staffing and vacant positions at Cessnock, the NSWNMA has been assisting the branch in setting up a Reasonable Workload Committee and use of the award to address their issues. The NSWNMA has requested a meeting with Justice Health to discuss staffing issues.

Forensic Hospital After a protracted dispute over the retention of paid meal breaks in the Forensic Hospital, the NSW IRC ruled against the Association’s claim for its retention. Justice Health maintained that it has put in place an appropriate system for supervisors to clearly record all requirements for a nurse to work through a meal break, and confirmed the release of a nurse to an off-duty area for the purpose of a meal break.

AGEING, DISABILITY & HOME CARE

Restructures and Redevelopments Regional group homes in Metro North and Maitland, where all direct care is provided by nursing staff, are transitioning to come under the Large Residential Centres and Specialist Supported Living. The NSWNMA and members are seeking appropriate access to improved clinical support, supervision of practice and training for nurses so that nursing care can be appropriately provided for people with complex health needs. The NSWNMA will continue to consult with ADHC and members for the retention of a nursing model. Consultation meetings continue with ADHC on the redevelopments of the Riverside Centre at Orange and the Marsden and Rydalmere complexes.

Workplace Matters » Norton Road Specialist Supported Living In 2010 the former Lachlan Centre was decommissioned and the residents moved into cluster style housing at the new facility, Norton Road Specialist Supported Living at North Ryde. The agreed structure and staffing was reviewed at the end of the two-year period and members are currently assessing the recommended changes.

» Stockton Centre

Disability nurses from the Marsden Centre rallied in the dripping rain outside the Sunrise program at 7am in Martin Place.

Award Campaign The campaign for improved conditions in members’ wages and conditions commenced last year. Campaign activities included the collection of petition signatures, with the aim of collecting 10,000; wearing of campaign t-shirts on a regular basis, and visiting MPs to apply pressure in support of ADHC members and nurses working in disability services. The Member for Wallsend, Ms Sonia Hornery, tabled a notice of motion in the NSW Parliament on 30 May 2013, calling on the Minister for Disability Services to commit to providing disability sector nurses pay parity with their public sector counterparts. In June 2013 the Association received a revised wages offer of 2.5% per annum for 2012-2013 with backpay to 1 July 2012, and a new wages offer of 2.7% for 2013-2014. The win on backpay and the 0.2% premium above 2.5% in 2013-2014 did not involve trade-offs and were a symbolic win for ADHC

Page 37 » Local Health Districts, Networks, Justice Health and ADHC

Stockton Centre, the largest disability facility in NSW, has a 40% RN vacancy rate, while other facilities have a minimum 20% shortage. The NSWNMA and members have been urging the Minister for Disability Services to address these drastic shortages and increase nursing numbers at the Stockton Centre and throughout NSW to minimise risks to patients. The NSWNMA has been working with branches to establish Reasonable Workload Committees and assisting members in utilising the award to address staffing shortages and workloads.

Stockton Centre nurses held a stopwork meeting in the International Day of Persons with Disability.

Private Hospitals PRIVATE HOSPITAL BARGAINING

A large number of private hospital members campaigned for new enterprise agreements during the 2012-2013 year. A table summary of the outcomes achieved in agreements finalised last year for NSW private hospitals is contained on the USB provided with the Annual Conference meeting papers, and can be found on the Branch Officials page of the NSWNMA website: http://members.nswnma. asn.au/officials_only/official_entry.htm

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increases from 16 hours to 24 hours a year in paid professional development leave; increases to 15 weeks in paid maternity leave; employer commitment to provide operating theatre staff with their annual leave accrual on a six-weekly basis, and increases in the continuing education allowance for post-registration hospital and post-graduate certificates.

COLLECTIVE BARGAINING ROUND

This is an excellent result for CHCR nurses and midwives and is due to the activity and contributions of the CHCR branch members.

Calvary Health Care Riverina

Healthscope Private Hospitals

In early 2013, nurses at Calvary Health Care Riverina (CHCR) voted ‘yes’ to a new enterprise agreement negotiated by the Association. The agreement provides:

A new three-year enterprise agreement was negotiated during 2012-2013 for nurses and midwives employed by the twelve Healthscope hospitals. The new agreement:

a total cumulative increase of 10.4% in wages and allowances over a three-year agreement;

includes a 10% wage increase for ENs and 9% for other nurses;

Private Hospitals « Page 38

» improves the banking of hours arrangement; » enhances time in lieu so that it is accrued and paid at the relevant overtime rates; » introduces an EEN education allowance; » moves the on-call allowance to public sector rates, and » removes the requirement for parents to return to work in order to receive three weeks of their nine weeks paid parental leave. Hunter Valley Private Hospital In the first half of 2012, nurses at the Hunter Valley Private Hospital voted to reject a proposed enterprise agreement which would have increased their salaries to public health system rates from January 2013. Subsequent negotiations in September 2012 resulted in an agreement that retains the pay increases and other improvements in the previous draft, and updates the time off in lieu and overtime clauses so they more clearly reflect the practice at the hospital. The new clauses have time off in lieu taken at overtime rates and part-time staff receiving overtime after working eight hours in a day, unless their rostered shift is greater than eight hours. In the latter case, nurses are paid overtime for all hours worked in excess of their rostered shift. The agreement was approved by the Fair Work Commission in December 2012.

Pulse Health Ltd » Bega Valley Private Hospital A lengthy campaign during 2012 and 2013 for Bega Valley Private Hospital involved members voting to take protected industrial action when the employer, Pulse Health Ltd, refused to make any wages offer. The previous increase was received in October 2010. When negotiations stalled in late 2012, members resolved to take steps towards protected industrial action; after a successful ballot and before the action was taken, the employer commenced bargaining. The result was a 24-month enterprise agreement which includes an initial 4% wages and allowances increase, followed eight months later by a 2% increase with a further 2% payable 16 months later - a cumulative total increase of 8.2% over the life of the agreement. A higher pay point for ENs who are qualified to distribute medication is also included, along with other improvements to conditions.

» Forster Private Hospital In October 2012 members at Forster Private Hospital began a campaign of industrial action in support of

Page 39 » Private Hospitals

Nurses at Forster Private had not received a wage increase since October 2010 and were 15% behind their public sector colleagues. their claim for a new enterprise agreement. The matter came to a head when, after 14 months of seeking a wage rise, management offered an increase of 2.75% in the first year of a two-year agreement, and an undetermined amount in the second year, based on the financial performance of the facility. Nurses at Forster Private had not received a wage increase since October 2010 and were 15% behind their public sector colleagues. Members took part in an eight-hour strike and conducted a rally and sausage sizzle at a local shopping centre in early October 2012; the event made a great impression on local members of the community who offered many expressions of support. Branch officials conducted TV, radio and newspaper interviews which strengthened the Association’s claims for an improved agreement. Members also undertook a number of bans including overtime and non-clinical paperwork for billing patients. Industrial action of bans and strikes continued into early December 2012 when, with the assistance of the Fair Work Commission, an acceptable agreement was negotiated. The final package was an agreement of 27 months which includes three increases of 3.25% in December 2012, December 2013 and September 2014. This result was only possible because of the determined efforts of the branch officials and members at Forster Private Hospital.

St Vincent’s and Mater Health » Mater Misericordiae Private Hospital A successful campaign at the Mater Misericordiae Private Hospital during the year resulted in a new agreement which contains wage and conditions improvement substantially above the original offer made by the employer. Branch officials were integral to the negotiation team and the widespread involvement of members throughout the hospital was a vital component in this achievement.

WORKPLACE MATTERS A successful campaign at the Mater Misericordiae Private Hospital during the year resulted in a new agreement which contains wage and conditions improvement substantially above the original offer made by the employer. The three-year agreement contains a number of improvements:

increases in wages and allowances by 10.9% (cumulative total) over three years;

introduces a professional practice allowance of $30.00 per week for relevant post-graduate qualifications, with an additional $30.00 per week for a relevant Master’s degree;

» »

includes a new senior midwife classification;

varies time in lieu arrangements so that time off in lieu is now accrued at overtime rates.

improves parental leave which is now paid for 12 weeks, and

Healthe Care Australia Pty Ltd » Toronto Private Hospital Members are actively attempting to address poor staffing/ skill mix issues. There is clearly inequity between Toronto Private and its other facilities with access to agency staff and a casual pool. The branch and NSWNMA continue to educate members on recognition of excessive workloads and appropriate action.

