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Content 4 Report to 2016 Annual Conference 6 A Year in Review 14 Report to 2016 Annual Conference 18 Key Direction 1 2016 Federal Election 19 NSW Health 20 NSW Government 22 Local Health Districts 23 Private Hospitals 30 Aged Care 31 NSWNMA Member Development 34 Recruitment 35 36 Key Direction 2 Local Health Districts 37 Affiliated Health Organisation 39 Aged Care 39 Private Hospitals 42 Private Sector 43 44 Key Direction 3 Education 45 Scholarships 46 Consultation 47 Submissions and Inquiries 48 Work Health and Safety 49 Community Issues 53 54 Key Direction 4 Establishment of a memorial 55 Environmental Issues 55 Key Partnerships 57 60 Key Direction 5 Governance Systems developed and revamped 61 Staff Education 61 63 Conclusion 65 New South Wales Nurses and Midwives’ Association Summary of Financial Information for the Year Ended 31 December 2015 66 Index
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Report to 2016 Annual Conference Coral Levett, President
last Conference. This has provided a platform of stability for the Association that has been most welcomed. Leading and managing this organisation continues to be an extremely challenging but important responsibility, and I acknowledge the continued commitment of Brett and Judith. The Councillors feel very proud and privileged to be on the Council of the Association and to be a part of such a progressive, dynamic and inspirational leadership team.
A
warm welcome to all the delegates here today attending our 71st Annual Conference. I would also like to welcome our special invited guests, including life members. It is my hope that this conference meets your expectations in every way. I trust you will enjoy your time with us and we look forward to hearing from you, both formally during debate and informally during the social program.
Over the last 12 months, the Executive and Council has had a very busy, but productive time, with just some of our activities including:
• Campaigning to improve and extend nurse-to-patient ratios;
• Campaigning for RNs in Aged Care 24/7; • Campaigning to Save Medicare; • Campaigning against the $57 billion in health cuts
This President’s report provides a brief summary of the activities of the Association’s Executive and Council for the past year. The General Secretary’s report will provide a more detailed account of the full range of activities of the Association.
nationally made by the Coalition in recent years;
• Campaigning to keep the NSW government’s Hands Off Public Disability Services;
• Campaigning to Build a Better Future in order to
NSWNMA Council and Executive
oppose the Coalition governments’ privatisation of our state and national assets;
For those attending conference for the first time, the Association Council is made up of 23 democratically elected nurses and midwives 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.
• Campaigning to save penalty rates and the meaning of our weekends;
• Campaigning to save Paid Parental Leave • Campaigning against the China Free Trade Agreement; • Campaigning against the Trans Pacific Partnership; • Attending and supporting the Sydney Alliance movement;
As this is not an election year for the NSWNMA, we have had no changes to the membership of Council since our
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Report to 2016 Annual Conference
• Active involvement as committee representatives
of the ANMF which allows us to exert our influence on professional and industrial matters at the national level. As a state Branch of the ANMF, we form a sizable component of a collective of almost 250,000 members throughout the nation. We are the second largest member state, with Victoria being the largest.
in The Lamp Editorial, the Professional Issues Committee (PIC), and the Edith Cavell Trust;
• Authorising around $70,000 worth of donations and community engagement sponsorships to various charities and community groups on your behalf;
•
Continuing to be at the forefront of policy and procedure review for both the NSWNMA and the ANMF.
Every two years, representatives from all the states and territories meet to progress issues of common interest. The last Biennial Delegates’ Conference was held in Adelaide in October last year with NSW representation from the ANMF NSW Branch Council. As always, it was a very rewarding experience meeting with like people from across the nation.
NSWNMA Council – meeting attendance Meetings held from September 2015 – July 2016 = 9 Number attended
Number attended
Alldrick, Annette
9
Makepeace, Edward
8
Brazil, Sue
6
McCall, Liz
9
Cashman, Michelle
9
McKenna Lucille
8
Clark, Gary
8
Nicholson, Michelle
7
Dine, Lyne
4
Noort Richard
7
Gleeson, Tania
9
Rodgers, Kerry
8
Hibbert, Peg
7
Scott, Lorna
8
Holmes, Brett
8
Smith, Debra
8
Hopper, Lyn
9
Smith, O'Bray
8
Kiejda, Judith
8
White, Sue
9
Lang, Debbie
9
Wilson, Gil
8
Levett, Coral
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The ANMF has also enjoyed a period of stability in mem bership with Lee Thomas as Federal Secretary, Annie Butler as Assistant Federal Secretary, Sally-Anne Jones as Federal President, and Maree Burgess as Federal Vice President. The NSW Branch of the ANMF joins with the Federal Executive and the other Australian states and territories in our ongoing attempts to stop the drain of funding to Australian health services. The ANMF NSW Branch have been a proud and critical contributor to the If you don’t care, we can’t care campaign in the lead up to the Federal election.
Conclusion This union’s ongoing success and growth comes down to the extraordinary efforts by many people. Supporting the leadership team of Brett, Judith and Council, are our dedicated and committed staff. Each person within their team plays an important part that helps make this union the vibrant, successful and influential organisation it is today. I would also like to acknowledge the delegates and Branch officials here this week for all the work you do up front and behind the scenes. One of the key elements of our strategic plan and the survival of this Union, is the growth of our membership. We all need to keep working together with our common goals and ensure this growth becomes a reality – for without our members we have nothing.
Edith Cavell Trust Edith Cavell scholarships are awarded to enable current and future nurses and midwives to embark on undergraduate or postgraduate studies. An amount of $100,000 was allocated this year. Congratulations go to the 35 members (some of them students) who were successful with their scholarship applications for the 2016 academic year. As the Trust scholarships are only available to members and associate members, it is a great reason to encourage non-members and students to join.
We are a strong and proud family of nurses and midwives, and we will not give up on the health of our community. Our campaigning will continue on many fronts, and with great energy and enthusiasm from us all.
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. Thank you to all the members of the PIC for their ongoing contribution, including regular attendance at our meetings.
I congratulate Brett and Judith once again on their exemplary leadership and their ongoing capacity to keep this union relevant and progressive. Let’s continue to work together to achieve a better deal for the nurses and midwives of NSW. I wish you all an enjoyable and productive 71st Annual Conference.
Australian Nursing & Midwifery Federation (ANMF) As well as being members of the NSW Nurses and Midwives’ Association, we also form the NSW Branch
Coral Levett President
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Introduction
I
t has been a year since we launched our strategic plan at last year’s annual conference and work is underway to ensure that we are evolving as an organisation to meet the complex and ever changing environments in which we operate.
A Year in Review
Internally, a robust process to operationalise our strategic plan has been well under way and I am confident that the input from staff will help deliver actions that will engage members in the achievement of our strategic objectives.
Brett Holmes, General Secretary
Teams have been formed to address each of the pillars of our strategic plan and work through the strategies that will produce the outcomes we desire. By 2017 you will see some of the important preparation work translated into actions that members will be asked to engage in, particularly in development of workplace leaders through education and coaching and the exercising of workplace power. On a macro level, our peak body, the ACTU, is also addressing similar challenges to the union movement, declining union membership and power in some industries; and, the challenges of growing in increasingly uberised, digitalised and fragmented workplaces. Taskforces have been set up that will address: building organisational adaptability through innovation; creating a union movement that is future proof; organising for growth; setting a new union agenda and looking at alternative membership models. We are not immune from these changes, for example consumer directed care (CDC) in both aged and disability care areas means that old models of service delivery will be disrupted. Already we see online matching of elderly people with “carers� who invite the aged person to come and live in the spare room for a portion of their pension or other payments. Eligible aged care recipients will be deciding what care they think they need and who delivers it. Sounds very good and empowering on the surface but questions about what happens when wrong choices are made are, of course, yet to be understood. So the models of care delivery in the community setting may well change significantly and we need to prepare ourselves for those changes. Building a better future for working people has never been more important than it is now and if we want our voices to be influential in Australian life, we must continue to grow and strengthen. Not surprisingly Uber drivers are already talking about the need for collective action but are avoiding the idea of joining a traditional union because they see themselves as different. The union movement needs to be abreast of these changes and ready for fairly rapid change and evolution.
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Report to 2016 Annual Conference
Membership Growth
Finance
The NSWNMA has recorded a net increase of 1,195 financial members in the 12 months to 30 June 2016. This brings the NSWNMA to a financial membership of 62,242 at 30 June 2016, representing a growth of 1.96% for the 12-month period.
The NSWNMA is in a sound financial position with the benefit of a 1.96% membership growth to 30 June, and prudent expenditure. The Audited Accounts for 31 December 2015 are summarised at the end of the report and a full set is supplied to delegates and available to members. The result is a surplus attributable to members of $2,738,078 and a total comprehensive income attributable to members of $3,594,514 (compared to $1,693,186 in 2014). Our Net Assets as at 31 December 2015 were $37,328,803, an increase of $3,594,514 from 2014. It should be noted that a positive revaluation of $948,099 in Defined Benefit Superannuation liabilities represents a significant component of the movement (compared with a negative revaluation of $888,368 in 2014).