Healthscope Ltd » Brisbane Waters Private Hospital The NSWNMA assisted members in 2012 when the facility made a number of nurses redundant following the closure of a specialty service. Many of those staff members were long-term employees. During the process of assisting these members, a number of other issues arose - significantly, the number of staff with considerable amounts of accrued leave but with little or no ability to use that leave.

» Campbelltown Private Hospital After a long period of uncertainty, management at this facility moved to close its mental health inpatient unit at the end of June 2013 and offer redundancies to staff. Members met with NSWNMA officers and the branch executive to ensure members were making an informed decision on the offer.

Ramsay Health Care Australia Pty Ltd » Figtree Private Hospital Members initiated a resolution at the May 2013 Committee of Delegates to commence a campaign to address workload issues. Members at Figtree will use the clause within their agreement to force the employer to meet with them and are actively collecting data to support their case for increased resources.

Private Hospitals « Page 40

Aged Care Sector QUALITY AGED CARE ACTION GROUP INC

as ‘sufficient staffing’ and ‘flexible staffing’, rather than ensuring any tangible staffing requirement, is regarded by the group as completely inadequate.

With the release of the Federal Government’s Aged Care Reforms, the Quality Aged Care Action Group Inc (QACAG) members have been active in monitoring these reforms for impacts on older people and quality of care. Many changes have been welcomed, particularly the increase in community packages, the move to consumer-directed care, the promise of carer support centres, and the Workforce Compact (now the Workforce Supplement) as a means for better pay and conditions for nurses and AiNs.

The reforms have also raised concern with the removal of the distinction between high and low care, which intends to allow many changes related to payment of bonds and fees. There is no clarity about how this federal change may affect the NSW Public Health Act 2010, where a registered nurse is required on duty at all times in a nursing home, as the definitions include reference to the federal Aged Care Act 1997.

Overall, members welcome more transparency and tighter regulation of bonds and fees, linking these to cost of care and providing more options for payment. However, the lack of linking assessed care needs to staffing numbers and skill mix remains a significant disappointment. The reliance on terms such

Page 41 » Aged Care Sector

Several members have written to their state and federal MPs seeking assurance that this registered nurse requirement will not be undermined. Replies have been evasive, and it seems that this will not be determined until the state decides to examine the impact of these federal changes. QACAG members had concerns about a series of advertisements in local newspapers advertising “Be

For example, the proposal to introduce a behaviour management supplement did not detail any associated requirements about number or skill mix of nursing staff to provide care to people with specific behavioural needs related to dementia or other conditions. The Association’s submission reiterated its position that the aged care nursing team must be supported to provide the right level of care with proper resources, including sufficient staff, strong nursing skill mix and level of expertise, and appropriate equipment and support services.

Quality Aged Care Action Group Inc (QACAG) members.

a nurse in five weeks” and over a period of months, lobbied to have this addressed. As well as misuse of the title ‘nurse’ to refer to care workers, the advertisements made several questionable claims, undermining a quality approach to aged care and training. Letters were sent to the NSW Minister for Health, the Federal Minister for Mental Health and Ageing, the Director of the Health Professionals Councils Authority, and the Chief Commissioner of the Australian Quality Skills Authority. The latter has taken an active interest, as this agency monitors the quality of training providers, including their marketing practices. Several QACAG members provided input for the Association’s submission to the Senate Inquiry into Care and management of younger and older Australians living with dementia and behavioural and psychiatric symptoms of dementia. This ensured that the voices of older people and their loved ones and carers were included, as well as perspectives from nurses currently or previously working in aged care.

PROPOSED AMENDMENTS TO THE AGED CARE ACT 1997 In November 2012, comment was invited on proposed changes to the federal Aged Care Act 1997 and regulations. The changes are to facilitate the passage of several key reforms as part of the Living Longer. Living Better reform process, which arose from the Caring For Older Australians Inquiry. The Association provided comment to the ANF federal submission and also prepared a submission at state level, predominantly focussing on how the proposed changes may impact on safety and quality of care related to our membership delivering care to older Australians. The Association recognised the government’s overall intention to increase consumer choice and ensure funding better matches care needs. However, some areas of the proposed changes were low on detail and others raised potential concerns for the nursing workforce.

One significant legislative change proposes removing the distinction between high and low care, with the aim of increasing consumer choice and improving the responsiveness of funding systems. Disappointingly, this proposed change continues to rely on allocating funding based on care needs, but does little to ensure funds are spent directly on care provision, especially in relation to staffing numbers and skill mix. Staffing, skill mix and quality of care would remain at the discretion of providers, with the only monitoring emanating from the accreditation and complaints systems, rather than staffing being tied to assessed care needs and funding level.

Of the 885 homes in NSW, about 425 are nursing homes ... It is of great concern that changes which are put forward as positive by the government could compromise the intention and operation of the Public Health Act 1997 and weaken the quality of nursing care to older people. In addition, the Association’s submission raised a major concern that removing the distinction between high and low care in the federal legislation should not have a detrimental effect on NSW legislation, the Public Health Act 2010, No 127. This state legislation includes the requirement for a registered nurse on duty at all times in a nursing home, as well as prescribing some conditions for the role of a Director of Nursing in a nursing home. The Association’s position is that, as a minimum, where there are residents with high care needs (and consequently high care funding), a registered nurse

Aged Care Sector « Page 42

should be required on duty. This is not the case however in ‘ageing in place’ or hostel settings, despite these being predominantly occupied by residents with high care needs, although it is a requirement in nursing homes providing high care in NSW. In its definitions, the NSW Public Health Act 2010 includes references to the federal Aged Care Act 1997 and is therefore potentially affected by changes to the federal Act.

final Departmental guidelines are still to be issued. The Supplement will provide additional funding of 1% for each of 2013, 2014 and 2015 and 0.5% in 2016, to be handed on as a wage increase if an employer signs up to the Supplement and has a compliant enterprise agreement. A compliant enterprise agreement must include:

an employer-funded pay increase of at least 2.75% per year (or the Fair Work Commission minimum wage increase, whichever is higher) in addition to the funding provided by the Supplement;

wage rates above the minimum rates in the 2010 nurses’ award by set percentages;

» » »

a workload management clause;

AGED CARE BARGAINING

a clause that provides for the review of hours worked by permanent part-time employees;

A comprehensive table, summarising the outcomes achieved in agreements finalised in the last year with aged care employers in NSW, is contained on the USB provided with the Annual Conference meeting papers. The summary can also be found on the Branch Officials page of the NSWNMA website: http://members.nswnma. asn.au/officials_only/official_entry.htm

a general training clause which includes access to training, professional development and representational leave, and

a casual conversion clause.

Of the 885 homes in NSW, about 425 are nursing homes under the definition of the state Public Health Act 2010, No 127. It is of great concern that changes which are put forward as positive by the government, including removal of the definitions of high care and low care, could compromise the intention and operation of the Public Health Act 1997 and weaken the quality of nursing care to older people.

Aged Care Workforce Supplement (previously called the Compact) The legislation required for the implementation of the Aged Care Workforce Supplement was passed by Federal Parliament on 27 June 2013, however the

a workplace health and safety clause; disciplinary procedures that provide for procedural fairness, representation and natural justice;

The NSWNMA has been negotiating with the Domain Principal Group, UnitingCare and ACS to produce compliant agreements. Finalisation will depend on the outcome of the legislation and the guidelines. A number of other employers have indicated in preliminary discussions that they are interested in signing up to the Supplement however they are waiting for more detail before they adopt

Jocelyn Hoffman, Mark Butler MP and Daryl Melham (Member for Banks) at the Aged Care Compact announcement.

Page 43 » Aged Care Sector

Forrest Centre

The Supplement will provide additional funding of 1% for each of 2013, 2014 and 2015 and 0.5% in 2016, to be handed on as a wage increase if an employer signs up to the Supplement and has a compliant enterprise agreement.

In May 2013 nurses employed by the Forrest Centre at the Mary Potter Nursing Home and the Loreto Home of Compassion, both located in Wagga Wagga, voted for a new enterprise agreement. The agreement includes:

wage increases of 3% per annum over three years with a total cumulative effect of 9.2%;

» » »

an extra increment for AiNs; a new Level II AiN classification, and increased paid maternity leave, from six to nine weeks, to be paid at the commencement of the leave.

Rather than delay the agreement until the Aged Care Workforce Supplement was available, the employer undertook to have further discussions when more information is presented. A health and safety clause and a disciplinary clause were added to the agreement, and the AiN Certificate III rate increased to ensure the agreement is compliant with the Supplement.

a formal position. A meeting of the Log of Claims Committee for members employed in the charitable sector was held during July 2013.

Regis Aged Care

As the legislation has passed through the Federal Parliament, the NSWNMA has commenced the process of renegotiating all aged care agreements to secure the additional wage increases for members.

In late 2012 an enterprise agreement with the Regis Group was supported by staff in a ballot and certified by the Fair Work Commission. This one-year agreement provides for:

LASA NSW-ACT (formerly ACAA-NSW) – 2012 Model Agreement

» » »

an increase of 3.52% in wages and allowances;

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an EN specialist classification;

a new CNE classification.

During the second half of 2012 the NSWNMA made considerable efforts to convince employers in the for-profit aged care sector to adopt the LASA Model Agreement. As at the end of June 2013, 74 employers representing a total of 105 facilities were covered by the 2012 LASA Model Agreement. This agreement will have to be varied in order to secure the Supplement increases although, to date, LASA have shown little interest in adopting the Supplement.

BCP Health and Aged Care Negotiations concluded in early 2013 for a new BCP Health and Aged Care Agreement. The new agreement:

increases rates of pay by 11.5% (the additional 0.5% is the result of the compounding of the increases) with the first increase of 2.5% backdated to 14 October 2012;

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increases allowances by 9%;

extends the reach of the dispute resolution clause - a dispute can now be about any matter and is not limited to matters contained in the agreement. This clause can also be used for workload management issues with arbitration available on the initiation of either party, and

improves redundancy provisions to the industry standard.

compresses the RN classification scale from eight incremental points to five;

improved paid parental leave from 10 to 16 weeks; a medication allowance of 75 cents per hour, for the entire shift, for an AiN dispensing medication; compression of RN pay points from eight to five allowing faster progression through the pay scale, and

Regis was not willing to commit to an agreement longer than one year because of the uncertainty they see with government funding in subsequent years. The other unknown at the time the short-term agreement was negotiated was the impending introduction of the Aged Care Workforce Supplement.

Southern Cross Care Broken Hill Negotiations for the Southern Cross Care enterprise agreement concluded in late July 2012. The NSWNMA and the Broken Hill Town Employees Union (BHTEU) were involved in the negotiations. Negotiations commenced in October 2011 and were finalised with the NSWNMA in February 2012, although there were delays with the negotiations with the BHTEU who had concerns with the grandfathering of some conditions for their members. Notwithstanding this, the BHTEU agreed to the document being put to a vote in early August 2012. However, the BHTEU members did not support it and on that basis the NSWNMA remained neutral and did not recommend either a ‘yes’ or a ‘no’ vote.

Aged Care Sector « Page 44

The outcome of the initial staff vote, conducted mid-August by Elections Australia was declared invalid due to security issues. A new vote was conducted in late August, with 80% of constituents voting ‘yes’. The agreement which expires in June 2014 provides:

» » » » »

a 3% pay increase back-paid to 1 July 2011; a 2.8% pay rise back-paid to 1 July 2012; a 3% pay increase from 1 July 2013; three days’ paid delegates’ leave, and double time for all overtime worked.

St Basil’s Nursing Home Following lengthy negotiations, an enterprise agreement for St Basil’s Nursing Home at Lakemba was accepted by members in early 2013. The agreement of three and a half years’ duration, based on the ACS template, includes four annual 3% pay rises (a cumulative increase of 12.55% over the life of the agreement) with the first increase back-paid to 1 July 2012.

AGED CARE MATTERS Cytotoxic Drug Issues Complaints from members are increasing on the issue of aged care residents being given oral cytotoxic drugs without the knowledge of the attending staff. Additionally, nursing and care staff are not always provided with personal protective equipment or checks to ensure pregnant staff are excluded from contact with the medication.

Health and Safety Representatives in Aged Care The aged care industry is slow to embrace the system of Health and Safety Representatives (HSR) under the Work Health and Safety Act 2011. Transitional arrangements for consultation expired on 1 January 2013 and the existing two-year representation for elected delegates will no longer be valid in 2014. Members are strongly advised to review the advantages of the current consultation requirement to ensure that their facilities are able to support the protection of staff overall and improvements in work health and safety generally at facility level.

Violence and Aggression in Aged Care The problem of client-related violence and aggression is a significant and continuing issue in residential aged care. The main areas of concern, common to almost every complaint received by the NSWNMA, include:

reductions in staffing levels such that nurses are required to work alone and in isolation caring for residents with challenging behaviour, particularly on evening and night shifts (e.g. reports have been received of nurses working alone in secure dementia units, leaving the doors open at night because of a lack of staffing);

Page 45 » Aged Care Sector

absence of, or inadequate personal duress equipment and duress response capability, both internal and external, and no written duress response plans, and

no systematic auditing of safety and security, including perimeter security, and no inclusion of relevant criteria in accreditation standards.

The NSWNMA has highlighted these issues to the Federal Minister for Health and Ageing, the Secretary of Commonwealth Department of Health and Ageing and aged care providers across the state.

AGED CARE SUBMISSION Senate Inquiry » Care and management of younger and older Australians living with dementia and behavioural and psychiatric symptoms of dementia (BPSD) This submission was lodged in May 2013 and included direct quotes from both NSWNMA aged care members and QACAG members. This grounded the submission in real experiences from both nursing and consumer perspectives. The main areas of focus were the impact of staffing and skill mix on quality of care, the poor outcomes of care when it is driven by a task-oriented rather than a true person-centred approach, and how staffing, activity levels and building design can affect safety and risk for residents and staff. Some specific examples were provided on reduction in staffing numbers, despite increases in resident acuity, as well as discussion about how staffing is often at its lowest at the times when residents may be at their most active or in need. In addition, examples were provided of secure dementia units being left unlocked at night purely due to staffing deficits, leaving both residents and staff at risk of adverse events.

The main areas of focus were the impact of staffing and skill mix on quality of care, the poor outcomes of care when it is driven by a task-oriented rather than a true person-centred approach, and how staffing, activity levels and building design can affect safety and risk for residents and staff.

Recommendations were made on these matters, as well as the need for training and development for nursing and other care staff in BPSD.

AGED CARE WORKLOADS Throughout the year there has been a considerable push by employers to increase the workloads of members. With the reductions in care/clinical hours, there are major challenges for aged care members in continuing their ability to provide quality care with fewer and fewer resources. Members are very distressed that their residents are not receiving the nursing care they deserve. While strong branches can achieve beneficial outcomes, intimidation and forced redundancies remain a constant threat to members.

WORKPLACE MATTERS A number of changes have taken place across a spectrum of aged care facilities during the past year.

Anglicare Anglicare has purchased the Storm Retirement Village Pty Ltd and Bishop Tyrell Nursing Home, both in the Taree area; the Association has been advised there would be no changes to frontline nursing services. Members have reported that the Bishop Tyrell site is experiencing a major restructure of their rosters with significant reductions in nursing care hours and removal of RN positions. The NSWNMA is currently in negotiations on this issue with management and members.

Chesalon Nursing Home, Malabar This facility has reduced its RN hours by 213 per fortnight and replaced some of these hours with Certificate IV staff.

Baptist Community Services (BCS) BCS is currently in the process of closing their 75bed Maranoa facility in Lismore to redevelop the site. Management is citing the Living Longer. Living Better reform package and other funding changes from the government as their main reason for these changes. All staff will be made redundant as there are no vacancies at their sister sites in Alstonville and Coraki.

BCP Health and Aged Care BCP has sold all nine of its facilities to Aquarius Pty Ltd, eight of which are located in NSW; prior to the sale, there had been no consultation with the NSWNMA. All existing staff in three of the sites received new contracts that included a six-month probationary period. The NSWNMA continues to work with members supporting them through this process.

BlueCare A dispute over workloads and the reduction of nursing hours at their Tweed Heads and Kingscliff facilities was lodged with the Fair Work Commission.