Key Growth
• An increase in the Public Health System for the year (30/06/2015 to 30/06/2016) – up by 878 members (2.17%).
• An increase in Residential Aged Care for the year – up by 76 members (0.76%).
• An increase in Private Hospitals for the year – up by 348 members (6.60%).
• An increase in Justice Health for the year –
In the unaudited five months to 31 May 2016 we recorded a surplus of $1,514,833 which was better than budget by $2,971,631. Our better than budget position is predominantly a matter of timing, with planned TV and campaigning expenditure postponed to coincide more closely with the Federal election and staff recruitment taking longer than anticipated.
up by 37 members (5.74%).
• Other sectors down by 144 members. • The number of PRD members has decreased by
553 for the year (30/06/2015 to 30/06/2016), from 7,512 to 6,959 (11.2%).
Branches:
393
Federal issues Federal election 2016
New Branches formed: 7 Branches reformed:
16
Delegates:
649
Branch Officials:
1,362
up by
878
members
Delegates Branch Official
1,362
up by
up by
76
649
members
348
up by
37
members
members
Public health system
aged care
private hospital
justice health
7 new branches 16 reform branches
Health and Medicare were top priorities among voters and we can say that we helped put it there by raising it very early with the ACTU and with the political parties. Of course, we were far from being alone in our concerns.
other sectors
Issues that resonated with voters were universal access with Medicare and health funding for public hospitals – both were issues that the Association has been campaigning around during the federal election and for the last three years since the Abbott government handed down its horror budget in 2013.
down by
144
members
393 branches
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The Fair Work Commission review of cutting Sunday penalty rates continued to dominate indus trial issues for members who are concerned that a cut in some industries like retail and hospitality, would mean a domino effect into other sectors like health and aged care.
Medicare payment services and if elected, lifting the freeze on GP payments, maintaining bulk billing incentives for diagnos tics and pathology and reversing and protecting penalty rates by resubmitting their submission (this time as the Government) to the Fair Work Commission to maintain Sunday rates.
Our paid election campaign which depicted nurses with their hands tied, unable to perform their duties properly due to the cuts to health, Medicare, and aged care, was about lobbying all the parties to commit to our key asks: restoring the health funding agenda, protecting Medicare, protecting penalty rates and committing to RNs 24/7.
It was unfortunate that the majority of Liberal/National candidates either refused to meet, or if they did meet, would not sign onto the pledge. This exercise identified a number of candidates that were not prepared to be held accountable for their political views, instead hoping to glide into their seats in Parliament without listening to constituents with a different set of values.
Our Federal election issues-based campaigning efforts in NSW produced the desired result with Labor and the Greens supporting in part or full our campaign targets.
Despite the groundswell of support around our State RNs 24/7 campaign, much more work needs to be done with this sector no matter which party is elected. The Turnbull Government budget cuts to complex care funding within ACFI were criticised but not rejected by the ALP despite promises to review ACFI and set up a workforce review process. A comprehensive and ongoing campaign will be needed to get proper funding for residential aged care. Cuts to complex care funding goes to the heart of much of the role of registered and enrolled nurses in aged care, so the battle for quality and safe care, is well under way. Clearly we do not support any alleged rorting of the system but cuts to complex care effects everyone who should be entitled to it.
All candidates in marginal seats and some others had an opportunity to sign onto our pledge and meet with nurses and midwives to discuss their issues. I thank all members who have participated in these important events. If elected, Labor has committed to restoring the 50% growth funding agreement with states and territories by contributing $4.9 billion to public health over the next four years. They have also committed $100 million to primary care over the next two years. They have also committed to legislating against privatising
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Report to 2016 Annual Conference
Build a Better Future campaign
abandoned the legal requirement for nursing homes to have a registered nurse on duty around the clock.
Since its NSWNMA launch at our 70th annual conference last year, the Build a Better Future campaign has built a grounds well of support within unions and broader communities.
The decision contradicts the unanimous recommendations of a parliamentary inquiry supported by the Baird govern ment’s own MPs.
Campaigning around the key issues of workers rights and defending jobs, Medicare and universal healthcare, education, public services, a secure retirement, and a fair go for all.
NSW Health Minister, Jillian Skinner, said aged care facilities were now regulated by federal law and it would “duplicate regulatory process” to keep the NSW law. The Minister believes the current legislation and regulation is unenforceable and irrelevant.
Nurses and midwives have been actively involved in their local union community groups speaking to other union members about the issues that matter to them.
However the parliamentary inquiry found that NSW should retain a 24/7 nursing rule because the current federal regulation fails to ensure safe staffing levels and registered nurse care for residents.
Issues like protecting penalty rates, Medicare and Gonski funding in particular have been amplified by the union movement’s involvement in this campaign. It formed the basis of the ACTU Federal election campaign. The ACTU and the affiliates are in complete agreement that no matter who is in Government, we need to continue this campaign as they are fundamental issues that continue to define a fair and just society that help make the lives of workers and their families bearable.
Federal law does not specify the number and skill mix of staff in aged care facilities. “Sufficient suitably qualified staff” will not hold aged care providers to account when the financial bottom line is the main driving force ameliorated only by the regular visits from the Aged Care Accreditation Agency and the Aged Care Complaints Commissioner. The NSW government’s decision ignores appeals from a wide range of nursing, seniors and health advocacy groups and a 25,000-signature petition circulated by the NSWNMA. The NSW Ministry of Health abandoned its consultation process because it could not get consensus from the participants to retain any oversight of aged care despite serious consequences for the Public Health System, and in particular, emergency departments.
Aged Care In May this year the NSW Minister for Health, Jillian Skinner, advised of her decision to remove the legal requirement for a registered nurse on site at all times in aged care facilities where there are people with high care needs. After almost two years of campaigning and a great victory at the State level with the positive recommendations of the Upper House inquiry, it was with great disappointment that we received that news from the Minister for Health.
We have received strong support from the Shooters, Fishers and Farmers and The Greens, in the Legislative Council with both trying to introduce legislation to retain RNs 24/7.
The NSW government has ignored public opinion and
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The survey revealed how very basic standards of care for nursing home patients, including feeding; bathing; bed changes; and pain and continence management were already suffering, as a result of poor staffing levels and lack of funding. At some nursing homes across the country, one registered nurse was caring for up to 130 residents.
We will keep campaigning on this issue and ensure that it will be on the radar of all decision makers and candidates at the next state election. This disappointing decision means the issue will now have to be resolved by the Commonwealth as the State has absolved itself of this important responsibility and could create a knock-on effect destabilising the entire skilled staff structure. The Minister has promised to put the issue on the COAG Health Ministers agenda.
As with our other campaign asks during the federal election, we called on all parties to stand up for elderly Australians and commit to restoring the funding which has been cruelly axed from aged care.
The federal government’s decision to slash $1.2 billion in funding from the budget for nursing home residents with complex health care needs is also an area of grave concern.
State issues Violence roundtable
We fear both revisions are a recipe for disaster in NSW, promoting a dangerous model of care that permits completely untrained staff to manage patients with complex care needs in residential aged care. Even the best providers are warning they will be in financial difficulty and will be under pressure to remove RNs.
Our January Committee of Delegates meeting hit some emotional peaks for all who attended following the shooting incident at Nepean Hospital. It quickly became clear that this is a systemic issue with 140 delegates from both metro, regional and rural hospitals, EDs, mental health units and even maternity units sharing their horror stories occurring in public hospitals and other health care settings across the state.
It is with these sudden and extreme changes that we participated in a national aged care phone in campaign on June 18th with the involvement of all the branches in the federation.
Four resolutions moved by the NSWNMA’s Nepean Hospital Penrith Branch were passed unanimously during that meeting. All four resolutions sought urgent interventions by the NSW Minister for Health, Jillian Skinner. I am glad to say that the Minister and the Ministry of Health have responded and a more comprehensive report is included later in this report. The strongest message that needs to be reinforced to nurses and midwives at all levels is that your own personal safety comes first and personal and patient safety is everyone’s responsibility. No one is expected to be a martyr trying to give patient care when your own safety is at risk.
The results were compelling: more than 2,500 aged care nurses and concerned community members called the hotline or filled out a survey online and shared their views about aged care. More than 93% of workers and 96% of community members saying the current level of funding did not meet the needs of residents, particularly those with high-care requirements. When asked to list the issues they were most concerned about, over 90% of workers and over 92% of the community both said adequate staffing levels for providing high care was a high priority.
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Report to 2016 Annual Conference
Aged Care Bargaining Opal Specialist Aged Care
and midwives is always welcome, but the only way to ensure we have appropriate staffing to meet increasing patient demand is to introduce nurse to patient ratios, particularly in our emergency departments, paediatrics and critical care as well as enforced BirthRate Plus in our maternity services. We continue to rely on our members to help us enforce ratios in areas where we already have them.