Bupa Aged Care Bupa will close their Queens Park site for redevelopment, with the proposal that staff be redeployed to 13 other facilities. In October 2012 a restructure was proposed at the Seabreeze Aged Care facility at Pottsville, a facility that was then owned by Innovative Care but now owned by Bupa. Despite considerable consultation with the NSWNMA, the restructure proceeded with most members agreeing to the changes. The formation of a branch was a significant consequence that has helped those members who were previously reticent to find a voice and advocate for themselves and their residents.

Columbia Aged Care Services The Fair Work Commission determined that all nine members at the Strathfield site have their contracted hours reinstated when Columbia Aged Care Services reduced staff hours as a result of a restructure and without consultation with staff.

Domain Principal Group In January 2013, nursing staff at the Coffs Harbour Aged Care Facility were advised that an AiN position would be removed from the night shift roster, to commence immediately. After an extraordinary branch meeting the day following the announcement, it was resolved that the branch oppose the reduction in night shift staffing because of workload and safety concerns. A facilitywide petition was launched and received 60 signatures. After applying this pressure and with a change in local management, the branch was able to have the amended roster set aside indefinitely.

Kanandah Retirement Village, Mudgee The facility manager advised the NSWNMA that the staff shoe allowance would not be paid, as the facility did not stipulate the shoes that were to be worn. On

The facility manager advised the NSWNMA that the staff shoe allowance would not be paid, as the facility did not stipulate the shoes that were to be worn. Aged Care Sector ÂŤ Page 46

investigation, the issue of uniforms generally was raised and, according to Kanandah’s uniform policy, shoes must have a non-slip sole and all staff must be provided with two shirts plus an allowance towards trousers/skirts. Kanandah’s EBA states that staff members are to be either supplied with or receive an allowance for sufficient, suitable and serviceable uniform or overalls. In lieu of supplying special shoes where required, an allowance will be paid, as well as the supply of or an allowance for a cardigan or jacket, and stockings or socks. As no response was received from management to an Association request for uniforms to be supplied to staff without delay, a letter of dispute was sent to facility management.

Kennedy Health Care Group The Eddystone Nursing Home at Bexley will be closed for redevelopment; staff were offered voluntary redundancies and redeployment.

Mercy Aged Care Services, Singleton Mercy has amalgamated with the Institute of the Sisters of Mercy of Australia and Papua New Guinea to form one company to be known as Mercy Services.

Regis Hastings Manor, Port Macquarie Late in 2012 a restructure was undertaken by the employer without any consultation with the NSWNMA. Members raised multiple concerns with management in relation to workload, and following an accreditation agency review, the facility was ordered to return most of the lost hours because of workload concerns. Members were satisfied with this return of hours and no further reduction of hours has been attempted by the employer.

UnitingCare UnitingCare conducted a state-wide restructure bringing their six regions into three streams: community housing, community care and residential. A total of 11 clinical nurse educators, clinical nurse consultants and clinical nurse specialists were affected by this restructure. A dispute was lodged in the Fair Work Commission on the reduction of contracted hours, without consultation with staff, at Caroona Marima and Caroona Kalina Nursing Homes and Caroona Jarman Hostel. A hearing to be held on 25 June 2013 was subsequently held over as UnitingCare advised the NSWNMA they would continue with consultation; implementation of the new rosters was delayed until 29 July 2013. The NSWNMA has since met with UnitingCare and a further hearing held in the Commission in July.

Page 47 » Aged Care Sector

Registered nurse hours have been reduced and positions filled by Certificate III and IV staff who are expected to accept the role of administering medications in high care, developing care plans, liaising with doctors, making clinical decisions and leading teams of staff. Summary Generally the employer groups are now managing restructures and changes in nursing care hours by conducting individual meetings with staff. Because of the fear of losing their job, some members will not become active or assert their rights which allows management to make changes without appropriate consultation. Changes to the Aged Care Funding Instrument (ACFI), low bed occupancy and the government’s Living Longer. Living Better packages are the reasons given for reductions in care hours across the sector. Registered nurse hours have been reduced and positions filled by Certificate III and IV staff who are expected to accept the role of administering medications in high care, developing care plans, liaising with doctors, making clinical decisions and leading teams of staff.

Other Industry Sectors COLLECTIVE BARGAINING ROUND Medibank Health Solutions During 2012 the ANF, CPSU, USU and ASMOF attempted to negotiate a national agreement with Medibank Health Solutions. ANF members work with telehealth solutions and directly with patients in Medibank Health Solutions clinics. In late 2012 the employer asked staff members to vote on an agreement that had not been agreed by the unions. The unions ran a ‘no’ vote campaign and the final result was a close 51% ‘yes’ vote. Following the vote, the unions opposed the approval of the agreement in the Fair Work Commission on the basis that it did not pass the ‘better off overall test’ (BOOT). After several days of hearings the enterprise agreement was approved on 13 December 2012, with Medibank Health Solutions being required to make fifteen undertakings to satisfy

the Commissioner that the BOOT was met. The undertakings included amendments to the following terms and conditions:

overtime conditions for part-time and casual employees;

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variation of work days for part-time employees;

» » » » »

disputes settlement procedure;

protections around the introduction of annualised salaries; flexible working arrangements; definition of a shift worker; annual leave loading on termination, and accident pay.

Other Industry Sectors « Page 48

The Association has filed 84 individual member matters with various tribunals from the 2012 Annual Conference until June 2013. The NSWNMA also assisted members in relation to over-payments of wages totalling $178,652.00. 14

Recovery of Monies Applications filed in the Chief Industrial Magistrate’s Court of NSW

Dispute Notifications filed with Fair Work Australia

members represented at the Nursing and Midwifery Council

Applications filed in the Anti-Discrimination Board

Unfair Dismissal Applications filed with Fair Work Australia

Applications filed with Australian Human Rights Commission

Unfair Dismissal Applications filed with NSW Industrial Relations Commission

Dispute Notifications filed with NSW Industrial Relations Commission

DISPUTES FILED BY NSWNMA

ten Unfair Dismissal Applications filed with NSW Industrial Relations Commission;

The Association has filed 84 individual member matters with various tribunals from the 2012 Annual Conference until June 2013. These include:

three Applications filed with Australian Human Rights Commission;

three Applications filed in the Anti-Discrimination Board;

four members represented at the Nursing and Midwifery Council, and

14 Recovery of Monies Applications filed in the Chief Industrial Magistrate’s Court of NSW.

14 Dispute Notifications filed with Fair Work Australia;

17 Unfair Dismissal Applications filed with Fair Work Australia;

19 Dispute Notifications filed with NSW Industrial Relations Commission;

Page 49 » Other Industry Sectors

The NSWNMA also assisted members in relation to over-payments of wages totalling $178,652.00.

Professional Services RESPONSES AND SUBMISSIONS AHPRA Consultation on International Criminal History Checks In this submission, the NSWNMA provided comment on options for refining international criminal history checks used by AHPRA in assessing applications for registration of the 14 health professions regulated under the Health Practitioner Regulation National Law Act 2009.

clearance certificate, and the Association advocated an appropriate level of flexibility in this regard.

Australian Commission on Safety and Quality in Health Care Review of Open Disclosure Standard

The Associationâ&#x20AC;&#x2122;s submission supported the adoption of a consistent approach to criminal history checks for all regulated professions. The NSWNMA supported an approach which requires applicants to provide a criminal clearance certificate (already required for a number of visas) and a random audit process to verify any documentation submitted.

Open disclosure is the open discussion of incidents that result in harm to a patient while receiving health care, a key part of improving the quality of patient care. The essential elements of open disclosure are outlined in the National Open Disclosure Standard. The Australian Commission on Safety and Quality Health Care (ACSQHC) open disclosure program aims to develop knowledge and tools to support jurisdictions and facilities in implementing the Standard. It also aims to explore and clarify the legal barriers to performing open disclosure, and recommend ways to address these barriers.

The submission recognised that for some international applicants it may be difficult to provide the criminal

The Standard has recently been reviewed and the NSWNMA provided a response through participation

Professional Services ÂŤ Page 50

in a multidisciplinary discussion forum as well as a written submission. Overall, the Association welcomed ACSQHC’s efforts to refine and update the Standard and supported wider adoption and implementation of open disclosure, underpinned by the principles as set out in the Standard. We noted however that more work is required to ensure that nurses and midwives can participate in the process, confident that they will be supported by their employer and colleagues. The NSWNMA believes that the document could be strengthened with a clearer declaration that environmental factors such as staffing, skill mix and workload should be taken into account and included, where relevant, in explanations of how and why an adverse event occurred. The NSWNMA recommendations included:

that nurses and midwives who participate in an open disclosure should have the option of attending with their chosen support person, which may include a union representative;

that where a clinician indicates they do not wish to participate, this will be respected by the organisation;

that the Standard should allow for the presence of a legal representative of the clinician, as well as representatives for the patient and health service;

that training in open disclosure should be extended to other relevant parties, including legal representatives, insurers and industrial representatives; and,

that the concept of open disclosure should be embedded in undergraduate curricula for all health professionals, recognising that the skills and attitudes that underpin open disclosure are relevant to other important quality and patient safety concerns.

The Association welcomed ACSQHC’s efforts to refine and update the Standard and supported wider adoption and implementation of open disclosure, underpinned by the principles as set out in the Standard. Page 51 » Professional Services

EN Review of Competency Standards Monash University is undertaking this review, the primary purpose of which is to revise the current NMBA competencies for enrolled nurses for relevance and currency against the contemporary role and scope of practice of ENs. These competencies are to be revised using the best available evidence to ensure a strong foundation for the education and assessment of ENs into the future. Specifically the project aims to: 1. review the relevant national and international literature; 2. review extensively the current scope of practice and role of enrolled nurses across Australia. In particular, the review will note variations in practice between jurisdictions and/or sectors, the impact of employment arrangements on role and scope of practice, approaches and differences in educational preparation, and state and territory legislation and regulations; 3. undertake a thematic analysis of stakeholder comments; 4. undertake a gap analysis and develop a draft discussion paper and draft revised standards; and, 5. consult with stakeholders. The NSWNMA contributed to a consultation workshop and the findings from all consultation work will be developed into new draft competencies that will be distributed for comment in the coming months. The NSWNMA will contact enrolled nurses for responses when the draft document is available.

Health Workforce Australia » Leadership Framework Health Workforce Australia’s (HWA) Health LEADS Australia is a leadership framework that defines the capabilities needed for leaders in all areas of health. It has developed from the National Health Workforce Innovation and Reform Strategic Framework for Action, 2011-2015. This national action plan describes the complex overlapping roles in the current and future health workforce and identifies leadership as a crucial factor in successful health reform. Health LEADS Australia has five areas for focus: leads self, engages others, achieves outcomes, drives innovation and shapes systems, each of which has three associated capabilities. Together, the five focus areas reflect the challenge of leadership in health today. The NSWNMA contributed to the nationwide workshop consultations for this project. This consultation period has now ended and feedback will be used to improve the framework and develop tools for implementation.

» Nursing Retention and Productivity Project The NSWNMA has provided comment on this discussion paper, with the response emphasising the interplay of excessive workloads, diminishing skill mix, quality, safety and nurses’ satisfaction at work. The Association noted that nurses in Victoria and NSW, who currently work under NHPPD/ratios, indicate that if this workload management ceased then up to half would reduce hours or seek alternative employment. Our response also cited recent research from Western Australia demonstrating that safe staffing actually reduces costs overall through improvements in the quality of care and reduction in the incidence of nurse-sensitive indicators. While it was noted that workload management is not the panacea for all issues in relation to retention and productivity, it was argued that any effective strategy for nursing retention and productivity must include a commitment to workload management.

Nurse Practitioner Review of Competency Standards The NMBA sought responses to a review of national competency standards for nurse practitioners by way of a survey. This was undertaken as part of a collaborative research project by Southern Cross University and The University of Sydney, funded by the National Board. Southern Cross University and The University of Sydney are still collating responses received that will be published on the National Board’s website as soon as practicable. Nurse Practitioner members of the NSWNMA were contacted and encouraged to respond to the survey.

Review of the Mental Health Act 2007 The NSWNMA was given the opportunity to provide comments as part of the 2012 statutory review of the NSW Mental Health Act 2007. A comprehensive review was submitted by the Association in December 2012.

products purchased following a consultation with a health professional, usually with a prescription.

Improvements to the visual presentation of the labels and packages of medicines are aimed at enabling the safe use of medicines by consumers. The ANMF Federal Office has worked closely with ACSQHC and has participated in committees and working groups developing mechanisms for safer medicine labelling processes. ACSQHC supports many of the changes proposed by the TGA and made some recommendations to strengthen regulations on labelling and packaging of medicines. The NSWNMA response also supported the ACSQHC position.

WORKFORCE MATTERS Nursing and Midwifery Leaders Forum – Have your say we are listening In September 2012, the NSWNMA hosted 105 nursing and midwifery leaders from around NSW to continue a strategic dialogue with this important segment of the health workforce. Speakers included Professor Christine Duffield on leadership and workforce; Judith Kiejda delivered a presentation on the ratios campaign; Paul Gilbert, ANF Victorian Branch Assistant Secretary, provided an overview of the Victorian Branch’s successful defence of their ratios, and Michael McQueen, social researcher, facilitated a workshop on intergenerational workplace dynamics. Responses to a pre-conference survey revealed considerable tension with the relationship between Nurses Managers and officers of the Association. Nurse and Midwifery Managers occupy influential and somewhat powerful positions and, in light of the enormity of the task ahead, it would be of great strategic value if these relationships could be improved.

Review of the Mental Health Regulations 2013 The NSWNMA was also invited to review the Mental Health Regulations 2013 (2013 Draft Regulations). After review of the changes, which were minor in any practical sense, the NSWNMA had no further comment to offer as part of the review process.

Therapeutic Goods Administration Review of Labelling and Packaging of Medicines The submission to the Therapeutic Goods Administration (TGA) outlined NSWNMA feedback on recommendations to change the presentation of information on the labels and packages of medicines. The recommendations cover:

products purchased from a supermarket or a pharmacy without a prescription, or

A panel discussion from the morning session comprising of from left: Brett Holmes, NSWNMA General Secretary, Sue Brazil, NUM, HNE LHD, Dr Margaret Fry, Director Reserach & Practice Development, RNSH, Dale Sutton, Area DONM, Far West LHD).

Professional Services « Page 52

Discussions were robust and there were agreements and disagreements. It is important the NSWNMA continues to work toward constructive working relationships with managers and this was an important opportunity to initiate those efforts. A report of the forum was sent to the attendees in May 2013, along with a brief survey. In the survey, the nursing and midwifery leaders were asked to rank in order of priority the three most important issues to progress that were gleaned from the forum evaluations. We also invited these leaders to become involved in a Reference Group for Nursing and Midwifery Managers and Leaders and, to date, nine responses have been received.

NATIONAL REGISTRATION ISSUES Dual Registration National registration issues continue to be a problem for NSWNMA members. Dual registration as nurses and midwives is proving very contentious as many employers are taking the line that the nurse or midwife should opt for the non-practising category, the area in which they are not working. Although it is acknowledged that there may be some registrants who would elect to register for only one profession, registrants should not be forced to discontinue their registration at the request of the employer. The NMBA responded to the ANMF Professional Advisory Committee enquiry on dual registration that there is no definitive answer at this stage, and that the level of detail provided to nurses and midwives by AHPRA staff about maintaining dual registration may be different across jurisdictions. The NMBA has advised the Association that the Policy Committee of the Board, in conjunction with AHPRA, is developing information to provide clarity to nurses and midwives, stakeholders and the public about dual registration. It is important that considerable debate on this workforce issue is undertaken by the professions.

Recency of Practice in Midwifery With the concern of midwifery staff shortages and the Fairfax media recently reporting a chronic shortage of midwives across NSW, the issue of recency of practice in midwifery is being raised. The NSWNMA Midwifery Reference Group asserts that there are shortages of midwives at a number of sites in NSW due to the problem of inadequate support structures to enable midwives to flow into the workforce. According to Dietsch et al., 2008, 130 rural and maternity units across Australia have been closed since 1995, with 32 of these closures occurring in NSW. While the Association is aware of these facts, there is no recorded evidence that midwifery numbers are dropping. Assessing how midwives may take up re-entry in NSW is problematic as these returning midwives

Page 53 Âť Professional Services

are unlikely to have retained their membership with the Australian College of Midwives (ACM) or the NSWNMA. The ACM is hesitant to commit to a course due to lack of information about a potential intake, while the NSWNMA is concerned that until a course exists these midwives may be hidden. Many enquiries are received by the NSWNMA and AHPRA from midwives who have not practised for five years and who want to undertake an approved midwifery re-entry to practice course. The situation is dire for these NSW midwives, as there is no approved program in NSW, requiring them to travel interstate to study a re-entry course. To date this issue has been raised by the NSWNMA with the NSW Minister for Health and discussions and lobbying are continuing with the NSW Chief Nurse. The NSWNMA will continue to pursue resolution of this issue for midwives in NSW.