Opal became the first aged care employer where we have claimed nurse to resident ratios. Whilst management pushed back hard against ratios, we have had a significant win by placing the standard company rosters into the enforceable agreement. These set out staffing numbers that have a ratio basis.
Staffing and skill mix issues
State Budget
Last year and this year we have been in local regional battles to address appalling understaffing issues.
The state government boasted a budget surplus worth more than $3.4 billion with the State Treasurer bragging that the Wages Policy has already saved the State $2.5 billion dollars over the last five years.
There is a clear pattern emerging – brand new buildings without appropriate staffing to meet the new footprint or existing staffing issues made worse.
The Health budget continues to grow but at what point the Commonwealth’s inadequate response to that growth starts to have a very big impact on front line services is not quite clear, with our State Government keeping very quiet during the election campaign in relation to health funding needs.
At Tamworth Rural Referral Hospital last year chronic understaffing and overtime led the branch to take their concerns to the Industrial Rela tions Commission of NSW (IRC) and the local community as patient safety was put at risk. There had been longstanding work loads issues in the emergency and maternity departments even prior to staff moving to the new facilities.
Within the Health Budget an allo cation of $375 million for additional demand has been made, with $40 million allocated to six regional hospitals that have been recently rebuilt and opened to experience unbudgeted, and seemingly, unpredicted increased demand. Funding for upgrades to hospitals are a welcome addition in the budget, but crucial funding for commensurate staffing needs to be prioritised as demand for health services continues to grow.
The evidence clearly indicated there are nursing staff shortages on night shift in the emergency department. Staffing data also demonstrated major concerns with the way Hunter New England LHD management was calculating midwifery staff for the maternity unit. After months of campaigning by the Association’s branch and several conciliations before the IRC, Hunter New England LHD initiated some short-term solutions to safe staffing issues at Tamworth Hospital, but the NSWNMA branch is still fighting for long-term resolutions.
Unsustainable overtime and bed block at new regional hospitals and record increases in emergency department presentations to our public hospitals have been well demonstrated.
There is a similar story at Wagga Wagga Rural Referral Hospital, with severely overworked nurses reaching breaking point this year. Despite warnings from the Association to the LHD that funding was inadequate
In the first quarter of 2016, NSW emergency department presentations grew at a record rate of four per cent. Promises of additional funding for specialist nurses
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to staff the new hospital, unfunded or ‘surge’ beds have been staffed exclusively by nurses on overtime since the hospital opened in January. Issues at Bega and Dubbo hit a similar note however staffing issues at Bega were resolved prior to it opening in March but the understaffing issues at Dubbo Base Hospital resulted in the branch taking industrial action in May. Negotiations are still ongoing to resolve the issue. Skill mix issues came to a head at Hornsby Ku-Ring-Gai Hospital’s Mental Health Unit when in an unprecedented move for Australia’s health sector, the hospital advised of its intention to introduce unregulated Assistants in Nursing (AiNs) into its unstable and unpredictable clinical environment. The Hornsby Branch held a stop work meeting in May to voice their concerns. The issue is still ongoing in the IRC and a decision yet to be made.
Both the ANMF Victorian and Queensland Nurses Union branches successfully campaigned to convince their state governments around this important evidence and we must continue to do the same. Currently ratios legislation only exists in four places: Queensland, Victoria, California and Wales.
NSW Government anti-worker laws The Baird government has continued introducing legislation after legislation that is anti-worker and draconian. Just last month the Premier introduced a regulation that terminates the redundancy entitlements of public servants who are transferred to the non-government sector. With the track record of privatisations that this government is notching up, this does not bode well for those members who are currently in transitional agreements as the regulation forces a take it or leave it
Our resolve will be severely tested next year when we again attempt to claim nurse to patient ratios to put patient safety first, but the staunch campaigning efforts of our branches reassures me that we will not retreat from our claims or our desire to emulate Victoria and Queensland in convincing the government of the day to legislate and mandate ratios.
Ratios victories in Queensland and Victoria The recent victories by our sister unions in these two Labor governed states is a testament to the fact that nurses and midwives are the legitimate voice of reason when it comes to patient safety. International evidence concludes that patient mortality rates and outcomes are directly linked to nurse numbers and the level of care each patient receives.
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Report to 2016 Annual Conference
Key Direction 3
policy that would leave many marginalised. We have been reassured by the NSW Health Minister and the Ministry of Health that the Northern Beaches arrangements, as promoted by Government in 2013, will stand but as yet no signed agreement on transfer payments or other entitlements exists with the unions.
A consultation process has begun with members utilising both The Lamp and on Nurse Uncut to stimulate thought and discussion and to provide a mechanism for feedback through both. This process appears to be working well and has generated some thoughtful commentary from members. This series will continue on a monthly basis, providing links to further reading and an overview of the relevant issues. Articles were written for the April, May, June and July editions of The Lamp and on Nurse Uncut.
The NSW anti-protest laws passed in March give police excessive new powers to stop, search and detain protesters and seize property as well as to shut down peaceful protests that obstruct traffic. They expand the offence of “interfering” with a mine, which carries a penalty of up to seven years’ jail, to cover coal seam gas exploration and extraction sites.
Feedback from members will be used to inform the development of our position on health policy matters. We are in the development phase of preparing a Discussion Paper for circulation.
This severely limits our ability to campaign around the issues that we are concerned about. While the Association has never set out to break the law, laws like this form an alarming trend by governments nationally in eroding some of the vital foundations of our democracy, from protest rights to press freedom. Entrenching their own power and that of vested business interests.
An outline and timeline has been developed to construct a Reconciliation Action Plan (RAP), which will demonstrate our commitment to Aboriginal and Torres Strait Islander issues and in turn assist in closing the gap in health.
Key Direction 4 The KDLT 4 team has developed a number of projects aimed toward the achievement of the strategies within the Key Direction.
Progress on the Strategic Plan
The first exciting project is a Communications Review covering both internal and external communications. The review commenced in mid-May, and is assessing what current communication methods and mediums are used, their effectiveness against organisational priorities, the skill level of staff and resourcing. Interviews with a selection of staff have been undertaken. Further interviews and group discussion will be held post-Annual Conference, desk research is ongoing and a report due for completion by the end of July.
The strategic plan, launched at the 2015 Annual Conference, steps out the NSWNMA’s vision and values and the key directions it will follow. To implement the Plan, five internal groups have been formed, comprising relevant staff from across the Association, to develop, work on and implement the strategies related to each Key Direction.
Key Direction 1 The KDLT 1 group has developed a definition of our goal for member leader development that explains the Strategic Plan goal in more detail. This definition is currently being discussed by Association staff and will form the catalyst for deeply reviewing member leader development and education, and the structural and cultural change required to achieve this goal. The current development level of Branches has been audited to provide a benchmark for the five year plan.
Another project underway is the mapping of external key stakeholders with the aim to develop partnerships with organisations to identify their key goals and values to enable the NSWNMA to strengthen or forge new partnerships. Further work is being developed in ensuring our messaging and promotional materials represent the membership of the NSWNMA in terms of culture and gender.
Key Direction 5 KDLT 5 has examined preliminary concepts for a values program to be run in the Association to ensure a common understanding of our values, identify behaviours demonstrating those values in action and thus strengthen the Association.
A second project has commenced to identify technological requirements for an organising IT platform.
Key Direction 2 KDLT 2 has undertaken preliminary work to audit current issues mapping tools used by the Association office to record and identify trends, and the staffing arrangement/ workload clauses achieved in NSWNMA Enterprise Agreements. Analysis of this information will now occur.
A priority for the second half of the year, however, is to conduct an internal resource survey to form the basis of the assessment for future requirements when other KDLT projects come online.
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Organising for Strength
P
leasingly our Union continues to grow in num bers and that ensures that we are heading in the right direction to achieve the capacity we need to influence decision makers as we advocate for those in our care. We are well into the second term of the state Liberal government and that fact continues to provide a number of barriers to any constructive discussion about safe staffing and other important issues facing our members.
Community Organising The last two years have really shown how well this Union orga nises in the community. The RN24/7 campaign has really shone a light on the aged care sector and the requirement to retain an RN 24/7 in all facilities where there are high care patients. A number of activities were con ducted over time to ensure the entire community was aware of the change to NSW legislation. Despite an Upper House inquiry producing un animous recommendations including the retention of the status quo, the current Baird state government saw fit to completely ignore the wishes of the community and refer to the Federal arena. The work done to achieve such com munity engagement has been out standing and I wish to cong ratulate all those involved especially the aged care acti vists who have participated in this campaign to a level I have not witnessed before.