130 rural and maternity units across Australia have been closed since 1995, with 32 of these closures occurring in NSW. Recency of Practice Registration Standard and Re-entry to Practice Policy: Dispute On 15 April 2013, the Association filed an application to the Federal Circuit Court of Australia, on behalf of a midwife, alleging that AHPRA/NMBAâ&#x20AC;&#x2122;s changes to the terms and conditions of registration of midwives constitute indirect discrimination under the Sex Discrimination Act 1984 and the Disability Discrimination Act 1992. Many nurses and midwives did not meet the Recency of Practice Registration Standard which was introduced in July 2010 as a result of taking time out of the workforce because of their family responsibilities. For midwives trying to regain their midwifery registration there are no Board-approved re-entry to midwifery courses offered in NSW. As an alternative to a re-entry course, the Board has approved supervised clinical practice to be undertaken unpaid as a student registrant. However, there are currently no Board-approved guidelines for supervised clinical practice, a further barrier for midwives seeking a suitable clinical placement. Even where midwives have been offered a placement many midwives with family responsibilities

or disabilities have not been able to comply with the requirement that three to six-month periods of supervised clinical practice be completed within 12 months. In addition, the Board requires some midwives to complete a university subject on contemporary midwifery practice. The Association has agreed to represent midwives struggling to regain their midwifery registration in these circumstances in the Federal Circuit Court.

INTERNATIONAL COUNCIL OF NURSES

16TH SOUTH PACIFIC NURSES FORUM The Association was again represented at the South Pacific Nurses Forum (SPNF) by Aboriginal nurse member, Deborah Monaghan and the NSWNMA Professional Services Manager. The ANMF hosted the event in Melbourne in November 2012, an event that was well presented, conducted efficiently and greatly appreciated by the attendees. The South Pacific Island nations represented were Cook Islands, Fiji, Solomon Islands, Samoa, Papua New Guinea, New Zealand, Niue, Tuvalu, Kiribati, Tonga, Tokelau, Vanuatu and Australia. The nurses of the South Pacific are facing many economic, health, cultural and environmental problems. With the significant issue of noncommunicable diseases and the prevalence of obesity and diabetes, nurses are struggling to reduce these health problems within their communities as well as within the nursing communities. The need for education and regulation are the two factors consistently raised at these forums. Nurses and midwives from the Kingdom of Tonga have offered to host the next SPNF in 2014.

Kerry Rodgers NSWNMA Councillor (left) and Rebecca Roseby Enrolled Nurse at the International Council of Nurses (ICN) Congress in Melbourne.

The NSWNMA was represented by a number of Councillors, three Professional Officers and a member from Grafton at the International Council of Nurses (ICN) Congress held in Melbourne in May 2013. This was the 25th event of the ICN and is one of the largest assemblies of nurses from around the world. The keynote speakers were excellent and inspiring, although the session on the Australian health system was very disappointing with the Australian Health Minister presenting a discourse on Florence Nightingale. Further disappointments were that only one speaker made a brief mention of the Closing the Gap strategy and the event lacked any Aboriginal and Torres Strait Islander aspect. Overall, however, the Congress was a wonderful opportunity to meet nurses from all over the world and to select from the many topical areas of discussion such as workforce, ethics, clinical care and regulation.

LEGAL MATTERS Throughout the year, members have been assisted with disciplinary matters, as well as the preparation of statements, in Coronial Inquiries, Health Care Complaints Commission Inquiries and the Health Professional Councils Authority (Nursing and Midwifery Council of NSW). From the period June 2012 to June 2013, about 565 new issues related to professional legal matters have been referred to the NSWNMA Legal Officers.

Some of the attendees at the South Pacific Nurses Forum in November last year in Melbourne.

It is anticipated that a larger number of matters will be referred to the Tribunal in 2013, compared with 2012, because of a higher number of matters being referred from the Nursing and Midwifery Council to the Health Care Complaints Commission.

Professional Services ÂŤ Page 54

MEMBERS EDUCATION AND SEMINAR PROGRAM

1,377 998

2012

2013

Summary of Educational Seminar Activities July 2012 to June 2013 Seminars scheduled

Metropolitan

Regional

Cancellation of Seminars

Number of attendees

998

The member education program has delivered 56 courses over the period via the formal member education calendar. The number of courses on offer has risen from 54 last year to 59 this year. This figure will increase next period as a number of courses which attract larger attendances are scheduled to be held in the second half of this year. The number of attendees this year has however decreased to 998 from a high of 1,377. This has been most evident in the regional areas, with continued lack of access to study leave an ongoing issue for members and its impact on their ability to complete their CPD requirements. The forums have also been less well attended than in previous years, with a major drop in the number of aged care nurses accessing the annual forum and the regionally-run seminar series. The number of aged care nurses attending the annual forum has dropped from 120 last year to 43 this year. The restructuring of the Are you meeting your CPD requirements? workshop to include RNs, ENs and midwives in one group, and reducing the workshop to a half-day, has proved very successful.

Bob Fenwick Memorial Mentoring Program Grants mentors and mentees — with The Hon. Kevin Humphries, Minister for Mental Health (back, left).

Page 55 » Professional Services

2012

2012 2013

120 2013 43

54 59 number of courses on offer

number of attendees

number of aged care nurses attending

Special Request Seminars July 2012 – June 2013 The number of facilities requesting seminars to be held on site at their facility has seen a continued increase, particularly for the Legal and Professional Issues and the Importance of Documentation seminars. Fourteen Special Request Seminars have been delivered onsite, and the increase in requests is in spite of the increase in the number of scheduled seminars. The main reason given for requesting the onsite delivery mode is the continuing difficulty for staff to access study leave for education and training; facilities can also arrange rosters to incorporate an onsite session for staff.

MENTAL HEALTH MATTERS Bob Fenwick Memorial Mentoring Program Grants The NSWNMA, in collaboration with the NSW Ministry of Health, successfully managed and

concluded the 2011-2012 grants round of the program last year; the Ministry has provided a commitment to funding the program for another two years. In the current 2012-2013 round, twelve Mentee applicants were successful and all Mentees completed their placement by the end of July 2013. Positive feedback has been received regarding the program to date, and calls for expressions of interest for the third round in 2013-2014 are scheduled to commence in September/October this year.

SCHOLARSHIPS The Edith Cavell Trust Scholarships A total of 155 scholarship applications were received for The Edith Cavell Trust Scholarship for the 2013 academic year. The largest scholarship amounts of $4,000 were awarded to successful applicants in Category 1 to assist them in undertaking programs leading to initial registration as a nurse. Awarded amounts were distributed evenly among the successful applicants within each category. In accordance with guidelines provided by The Edith Cavell Trust Committee, the culling committee continues to award fewer grants of larger size; this was achieved with the awarding of 24 grants to a total value of $80,000. This amount is a decrease of $30,000 on last year’s figures largely as a result of the global financial crisis and the flow-on effect to the investment market. A waiting list of three applicants was created for Category 1 and a waiting list of four was created for Category 3(i).

Lions Nurses’ Scholarship Foundation Lions continue to support the profession through their ongoing and committed work with the Lions Nurses’ Scholarship Foundation. In 2013 a total of $46,000 was awarded to 15 successful applicants. Lions members continue to grow the Foundation which enables more scholarships and larger grants to be offered to nurses across NSW and the ACT. The Association is very grateful for this valuable project.

UNIVERSITIES AND COLLEGES Transitional Year and New Graduate Recruitment Strategy The Transitional Year Recruitment Strategy for 2013 has once again been very successful and recruitment of new graduate nurses and midwives is on par with 2012 numbers. Well over 1,200 new members joined in the first half of 2013 and it is expected that further graduates will be welcomed at the mid-year orientations. Recruitment on this scale would not be possible if it were not for those dedicated branch officials, members and staff who assist with this important union growth activity.

The graduate recruitment

It is always pleasing to welcome new nurses and midwives to their union and we look forward to supporting and encouraging younger members to become more active and engaged in the coming years.

Union Summer Program The Association once again took part in the Unions NSW-facilitated Union Summer Program. The program continues to be a great success with students coming to the Association to work for three weeks during the Summer break to learn more about how their union works. This year two nursing students from The University of Sydney and the University of Western Sydney undertook the program.

WORKPLACE HEALTH AND SAFETY Inquiries and Inspections ISSUE

NO.

Number of issues

266

100

Violence and security

Bullying/ harassment

Workloads/ shiftwork/ fatigue

Hazardous substances

Working environment

Manual handling

General WHS/ multiple issues / miscellaneous

Design (of facilities, layout)

Infectious disease/ infection control

Professional Services « Page 56

Inquiries and Inspections The NSWNMA received 295 work health and safety enquiries which were handled by a range of officers including information officers, member support officers, organisers and WHS officers. The distribution of topics and the number of enquiries as a percentage of total enquiries are provided below. It is worth noting that the single major issue of concern to nurses and midwives is violence and security which continues to represent one third of WHS issues raised by members. Twenty-seven (27) workplaces required or invited direct interventions including letters to management, workplace inspections and reports, or comments on policies, procedures or construction plans. In some instances, multiple meetings and visits were involved.

Violence in the Public Health System Violence in the public health system continues to be the main WHS issue requiring the intervention of the NSWNMA.

WHS Essentials for Nurses and Midwives Publication and DVD Development WHS Essentials for Nurses and Midwives was facilitated by a grant from WorkCover NSW under the WorkCover Assist Program. The Work Health and Safety Essentials for Nurses and Midwives publication has been uploaded to the NSWNMA website; the printed publication with DVD will be available for distribution at Annual Conference with subsequent mail outs to branches and members across the state.

Duress alarms and their maintenance, duress response and training in de-escalation, and duress response and patient restraint continue to be major areas of non-compliance. Funding for these essential risk management strategies is lacking. During the past year, two incidents occurred in close succession at the Pialla Unit at Nepean Hospital where the lack of ongoing preventive maintenance and system testing resulted in alarm malfunction at a time when it was required. Problems with the Bathurst Base Hospital duress alarm system also came to light after a serious incident in the ED. In the case of Bathurst Base Hospital, the original design, built to a minimum cost and functionality, proved to be ineffective.

Issue

Public health system [no.]

Aged care [no.]

Other [no.]

Total [no. (% of total enquiries)]

Violence and security

97 (32.9%)

Bullying/ harassment

45 (15.3%)

Workloads/ staffing/ fatigue

33 (11.2%)

Working environment (incl. design)

35 (11.9%)

Hazardous substances

22 (7.4%)

Manual handling

21 (7.0%)

Infectious disease / infection control

12 (4.1%)

WHS consultation

3 (1.0%)

General WHS/ multiple issues / miscellaneous

27 (9.2%)

185 (62.7%)

75 (25.4%)

35 (11.9%)

295 (100%)

Total (% of total enquiries)

Page 57 Âť Professional Services

Communications Campaigns The Unions for Transfusions campaign launched at Easter last year won the prestigious community outreach award at the 2013 ACTU National Union

Former Prime Minister Julia Gillard drew the Unions for Transfusion campaign winner in May 2013.

Awards. The campaign is a multi-union initiative with the goal of increasing the number of people donating blood in NSW. The NSWNMA works closely with branch officials to drive the recruitment of blood donors; 28 worksites had been visited and 1,923 pledges made to donate to the Australian Blood Bank as a result of the campaign.

28 worksites had been visited and 1,923 pledges made to donate to the Australian Blood Bank as a result of the campaign. Communications ÂŤ Page 58

Social Media The NSWNMA’s social media channels continue to grow from strength to strength, with over 8,000 ‘likes’ on our combined Facebook pages as well as 11 branch Facebook pages. Facebook continues to be an important forum where nurses and midwives share their thoughts and opinions about issues that matter to them. Twitter is also gaining popularity with NSWNMA members, and members of the political and health communities. With over 2,000 followers, the ‘Twitterverse’ has been abuzz of late with public health system campaign activities and politicians joining in the action from time-to-time.

+8,000 ‘likes’

branch Facebook pages

new online member portal

With an experienced Digital Producer employed from the start of this year, the team’s use of video and YouTube has become a big part of our daily workflow. Using this year’s campaign activities as a starting point, we have managed to produce two to three videos per month which has been a new medium of content for members. The blog site Nurse Uncut has consistent traffic of 12,000 to 13,000 visitors to the site per month and an active forum section that has seen many nurses and midwives sharing their thoughts and opinions on a range of issues.

+2,000 Twitter followers

12,000 13,000 visitors per month to Nurse Uncut

Page 59 » Communications

Marketing and Recruitment

Website

Marketing and recruitment initiatives continue to be a vital part the Association’s activities.

The NSW Nurses and Midwives’ Association website (www.nswnma.asn.au) continues to be a valuable resource centre for news, updates, campaign materials and media releases.

Our major sponsor, First State Super, has continued to support the Nurses and Midwives’ Short Film Festival which celebrated its fourth film festival this year and featured 12 entries. The short films, written and produced by NSW nurses and midwives, saw a range of quality amateur films which touched on some of life’s biggest questions and intimate moments. The first prize of $5,000, sponsored by First State Super, was presented to student nurse Ciara Rafferty for her black comedy Arthur; second prize of $2,000, sponsored by Behaviour Change, the Shannon Company, was presented to Carolyn Guichard for her film Soulcatcher, and the third prize of $1,000, sponsored by the NSWNMA, was presented to student nurse Asobede Dawodu for Echoes. The inaugural Maureen Puhlmann Encouragement Award of $1,000, sponsored by the NSWNMA, was presented to Leonie Keen for the Phone Call.

Online member services The Association launched its new online member portal at the May 2013 Committee of Delegates. The new service allows members to update their personal details, pay fees online, request tax statements and request a reprint of their membership card. It also provides direct access to Members and Branch Officials pages and allows a simple means of contacting the Association with member queries. This is another step in providing improved online services for members, along with a total re-design of the Association’s website currently underway.

This is the first year that student nurses have entered the film festival and their entries earned top prizes in the competition.

The winners of this year’s Nurses and Midwives’ Short Film Festival - with NSWNMA General Secretary Brett Holmes (middle).

Communications « Page 60

Community Sector 2013 MAY DAY PARADE The year 2013 saw Unions NSW revamp the Sydney May Day march, broadening its appeal to that of a Parade. This initiative was a great success with significantly larger participation from all unions, community and worker groups. The NSWNMA component was headed by a human time line dressed in historical nursing uniforms and holding placards depicting the significant industrial campaigns for nurses and midwives of those eras. This human time line concluded with a mass of members and supporters wearing the NSWNMA campaign scrubs promoting the message of Safe Patient Care. We are very proud that the NSWNMA won the inaugural shield and trophy for ‘Best Union Contingent’. It is hoped that participation and support for the May Day Parade will continue to grow in future years.

Page 61 » Community Sector

We are very proud that the NSWNMA won the inaugural shield and trophy for ‘Best Union Contingent’.

Conclusion Our commitment to safe patient care undoubtedly means that we are in constant campaign mode with only the intensity varying from time to time. Short-term agreements, whether in the public, private or aged care sectors, mean there is little time to rest the membership â&#x20AC;&#x201D; but if we are to achieve the expectations of our members then that will be the way of the future for some time to come. I am very proud of what our union has been able to achieve in the past twelve months in difficult circumstances. None of that can be accomplished by staff alone; the engagement of members, the hard work of branch officials and Councillors, together with our staff, are always at the core of our successes. While it is very important to recognise and celebrate our achievements there is much to be done and we need to continue to adapt our ways of operating and campaigning to meet the ever-changing circumstances in which we find ourselves.

Short-term agreements, whether in the public, private or aged care sectors, mean there is little time to rest the membership â&#x20AC;&#x201D; but if we are to achieve the expectations of our members then that will be the way of the future for some time to come.