Report to 2016 Annual Conference Judith Kiejda, Assistant General Secretary
As this government continues to make decisions that are not in the public interest – RNs 24/7, Council mergers, removal of prison teachers from the Corrections system being some of the most note worthy, we are seeing the community start to have their say and at last the real Mr Baird and his government are starting to tarnish. It has been most gratifying to watch the politicisation of our membership – by that I mean nurses and midwives now understand that as professions responsible to the Acts that govern their practice, they must advocate for those in their care and that goes to a number of things including resources. Many of our members have long believed nurses and midwives should remain apolitical however they now understand that to do the best by their patients they need to ensure the decision makers – be they at workplace or government level – understand the importance of issues as they relate to the community around health issues.
This campaign is not over. We will build on the momentum gained so far and fight on to protect those frail and aged many of whom would have fought for the working conditions and lifestyles we now enjoy. As we get deeper into the implementation of our strategic plan we will build on the increased level of activism now evident in our membership.
Campaigning to enforce our entitlements The last 12 months has seen a significant increase in the number of safe staffing disputes – particularly in the regional areas of the state. Much of the disputation arose from the building or significant enhancement of new Regional Referral Hospitals across the state – all with increased footprints and some increase in bed numbers without the commensurate staffing put in place. NSWNMA branches at Tamworth, Byron Bay/Mullumbimby, Bega, Wagga Wagga, Dubbo and John Hunter Hospitals in particular are to be congratulated on their commitment to safe staffing along with many other branches who have had safe staffing issues as well.
In spite of increasing safe staffing issues it has been really encouraging to see increasing numbers of members offering to assist in activities such as MP visits, callouts to other members, doorknocking, turnout at rallies and many others. While we are all busy with our professional and personal lives we must stay attuned to the issues affecting us and our families and stand up to be counted when required. Remember – the world is run by those who show up.
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Report to 2016 Annual Conference
Clearly one has only to look at these new or enhanced facilities to see that the previous staffing was not going to be adequate. I was continually amazed at the lack of understanding by management at these facilities – not only expected static staffing establishments to provide a quality service but some of those facilities carrying significant staffing vacancies as well.
governments to bring down our health system. In this state we are seeing cuts to mental health, palliative care and other services which have already happened by the time we get to know about them. We have tried to work with the other countries on work place safety and the professional standards of nursing in an attempt to achieve professional consistency however the language barrier has made this exercise very difficult. The next annual meeting is due to be held in September.
It concerns me that there are constant attempts to restructure. Nursing structures and classifications are under attack relentlessly. It seems to me there is a real belief by management that they see some Nurse Manager and senior clinical positions like CNCs, CMCs, CNS2s, CMSs, Nurse/Midwifery Educators and CN/ ME positions as ‘nice to have but not essential’. There is still no clear understanding that these essential support positions is what makes the professions able to deliver safe patient care. The attempt at deleting such positions is nothing more than engineering savings. We must be strong and stand up for these positions – they are essential for the credibility of the professions.
Public Services International (PSI) NSWNMA has been affiliated to PSI, a Global Union Federation (GUF), for a number of years now and is really coming into its own in the organisation. Earlier this year, Lead Organiser Michael Whaites was appointed the Sub Regional Secretary of PSI for the Oceania region which includes New Zealand and the South Pacific Islands. Since Michael has assumed this role there has been a higher focus and a more invested attitude by the Australian affiliates and that is starting to produce results.
The solidarity at the facilities experiencing these difficulties is edifying and I look forward to building on this capacity to make a difference moving forward. As Bernie Sanders said in the current US election campaign ‘when people stand together they win.’
There are so many issues that are facing us as nurses and midwives on a daily basis that have their genesis in global trends. An example, the issue of inadequate and unsafe staffing and a lack of funding for health and aged care in contrast to the trillions of dollars lost in the amoral tax avoidance carried out by big business. Or, the increasing deregulation and deskilling of our profession
Global Nurses United This coalition of international nursing unions is functioning well and continues to work towards its four core objectives:
• Nurse:patient ratios in all care settings • Universal healthcare as a right for all • Appropriate funding for healthcare via •
tax reform Resist privatisation of public health systems and services.
The 14 countries met last September to report on the health situation in each country and unfortunately the news is not good. There is a global push to dismantle public health systems. In countries like Canada and Australia where health systems are treasured by the citizens there is pushback from the communities to every attempt made by
15
Locally we continue to work with PSI and AFTINET in highlighting the health impacts of the numerous free trade agreements and with the Tax Justice Network on the issues of tax avoidance.
and the international free trade agreements that our politicians are signing us up to that force deregulation. Or, the growing trend to privatise our public services, including health, education and electricity to name a few.
Importantly the NSWNMA is joining with other PSI affiliates in Australia (CPSU, CPSU-SPSF, ETU and ASU) to mount a joint national campaign against the privatisation of public services. This campaign, the details of which will be announced later, will challenge the Turnbull Government’s drive to privatise all human services as flagged by an upcoming productivity commission inquiry into competition within health, education and social services. The unity of public sector unions, working together through PSI, means we can save our services and help build a better future for our communities.
This last year has seen many of these global issues in the headlines, through the China FTA, the Transpacific Partnership (TPP) and the exposure of off shore shelf companies that facilitate tax avoidance, it is clear that the effects of living in a global economy can often lead to bad outcomes for us as a profes sion, and for the communities we live in. But it does not have to be this way and through our affiliation to PSI we continue to work with like minded unions and community organisations. Over the last twelve months the NSWNMA has attended a health sector meeting in Manila which allowed us to share our experiences in campaigning, and to hear from others about their experiences. As the Asia Pacific Health and Social Services coordinator for PSI we continue to publish a newsletter bringing together the stories from issues and campaigns within the region.
Australian Council of Trade Unions (ACTU) With the federal election now behind us, the national peak union body – ACTU – to which we are affiliated will continue to build on the momentum gained leading up to the election. The Build a Better Future campaign is a
16
Report to 2016 Annual Conference
exist in order to bring issues of local importance to the forefront. They get very active at election time, however in between they maintain their momentum by being involved in important local issues.
The Lamp Our monthly communication to every member seeks to inform every member on all the important issues facing our Union. I believe we provide an excellent magazine that is modern and extremely informative. While I understand members have busy lives I would encourage all members to make sure they look at it when it arrives to ensure they are being correctly and well informed. When you are finished drop it in the tea room for others who may not be members to read and maybe they will be encouraged to join. campaign that was always intended to be ongoing with election campaigns along the way but not the total focus of the overall campaign. The campaign is about returning Australian society to one that is not so individualistic and which fosters collectivism as we strive to ensure more equity and fairness to our society.
Conclusion What a year we have just concluded! I am always humbled by my continued occupation of the Assistant General Secretary position in your Union and every year I foolishly think it might just be a bit easier. However every year we seem to be thrown more and varied challenges with the membership that the paid staff never ever shirk. This last year has made me so proud of the increased involvement of our membership in all issues of concern to our diverse membership. The sheer tenacity of our membership re gardless of their sector or in which campaign they have personally invested, we have proven that we continue to be a force to be reckoned with.
Governments of all persuasions need to know that workers and their families in this country will not stand for the continuing pandering to the ‘big end’ of town at the expense of the rest. It is about making sure people understand the value of unions and the power they have when united. I am a Vice President on the Council and feel privileged to be able to advocate for nurses and midwives at such a peak level. We retain our direct affiliation with the ACTU, but combined with the Australian Nursing and Midwifery Federation, we are the largest union in the ACTU with a membership just over 250,000. If we harnessed all that power there is nothing nurses and midwives collectively could not achieve.
Can I personally thank every member for their commitment; can I personally thank our paid staff for their energy and passion in executing all our campaigns, professional and industrial matters as well as those in the ‘engine room’ of our office that keep the business side of things ticking over. And finally, can I ask you all to be upstanding in thanking our General Secretary, Brett Holmes, for another year of exemplary leadership of our union which is now a very large component of Australia’s largest union.
Unions NSW As the peak body of the NSW union movement, Unions NSW faced its term elections early this year and a new Secretary, Mark Morey was elected, and I was elected President for the next 4 years.
Judith Kiejda Assistant General Secretary
It is a privilege for our union to occupy the Presidency role and I look forward to working with all the affiliates to make the organisation a thriving and innovative leader in the union movement. There are many Local Union Community Councils (LUCCs) – a Unions NSW initiative a number of years ago – which has grown and I invite members to get involved where they
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Key Direction 1
Grow our capacity to influence
I
n order to win better outcomes for our members, the NSWNMA must grow our influence. Influence comes when NSWNMA members and member leaders have the ability to use their collective power to enforce rights and achieve new outcomes in their workplaces, their sector and within the health system. We define the health system as inclusive of everywhere our members work.
STRATEGIES 1.1
Grow power and influence by increasing the number of NSWNMA members
1.2
Identify new member leaders who can build their workplace influence
1.3
Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
1.4
Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems
1.5
Ensure a focus on retaining as many members as possible
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Key Direction 1
2016 Federal Election The NSWNMA raised community awareness through candidate forums, street theatre actions and street stalls. All candidates and sitting members in the targeted electorates were invited to meet with nurses and midwives to hear about their issues. Members actively participated in community, media and candidate engagement activities, as well as union-driven activities such as doorknocking and phone banking. The NSWNMA also produced talking points for MP and candidate visits.
NSWNMA Campaign Key Direction 1 Strategy 1.1: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems At the May 2016 Committee of Delegates (CoD) meeting, the NSWNMA conducted Action a member-focused launch of its federal election campaign – a valuable opportunity to engage with the 55 new delegates who were attending CoD for the first time. More than 100 delegates registered for the election forum and 71 branches signed Association pledges, while 65 delegates indicated their desire to actively participate in the campaign.
Outcome
The four main issues identified for cam paigning were:
• Restore $57 billion in health funding cuts
• Support our Medicare system
• Protect penalty rates • Commit to registered nurses 24/7 in aged care
More than 10,000 members in 12 targeted electorates were contacted via email, robocalls or one-on-one conversations to discern the issues of most importance to them, not only in health but also broader issues such as education, workers’ rights and a fair tax and retirement system.
Campaigning across 12 marginal seats resulted in 23 senators, candidates and MPs signing the pledge to address each of our issues.
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Penalty rates campaign Save our Weekend
Facebook Outcome
Since 2015, the NSWNMA has been campaigning around the protection of penalty rates following the Abbott/Turnbull government decision to commission a Productivity Commission Inquiry that recommended reducing Sunday penalty rates. The NSWNMA has been involved in the Save Our Weekend campaign with unions that represent members in the retail and hospitality sectors particularly on the Central Coast of NSW. The Association has also worked closely with the ANMF on producing research with the McKell Institute that highlights the devastating impact of reducing the penalty rates of nurses, midwives and carers and the local economies where they live and work.
•
Christmas penalty rates video – 1,194 likes and 43,449 views.
• Easter penalty rates video – 342 likes and 18,413 views; Easter Memes x 2 – 699 likes and 432 likes. • General penalty rate material generated over 5,000 likes. Research
• The
research has provided a strong argument for the retention of penalty rates for use in current and future campaigns.
Key Direction 3 Strategy 3.4: Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care The penalty rates campaign was focussed specifically around public holidays to Action highlight employees who work unsociable hours for the public. The Association produced various digital materials such as photos, graphics and videos that were promoted extensively across all of the NSWNMA channels. Similarly, the Association also supported and promoted the ANMF, ACTU and other unions’ campaigns.
20
Key Direction 1
NSW Health
Code of Conduct The Ministry of Health released a revised Code of Conduct without consultation.
Inaccurate ADO Accruals A dispute arose with the Ministry of Health and NSW HealthShare on the allocation of ADOs to nurses and midwives working in the NSW public health system.
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
In September 2015, the Ministry of Health released a new version of the NSW Health Action Code of Conduct (Code) – policy directive PD2015_035. Disappointingly, this revised version of the Code, issued without prior consultation, contained changes that went beyond that which could reasonably be described as updating or clarifying. For example, a new provision was contained at Section 4.4.3, that introduced a prohibition in relation to industrial activities and campaigns. This created ambiguity and uncertainty as to its practical application, as well as being in part at odds with award provisions and the Leave Matters Manual as it pertained to trade union activities.
Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups In the latter part of 2014, a number of members were notified by their LHDs that they had Action negative ADO balances. After preliminary investigation that revealed some clear anomalies, the Association lodged a dispute with the IRC. While not resolving the matter in the first instance, the IRC recommended that ADOs should be provided to members as and when due, pending further discussions between the parties.
Following vigorous representations from Outcome the Association and other public health unions, the Ministry consultation resolved the concerns identified. As a result, a further revised Code was issued by the Ministry – PD2015_049 – superseding the previous contentious policy directive.
The Ministry and HealthShare eventually conceded that StaffLink software contained flaws, namely: 1. the extra annual leave provided to shift workers was not included when calculating ADO entitlements, and 2. the 19-shift counter built into StaffLink did not adequately manage the calculation of ADOs for staff working a combination of shifts.
Non-Emergency Patient Transport Transition to HealthShare of nursing staff working in Local Health District (LHD) Non-Emergency Patient Transport (NEPT) services.
• The
software was re-configured with the Outcome subsequent recalculation occurring on 5 November 2015 to address the issue of ADO accumulation on additional annual leave. This process led to a total of 21,199 ADOs credited to nurses and midwives across the state.
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members Strategy 1.2: Identify new member leaders who can build their workplace influence
• It
was agreed that if this process results in an accumulation of ADOs greater than three (precluded by the award), management will work with members to ensure utilisation of these additional ADOs by the end of June 2016.
Strategy 1.5: Ensure a focus on retaining as many members as possible On 10 February 2016, the Ministry of Health commenced consultation on a proposal Action that all nursing staff involved in providing NEPT services at LHDs in the Hunter/ New England, Sydney and Wollongong basins would unilaterally transition their employment to HealthShare and work directly under the state-wide NEPT service. A similar announcement was made in October 2015 regarding patient transport officers and drivers.
• Unfortunately,
no resolution has been reached on the 19-shift counter anomaly for those working a combination of shifts. The Ministry and HealthShare, while conceding there is a problem, have been reluctant to reconfigure the system to correctly ensure award entitlements are met. Consultation is continuing, although it was expected that this may take some time to reach an orderly conclusion.
21
A Union Specific Consultation Committee (USCC) process was commenced and progress has been made on a number of concerns, sufficient to enable transition during July 2016 within an agreed framework.
number of countries, notably those from India and the Philippines who may have been practising as a registered nurse in their respective countries for many years. It also generated unfair inconsistencies for nurses and midwives working side by side.
•
The establishment of a specific clinical Outcome and professional structure for nurses within HealthShare NEPT Services, led by a Nurse Manager Grade 6.
•
In the first instance, the Association was successful in ensuring that attempts Outcome by LHDs/Networks to retrospectively apply this new approach were resisted and/or reversed.
• A transition process that permits an election by nursing
staff to transition to HealthShare or alternatively remain in the LHD (in a non-NEPT position); the mandatory use of a functional assessment as part of that election was withdrawn by the Ministry.
• After a long and resolute battle, the Ministry conceded
that where an overseas-trained nurse or midwife is only required by AHPRA to successfully complete a bridging or assessment program to become registered in Australia, the overseas service will be recognised for salary purposes.
• Nursing
staff who transition will continue to be considered internal applicants within their former LHD to facilitate, for a period of two years, transition back to the NSW Health Service.
NSW Government
• The introduction of
a paid meal break provision for NEPT services, in lieu of existing award entitlements, will be introduced within an agreed framework and review process established by the Association and HealthShare/Ministry.
NSW Department of Family and Community Services Consultation Forum for Privatisation of Specialist Disability Services The NSW Government is preparing to privatise specialist disability services across the state.
• Staff will transition on the basis of their existing contract
hours with the LHD. Current roster arrangements will prevail, along with current work locations, and any changes will only occur after appropriate consultation.
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible Key Direction 2 Strategy 2.2: Ensure that advocacy and bargaining aligns with our growing capacity to influence
Recognition of overseas qualifications/ service for salary purposes The NSW Ministry of Health varied its previous practice of recognition of overseas service for the purposes of salary under the award.
Action
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
Clients and employees will be transferred to group homes in the community which will be operated by non-government organisations (NGOs). Disability staff will
In late 2014, the Ministry of Health adopted the position that overseas qualified nurses Action and midwives, who were required by AHPRA to undertake a bridging course to obtain registration, would not have their overseas service recognised for salary purposes under the award. This was despite the fact that the bridging course introduced in 2014 by AHPRA was no different from the previous assessment program (which was not considered by the Ministry as a barrier to having such service recognised). This new directive disadvantaged members from a
22
Key Direction 1
have their employment forcibly transferred to the private sector under the provisions of the National Disability Insurance Scheme (NSW Enabling) Act 2013 (Act). The Association has on several occasions conveyed to the NSW Department of Family and Community Services (Department) its disappointment and concern with the lack of consultation in relation to important decisions in this process.
discuss its claims. The Department emphasised that disability employees will not be offered a complete choice because they must be transferred to the NGO sector to ensure continuity of service.
Local Health Districts Hunter New England Local Health District John Hunter Hospital
The Association recently requested the Department to establish a consultative forum otherwise the Association would take the matter to the IRC of NSW. The Department agreed to the request and the first meeting of the forum was held on 17 May 2016.
Nurses in the ED became concerned with an unsafe workload generated by scope of practice issues. This was due to an increasingly junior nursing cohort that lacked the skills to effectively practise in this environment. The matter was compounded by the ED not having a CNE to train and precept the 174 FTE ED nursing staff.