Conclusion ÂŤ Page 62

Politics is important Over the last twelve months more than a thousand members have had their first political experience of being face-to-face with their local member of parliament, or being part of a group of members learning to hold their politicians to account. When governments are in dominant positions with what they consider is a mandate to do anything they want, we have no choice but to take our messages directly to them. The O’Farrell/Stoner State Government made the decision to remove the powers of the NSW IRC to arbitrate wages and for the government to set outcomes. This means there is no alternative but to use political power, rather than use the pure industrial methods to improve the wages and working conditions of our members, or improve patient safety. The State Government clearly hopes that we, as a union, will accept their unilateral outcomes and stop campaigning. I am confident that is not what we will do, nor is it expected of us by our members. I acknowledge that there are many members who are uncomfortable engaging in a political fight, but if a government takes away your rights to do otherwise members would have to severely modify their expectations of what we can achieve. Of course the State Government has made every attempt to prevent our voice being heard, loud and clear, in the six months prior to an election and is the reason that we are testing the electoral funding laws in the High Court.

A Few Weeks from a Federal Election We are a few weeks from the federal election and everyone must make their vote count. Everyone who is enrolled to vote has a choice: I hope that it is an informed and considered vote. Until the recent change of Prime Minister it looked like a landslide was inevitable with the possibility of an Abbott-led Liberal/ National Coalition Government having the chance to control both houses of parliament with almost no opposition remaining. That could still happen. The Howard Government implemented WorkChoices when it achieved power in both houses of parliament. It proved a fatal error to attack the workers when unions were able to garner the support of members and the community to fight back and overturn a government committed to unfairness in the

Page 63 » Conclusion

The combination of conservative governments at state and federal level will undoubtedly leave the door open to private operators to seize an opportunity to take control of the billions of dollars of public money currently paid by taxpayers to maintain our public health system. workplace. No one should be under any illusions that an Abbott Government would repeat that mistake. It is clear that an Abbott Government would use the poor behaviour of one union to justify tying the rest of the union movement up in legal inquiries or red tape (as the Queensland Government has done in an attempt to remove campaign capacity) to allow a future attack on workers’ rights. The Liberal/National Party policy on industrial relations is to use the Productivity Commission as a reason to remove workers’ entitlements, such as penalty rates and more, in their second term of office. Privatisation of our public health system is also on the agenda of the Liberal/National Parties. The combination of conservative governments at state and federal level will undoubtedly leave the door open to private operators to seize an opportunity to take control of the billions of dollars of public money currently paid by taxpayers to maintain our public health system. The granting of such control is under the false premise that private business is always more efficient than the public sector in management of crucial services.

ACKNOWLEDGEMENTS This report once again gives me an opportunity to record my thanks and gratitude to a group of people with whom I work closely. Coral Levett, our President, whose support and guidance in the difficult times is invaluable. Coral must again be congratulated on her contribution to the leadership of not only NSW nurses and midwives, but

also across the nation in her role as the Federal President of the Australian Nursing and Midwifery Federation. I also thank all of the Councillors for their contribution to the leadership and proper management of this union. Their job is not easy or often recognised but it is of enormous value to the union and its members. Judith Kiejda’s contribution as your Assistant General Secretary is always remarkable and I am grateful for her support, loyalty and enthusiasm. Judith’s commitment to her role within PSI and the Sydney Alliance is important but time consuming and I thank her for her commitment to these organisations. The establishment of Global Nurses United is a testament to her vision and tenacity.

Delegates and members can rest assured that this union does not depend upon one person alone and our leadership team is well supported by our staff in their many and different roles. Delegates and members can rest assured that this union does not depend upon one person alone and our leadership team is well supported by our staff in their many and different roles. Like any leadership team, Judith and I are indebted to our immediate support staff: Maggie Potts my Executive Assistant and Alyce Gillespie, Judith’s Personal Assistant. Without Maggie and Alyce neither of us would be able to function effectively and efficiently; their contribution to this union is acknowledged. Kerry Halliday has continued to produce outstanding records of our union’s important meetings. We also welcome Karen Chesher who recently joined the Executive Office in an Administrative role.

My final thanks go to the Senior Leaders Group and all their team members, the staff of the NSWNMA. We have all worked closely together in the current campaigns and the commitment and dedication of staff to the benefit of our members is remarkable. I wish to acknowledge the retirement of a number of long-term staff in the last twelve months: Denise Egan, Sharon Rea, Judy Hourigan and Carolyn Kulling, all of whom have made a contribution to your union with long and dedicated service. I wish to also recognise Denis Fahey who is retiring from his role as Financial Controller. Denis has provided invaluable assistance in the financial management of the Association and the Federation. His fearless and frank advice and management of the accounts always provides a level of assurance to our Council; to Judith and I, that means we have confidence in our accountability for the expenditure of members’ money. I acknowledge and thank those staff members not often seen at the frontline of the Association but who keep the organisation running and, when called upon, don the campaign gear and add their voice to our cause. I ask all the delegates here at Conference to join with me in recognising the work of the NSWNMA staff and to also recognise their own and their fellow branch officials’ contribution to their union.

Brett Holmes General Secretary

Conclusion « Page 64

Summary of Financial Information Year ended 31 December 2012

The financial statements of the New South Wales Nurses and Midwives’ Association have been audited in accordance with the provisions of the Industrial Relations Act 1991, and the following summary is provided for members in accordance with Section 517(2) of the Act, as applied by section 282(3) of the Industrial Relations Act, 1996.

A copy of the Financial Statements, including the Independent Audit Report, will be supplied free of charge to members upon request. Certificates required to be given under the Act by the Accounting Officer and the Committee of Management have been completed in accordance with the provisions of the Act and contain no qualifications.

2012 ($)

2011 ($)

Membership revenue

27,748,934

22,334,013

NursePower revenue

3,083,215

5,936,890

Other income

1,664,349

1,608,188

TOTAL INCOME

32,496,498

29,879,091

LESS TOTAL EXPENDITURE

30,175,138

26,977,683

2,321,360

2,901,408

Profit on sale of assets classified as held for sale

3,983,891

Reversal of impairment loss – O’Dea Ave, Waterloo

2,097,394

Loss on disposal of available for sale assets

(897,236)

Share of losses of investment in joint venture operations

(340,201)

(182,392)

(324,984)

SURPLUS FOR THE YEAR

7,165,208

2,394,032

Net gain/(loss) on revaluation of financial assets

1,364,388

(607,410)

(332,256)

(1,456,719)

324,984

8,197,340

654,887

Impairment loss – available for sale financial assets

Actuarial losses – defined benefit fund Financial assets reserve deficit recognized as impairment loss TOTAL COMPREHENSIVE INCOME ATTRIBUTABLE TO MEMBERS

Page 65 » Summary of Financial Information

BALANCE SHEET AS AT 31 DECEMBER 2012 ACCUMULATED FUNDS

31,999,421

23,802,081

Current assets

14,500,019

6,574,711

Non-current assets

28,722,350

34,300,196

TOTAL ASSETS

43,222,369

40,874,907

Current liabilities

8,616,470

8,106,393

Non-current liabilities

2,606,478

8,966,433

11,222,948

17,072,826

31,999,421

23,802,081

Represented by:

NET ASSETS

INFORMATION TO BE PROVIDED TO MEMBERS OR REGISTRAR In accordance with the requirements of the Industrial Relations Act, 1991 [NSW] the attention of members is drawn to the provisions of Sub-Sections (1) and (2) of Section 512 which read as follows: (1) A member of an organisation, or the Industrial Registrar, may apply to the organisation for specified information prescribed by the regulations in relation to the organisation.

AUDITORS’ CERTIFICATE We certify that the above Summary of the Financial Statements is a fair and accurate summary of the Report, Accounts and Statements of the New South Wales Nurses and Midwives’ Association for the year ended 31 December 2012. Our independent Audit Report to the members dated 9 April 2013 on the Financial Report did not contain any particulars of any deficiency, failure or shortcoming as referred to in the Industrial Relations Act 1991 [NSW], as applied by Section 282(3) of the Industrial Relations Act, 1996.

(2) An organisation must, on the making of such an application, make the specified information available to the member or the Industrial Registrar in the manner, and within the time, prescribed by the regulations. Daley & Co

Michael Mundt

Chartered Accountants

Partner

9 April 2013 Wollongong Liability limited by a scheme approved under Professional Standards Legislation.

Summary of Financial Information « Page 66

FOR MORE INFORMATION NSW Nurses and Midwives’ Association 50 O’Dea Avenue, Waterloo NSW 2017 Phone 8595 1234 (metro) » 1300 367 962 (non-metro) » Fax 9662 1414 Email gensec@nswnma.asn.au » Web www.nswnma.asn.au

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