• The Department provided information on
the anticipated stages of the transfer process. It is expected that the first NGOs could be selected by the end of 2016 following an EOI and tender process. Transfer of employees to the private sector could be staged, depending on the selection and readiness of NGOs.
Outcome
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members Strategy 1.2: Identify new member leaders who can build their workplace influence A planning day was organised for member activists and ED nurses to map the Action workload issues and potential resolutions. Through this process members realised that many issues were being compounded by the lack of education being offered to new and junior staff. Member activists were introduced to the Reasonable Workload Committee (RWC) process and training was provided to key activists on how to conduct a data collection to effectively demonstrate workload issues. Member activists developed a workloads data collection tool and conducted staff training sessions on how to use the tool and the importance of completing the data entries on each shift.
• The
Department indicated that it is unlikely any nursing staff will transfer before April 2017.
• The Association continues to make a number of claims
including choice for members (transfer to an NGO, transfer to the public health system or voluntary redundancy); an increase to the transfer payment (currently a maximum of eight weeks’ pay depending on length of service), and maintenance of public sector redundancy provisions.
• The Department indicated that these requests would
be declined but they will be referred to NSW Industrial Relations (NSW Treasury). The Association is seeking to meet with NSW Industrial Relations to further
23
Key member activists discussed the workload issues with management and explained how they would achieve their goal of a CNE for the department. A data collection was commenced by ED nurses.
members’ concerns. To counter this, the branch planned to demonstrate their strength by holding a rally to highlight the potential risks to patient safety should management not meet their demands.
During the data collection, management informed staff that they would recruit 1.0 FTE CNE for the ED.
Member activists sought to build their influence with a delegation visiting their local NSW Member of Parliament, the Hon Jenny Aitchison, who made a commitment to stand with the members at any planned rally or action.
Outcome
Members on the affected wards developed a data collection tool illustrating the safety issues. This data was later compiled into a report that argued staffing levels could not be reduced as this would compound current safety issues.
• A USCC was held to discuss the issues; the Outcome
NUM2 role in HDU was retained and an additional 1.0 FTE CNE was won for the unit.
• The management of the MAU was absorbed into the Medical Ward with the NUM regraded from a NUM2 to a NUM3; a 0.2 FTE CNE was allocated to the MAU; a nursing team leader was allocated on the MAU on all shifts to guarantee clinical leadership on the floor. • The NUM2 of the MAU took over the vacant role of NUM on the Surgical Ward.
Maitland Hospital
Scott Memorial Hospital
Local management proposed a restructure where the 2.0 FTE NUM positions across the Medical Assessment Unit (MAU) and the High Dependency Unit (HDU) would be collapsed into two NUMs providing 0.5 FTE of coverage in a job share capacity. This staffing reduction concerned members who anticipated significant safety risks as the NUMs provided substantial clinical support for staff on a daily basis.
Members became concerned about an unsafe workload generated by the need for the recovery nurse to leave the ward to collect patients from theatres. There was only one nurse allocated to these patients during shifts when endoscopies were being performed in theatres, leaving patients on the ward without any nursing supervision for up to 45 minutes at a time.
Key Direction 1 Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members and to use their influence
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
Strategy 1.4: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems
Strategy 1.2: Identify new member leaders who can build their workplace influence
The branch resolved to demand that the status quo be maintained by management Action until members conducted a data collection to demonstrate the validity of their safety concerns. Moreover, members called on management to consult appropriately with staff on this issue through the formation of a USCC.
Action
Outcome
Members were concerned that management would push through this change without respect for the branch
24
A branch meeting committed to forming an RWC and training was provided for the committee members. The subsequent com mittee meeting made recommendations to the DoNM that additional nursing coverage be provided in recovery on theatre days. An AiN was allocated to the ward to main tain some form of nursing observation on all shifts when endoscopies were occurring.
Key Direction 1
Singleton District Hospital Branch members were concerned about an unreasonable workload as a result of a NUM covering a combined surgical and maternity service. Key Direction 1 Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members and to use their influence Strategy 1.4: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems The branch resolved to secure a separate NUM for each service with clinical experience Action in the speciality under their supervision. Branch members working on the combined surgical and midwifery ward approached their NUM and developed a business case to escalate to the Service Manager at the hospital; the business case was further developed with the Service Manager prior to submission to the DoNM.
Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Combined strategies were implemented by the Association and the Tamworth Hospital Action branch from July 2015. Initially the branch took industrial action, forcing the HNELHD to bring the matter before the IRC.
The DoNM agreed with the issues raised by the branch members and the recom Outcome mendations provided. As a result, separate NUM positions were recruited for both the surgical and maternity services.
Outcome
•
HNELHD agreed that the triage and resuscitation nurse roles must remain separate and staffed accordingly.
• Additional staffing was provided to the ED on all shifts.
Tamworth Rural Referral Hospital
This staffing was sourced from the Emergency Short Stay Unit (ESSU), which at the time was not at full capacity.
Dispute: Emergency Department – staffing
HNELHD combined the triage and resuscitation nurse roles on night duty in contravention of the award. Staffing was also inadequate on the night shift resulting in workload issues and compromising safe patient care. These problems were then exacerbated by the move to a new and much larger department space.
• Escalation procedures will be utilised when the ESSU is at capacity or close to capacity and additional resources are required to meet demand in the ED.
Dispute: Maternity Department – staffing
Members considered that the level of staffing in the Maternity Department was not compliant with the award and the Birthrate Plus tool, generating unreasonable workloads and consequent risks to the provision of safe patient care. These issues were exacerbated by a move to a new department space with a much larger, compartmentalised layout. The layout also created isolation and security issues.
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups
25
Initially the branch took industrial action, forcing the HNELHD to bring the matter Action before the IRC. A highly visible public campaign was undertaken that included a community forum and lobbying the local MP.
representatives, and failing to participate in IRC proceedings with a genuine desire to resolve these issues, the LHD unnecessarily delayed these outcomes and the benefits they accrued to patients.
Mid North Coast Local Health District Dispute: Pre-employment health assessments
Ultimately, this combined pressure led to a breakthrough when the local MP intervened with the sanction of the Minister for Health, the Hon Jillian Skinner. This led to the HNELHD and its Chief Executive scrambling to reclaim the initiative. While continuing its attempts to marginalise the role of the Association by refusing to engage with its officials, the Chief Executive finally announced measures to address the problems identified by members.
The MNCLHD introduced pre-employment health asses sments of preferred applicants 45 years and over in its recruitment processes. This included existing nurses and midwives seeking alternate positions within the MNCLHD. Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
• HNELHD ceased rostering ENs on night
Outcome
duty, remedying one of the primary skill mix concerns.
The Association made a number of representations to the MNCLHD prior to Action and following the 2015 Annual Conference; representations were also made to the Ministry of Health. These efforts led to modifications to the original Health Check framework introduced by the MNCLHD.
• Permanent additional staffing of one midwife
for ten hours on each night shift for seven days per week was rostered. This staffing has been sourced, at least in part, from the Midwifery Group Practice.
• This action was promoted by the Ministry of Health
who conceded that at the origins of the dispute, and as claimed by the Association, the HNELHD was under its required Birthrate Plus staffing level.
• All
successful external (outside the Outcome MNCLHD) applicants will now be subject to health checks, regardless of age or health triggers.
• Models
of care and skill mix in the Maternity Department would be reviewed.
• In relation to internal applicants (existing employees
of the MNCLHD), only those progressing to a new position that has a higher job intensity will be required to undertake a health assessment (regardless of age or health triggers). Internal applicants taking up jobs of equal or lower intensity will not be required to undertake a health check.
• Regrettably these outcomes could have been reached much earlier in this dispute and, in fact, closely reflect earlier observations and recommendations made by Deputy President Harrison in IRC proceedings. By refusing to speak with staff and their legitimate
26
Key Direction 1
• The Association continues to make further represen
• The
IRC recommended that the branch cease the planned stop-work action and the NSLHD cease all plans to introduce AiNs into the MHICU. The branch made the decision to show their solidarity and held a rally and branch meeting in their own time.
tations that internal applicants should be internal to the NSW Health Service (rather than a particular LHD) and therefore external should be outside the NSW Health Service. Consistent position descriptions and job demand checklists are also being sought.
• However, the progression of the branch meeting, that
had the appearance of a protest, was the subject of three further appearances before the IRC on 26 and 27 May 2016. The President of the IRC expressed significant concern that the eventual nature of the branch meeting conducted was not made known to him at the initial appearance on 24 May 2016. The Association apologised for any unintended disrespect caused by any omission and not being able to identify more accurately the events that unfolded.
Northern Sydney Local Health District Hornsby Ku-Ring-Gai Hospital The NSLHD Mental Health Drug and Alcohol Services current workforce profile has a ratio of 70% RNs, 20% ENs and 10% AiNs. LHD management has proposed extending this nursing profile to the Mental Health Intensive Care Unit (MHICU) at Hornsby Ku-Ring-Gai Hospital. Key Direction 1 Strategy 1.2: Identify new member leaders who can build their workplace influence
• In the shadow of these IRC appearances, the Association
and the NSLHD arrived at a framework to permit consultation, a framework that continues to acknowledge the opposition of the branch and the Association to the use of AiNs in such a clinical environment.
Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members and to use their influence
• The initial recommendations made by the IRC remain
Extraordinary branch meetings held on 18, 22 and 23 May 2016 were attended by a Action wide cross-section of nurses from varying specialties. Comprehensive updates on the proposal were presented to the branch, including correspondence from the NSLHD to the branch, and details of discussions between the Association and the branch regarding options to progress the issue.
in place while consultation occurs.
South Eastern Sydney Local Health District Voluntary Redundancy Program and Disaggregation of Services The SESLHD has implemented a voluntary redundancy program with the aim of deleting 50 positions, mainly Health Services Union (HSU) roles and those deemed not to be “patient-facing”. This restructure also sought to separate several services shared by St George and Sutherland Hospitals. The disaggregation has been largely executed, however NSWNMA members opposed the deletion of the NUM1 of the 4 West Dialysis
• Members resisted the proposal because of safety concerns for staff, patients and the public.
Outcome
• A stop-work meeting was called for 24 May 2016 with the NSLHD responding by filing a dispute in the IRC to prevent the action. 27
unit at St George Hospital because of the clinical nature of this position and the increasing demands on the service.
the branch executive and ongoing educational forums have been developed by the Association to engage with members and non-members. Recruitment opportunities are a focus at these forums and educational opportunities on enforcement of award provisions is a priority.
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members Strategy 1.2: Identify new member leaders who can build their workplace influence
• Outcome
Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
• Recruitment to vacancies and staff/patient safety have been brought to light through the collective action of the membership. These issues are being addressed by local management.
Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care Several branch meetings were held with increased attendance at each meeting as Action identified activists were asked to encourage colleagues to attend. Multiple resolutions were passed at branch meetings to influence decision makers and increase pressure at the site. Activists have developed skills to lead their colleagues to take action in the workplace.
Outcome
The status quo remains as a result of membership opposition to the proposed changes.
South Western Sydney Local Health District Campbelltown Hospital Members have been experiencing ongoing staffing issues within the operating theatre complex that is using overtime on a regular basis, with staff being forced to remain after their shift to finish theatre lists. Compounding these issues is the lack of support staff, such as cleaners and ward orderlies. Key Direction 1 Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
The proposed deletion of the NUM1 has been delayed and a review of a new model of care is under way.
Prince of Wales Mental Health Services
Action
The SESLHD sought to restructure the Mental Health Service, and the Kiloh Observation Ward, in order to reduce the number of wardspersons based in the unit. Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
Members organised a series of consultation meetings to seek a resolution. The branch met with management on a regular basis to review the daily staffing and theatre list while recruitment was occurring.
Following consultation, the branch succeeded in securing a commitment to 5.4 FTE nursing staff to fill vacancies and increase staffing, including additional anaesthetics staff, a Nurse Educator, an Equipment Officer and a NUM for the Short Stay Unit. Additional cleaning positions were also achieved. Outcome
Strategy 1.2: Identify new member leaders who can build their workplace influence Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
Fairfield Hospital Branch members identified approximately 11.0 FTE midwife vacancies in the Maternity Unit, in breach of the Birthrate Plus staffing arrangements. They also identified an unsafe skill mix and work practice in the Maternity Unit, and unreasonable workloads for the midwives.
Branch members carried resolutions escalating the need for safe patient care Action and rejecting the restructure that seeks to remove a number of wardspersons from the unit. Branch meetings have been consistently well attended with strong support from nurses across several mental health specialties and geographically distant units. Two new activists were identified outside
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
28
Key Direction 1
Strategy 1.5: Ensure a focus on retaining as many members as possible
The branch endorsed a resolution requesting information on current staffing levels and Action strategies to improve safe staffing and patient care. Two meetings were called, with approximately 27 members attending the first and more than 40 members attending the second.
Given that the construction of the new car park would take some time, the branch Action was eager to keep the car parking issues at RPAH in the media and to identify members who were willing to recount their difficulties with parking. A combined union rally was organised for 12 April 2016 calling on the State Government to intervene; flyers were distributed and walk arounds of the hospital occurred on two occasions, along with an SMS to all RPAH members providing details of the rally.
•
Management confirmed 9.0 FTE mid Outcome wifery vacancies (6.0 FTE permanent, 3.0 FTE temporary), with 4.0 FTE recruited and waiting to commence. Following a review of the Birthrate Plus staffing arrangement, an additional 4.0 FTE have been recruited, with 1.0 FTE CMC position and 0.5 FTE CME position being created and recruited.
• Despite the efforts of the branch and the
promised support of members, attendance numbers at the rally were disappointingly low. An email from the Chief Executive the day prior to the rally announced that a decision was imminent on a site for the permanent multi-storey car park, and that a site at White Bay had been negotiated as a temporary parking area supported by a shuttle bus to the hospital. Members did not attend the rally as they believed that an outcome had been achieved.
Outcome
• The NSWNMA and members continue to monitor the progress.
Sydney Local Health District Royal Prince Alfred Hospital (RPAH) A protracted legal battle between the SLHD and the owner of a multi-storey car park at RPAH, Macquarie Health International Clinic (MHIC), resulted in the car park being handed back to MHIC on 2 November 2015. A fee increase to $5.00 per day was immediately introduced as well as a reduction from 1,049 to 600 car spaces available to staff. Members have since been struggling to find affordable and accessible car parking.
• The
rally was reported through a diverse range of media outlets, with the negative press influencing MHIC to increase to approximately 1,000 the number of car spaces available to staff; however, fewer staff members have been using this car park.
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
• On 23 May 2016, members received one week’s notice
of a further price rise of a standard flat rate of $9.00 per exit per day, effective from 1 June 2016. Future increases have not been ruled out.
Strategy 1.2: Identify new member leaders who can build their workplace influence
• The site for the permanent multi-storey car park has re
Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
cently been announced; it will be located on a site in Lucas Street, which currently houses the Child Care Services.
29
Private Hospitals
• The SLHD will build another child care centre to be
completed within two years. Interim arrangements have been made with a private child care centre located 600 metres from RPAH; the private operator will offer child care spaces for existing children and employ all staff from Lucas Street.
Ramsay Health Care Key Direction 1 Strategy 1.2: Identify new member leaders who can build their workplace influence Strategy 1.4: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems
Western NSW Local Health District Restructure – Mental Health Services Major changes are being introduced to the structure of mental health and drug and alcohol services across the WNSWLHD, which have historically been based at the Bloomfield campus in Orange. The broad aim of the transformation is to create three hubs at Bathurst, Orange and Dubbo. Some services are being transitioned to the NGO sector although nurses will remain employees of the LHD.
North Shore Private Hospital The NSWNMA was informed Ramsay were implementing cuts to longstanding ‘outside of Enterprise Agreement’ payments at North Shore Private Hospital with effect from 1 September 2015. The allowances affected were in-charge and on-call. An additional penalty rate of 12.5% paid on 4.5 hours of a 12 hour day shift was also proposed to be removed. Under the existing arrangements, in some circumstances penalty rates that applied to full-time employees also applied to part-time employees. This arrangement was going to be removed.
Key Direction 1 Strategy 1.5: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
Around 53 members met to pass a resolution to run a community campaign to stop the Action cuts and force management to consult fairly. Members launched a community petition and the North Shore Times published a story with 15 members participating in a photo for the newspaper.
NSWNMA members are actively engaged in meetings with senior executives of the Action LHD on these service changes to mental health. Members are aiming to maximise communication between all affected parties and advocate strategies that will benefit health workers, clients and their communities.
Members also demanded meetings of all staff with management and NSWNMA representation. At these meetings management put forward a modified proposal to the cuts; to phase them out over two years from January 2016 rather than the September 2015 complete cut. The members rejected this modified proposal.
The proposed restructure documents have exposed significant service shortfalls with a number of community mental health services having no RN positions putting into question adequate medication management.
Outcome
30
Key Direction 1
MyTime payroll system inadequacies
Management responded with a further proposal to maintain existing conditions for current employees. New employees would be employed under the terms and conditions of the new Ramsay Enterprise Agreement.
Ramsay Health Care (Ramsay) has been nationally implementing a new online time and attendance system (MyTime), using Kronos software. Members are experiencing significant reductions in amenity as a result.
Members held three meetings on 25 August 2015 to vote on the new proposal.
Outcome
The actual experience of staff is a limited online system that can only be viewed on time clock tablets located on hospital walls. The time clocks do not allow staff the ability to enter or view approvals for entitlements or make hardcopy records. Members are uncertain about the accuracy of their pay and conditions such as overtime, missed meal breaks and allowances are reportedly being routinely not paid.
• Members voted to accept the revised proposal. • Increase of 34% in membership during the immediate period.
• 15 new activists identified.
• An NSWNMA Branch was formed at this site for the first time in 10 years.
Organisers gathered a list of problems, in conjunction with key activists, and planned Action a campaign of workplace resolutions calling on Ramsay to fix the problems. In the initial campaign phase 13 sites passed resolutions which the Committee of Delegates resolved to support. The current phase includes an online petition and further communications to extend the reach of the union message.
Activist education and power building
•
In June 2016, the company agreed to provide online access; ongoing campaigning is underway to seek delivery of this function and to achieve wins on the other problems experienced by members.
Outcome
• The
campaign is providing activists with improved campaigning skills and to broaden the union presence and depth of engagement within the company.
An education day was held in late 2015, specific for Ramsay activists, in order to build power post the successful Enterprise Agreement campaign.
Aged Care Allity Pty Ltd Coastal Waters Residential Aged Care Facility & Bayside Aged Care Facility
A tailored agenda was designed to equip members with skills and knowledge.
Action
• Outcome
Workplace bullying has had a negative impact on staff and the working environment at these aged care facilities at Basin View and Bonnells Bay. Allity adopted a companywide initiative to remove casuals from their roster in an effort to reduce costs. The Bayside-Bonnells Bay branch became active in response; however, because of increased workloads and associated stress, the cohesion between employees deteriorated.
21 activists from 10 Ramsay hospitals participated.
• Positive feedback from activists particularly
in relation to the launching of the MyTime timesheet campaign.
• Activists also reported the strategies provided to them
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
around the recruitment conversion were useful.
• This
exercise was a test of new education initiatives and was assessed as an excellent beginning for under standing private hospitals organising imperatives.
Strategy 1.2: Identify new member leaders who can build their workplace influence
31
Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
Both branches, with the support of the NSWNMA, developed resolutions request Action ing local management engage with Allity’s head office to review workplace behaviour. The branches also used the opportunity to collect statements from staff regarding the behaviour of management towards members.
Strategy 1.5: Ensure a focus on retaining as many members as possible Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups
Action
•
Coastal Waters: The worksite review re sulted in an increase in nursing (AiN) hours to address a problem identified with the geographical layout and isolation of certain areas within the workplace. The members decided that in future they would bring a support person to all meetings with management, regardless of the purpose of the meeting. This has been effective in reducing the feelings of segregation experienced by members during communication with management.
Outcome
The Association has been assisting members in various facilities as an appointed representative. The key issues identified to date include:
1. Bupa has claimed to employees that it has the right to change part-time employees’ rosters unilaterally following the provision of notice. The Association contests this interpretation of the enterprise agreement and is of the view that agreement is required from employees for a variation in both the number of hours worked and a change to the days or shifts worked. 2. Bupa proposes to implement a significant change to nurses’ handover with no 15-minute overlapping period for a direct handover. Instead, the morning shift RNs and ENs hand over to one registered nurse who, in turn, hands over to the afternoon shift RNs and ENs. Bupa has indicated that it has not conducted any clinical trial on this change and has commenced implementation. The Association has indicated clinical concerns with the proposal.
• Bayside-Bonnells
Bay: Management claimed the action taken by members had made them feel bullied; the staff who were removed during the blanket removal of casuals were not reinstated. The branch is developing petitions and actions to refute the claims made by the employer that staffing levels are accurate and workloads not excessive.
Bupa Aged Care Services Dispute regarding consultation of major change
The Association has commenced a dispute in the Fair Work Commission (FWC) on the change to part-time employees’ rosters, and is considering the professional issue of the handover.
Bupa Aged Care Services (Bupa) is implementing major changes across their facilities nationwide. The changes include a new model of care, amended shift times including a significant reduction in the length of the afternoon shift, changes to nurses’ handover and proposed variations to nurses’ contracts.
• Outcome
Following two appearances before the FWC, the matter will now progress to arbitration.
• As the clause relating to the rostering of
part-time employees is very similar to the nurses’ award and many aged care enterprise agreements, a decision could have broad implications throughout the industry, and nationally.
Calvary Health Care Riverina Education and Recruitment
Key Direction 1 Strategy 1.4: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems
32
Key Direction 1
Action
Following the conclusion of bargaining for a new Enterprise Bargaining Agreement (EBA), the NSWNMA was approached to educate staff on documentation.
on one or more persons or entities as set out in s63.1AA(5) of the Act, which may include not notifying the approved provider (employer).
• The Association
made representations to the Aged Care Complaints Commissioner Outcome seeking a view on whether the obligations contained in the Columbia policy were consistent with the Act.
• The education took place in May 2016 and Outcome
was well-attended by both members and non-members.
• This resulted in increased density and activism through education and direct contact with the Association.
• The
Commissioner has, in turn, passed the matter on to the Federal Department of Health (Complaints Section) to investigate further.
Columbia Holdings Confidentiality and Reporting Agreements
Opal Specialist Aged Care Engagement project
Members across all of the Columbia Holdings sites raised concerns with the introduction of a policy requiring all new and existing employees to sign a Confidentiality Agreement, which prohibits any discussions or disclosures concerning residents or employees, unless through the employer.
The collective agreement expired on 30 June 2016. A claim for mandated ratios to be included in the Enterprise Agreement was served and is the first time we have claimed mandated ratios in aged care. Key Direction 1 Strategy 1.2: Identify new member leaders who can build their workplace influence
Key Direction 1 Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence
Strategy 1.4: Grow the number of NSWNMA members actively engaged across the health, disability and aged care systems
This policy initially included a prohibition on making reports to the police; following Action a request by the Association, this was removed. The policy, however, still required any notification that was permitted under the Aged Care Act 1997 be made in the first instance to the employer or their representatives. The Association believed that this requirement appeared at odds with the right of a staff member to report, for example, an assault
Action
In developing the claim there has been extensive research through focus groups held in late 2015, facility visits and a member survey in March.
A revised plan for engagement was developed out of the independently commissioned research.
33
Outcome
• There was unprecedented member engage ment in the member survey with over 68% of our members responding.
• In addition, 112 members identified themselves through the survey as wanting to be involved in the upcoming agreement campaign. • The focus groups, face to face discussion and survey were clear and consistent in saying that better staffing and better pay were the key issues for members.
NSWNMA Member Development
State-wide introduction of Alcohol and Other Drugs policy Late in 2015, Opal advised the Association that it was commencing random drug testing in one of their facilities, following anonymous reports of drug-affected staff. Opal believed it had consulted and received approval for their Alcohol and Other Drugs (AOD) policy after initial contact with the Australian Nursing and Midwifery Federation (ANMF) Victorian Branch. Full consultation commenced after a dispute was notified, leading to a unified action across the ANMF state branches. Random testing is not supported by ANMF policy. The NSWNMA has recently been advised by members that advertising for RNs includes a requirement for pre-employment drug testing. The NSWNMA and ANMF oppose pre-employment drug testing as there is no link between residual blood results and impairment.
Branch Official and Activist Training 2015-16 Program The overall aim of the Branch Official and Activist Training (BOAT) is to provide NSWNMA members with core skills and knowledge to develop the ability to achieve improvements in their workplace. For this reason, BOAT is tailored to the Association’s particular campaign goals and is separated into specific workshops to meet these goals. As 2016 was a biennial general meeting year, there was a return of the session on Branch Essentials. Key Direction 1 Strategy 1.3: Equip NSWNMA member leaders with the skills, knowledge and confidence to lead members to use their influence Key Direction 2 Strategy 2.3: Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance
Key Direction 1 Strategy 1.2: Identify new member leaders who can build their workplace influence Branch members at the site where this matter initially arose have been fully Action engaged in collective action, with a focus on activist development. A dispute was lodged to initiate appropriate consultation and a series of meetings commenced with Opal senior management. Teleconferences were also initiated with ANMF branches when it emerged that Opal intended to implement the random testing policy nationally. Members were kept informed of discussions throughout the process.
Action
Throughout 2015 and in 2016 to date, formal member/activist education was offered through six different workshops:
2016 2015
• Branch Officials and Activist Training (BOAT) 1 • BOAT 2 • Health Care and the Economy • New Delegates Orientation • Reasonable Workload Committee training • Safe Staffing (NHPPD/Ratios) training
Broad agreement has been reached for a Outcome revised AOD policy, with Opal supporting the ANMF position of education and rehabilitation, and a return to work. Opal has proposed a caveat to permit the organisation to conduct random testing if considered justified. The matter cannot be concluded because Opal has suspended discussion, except between senior officers from the ANMF Federal Office and the Chief Executive Officer of Opal.
• Branch Essentials - BOAT 1 • Winning at work and in your
community (incorporates health care economics) – BOAT 2
• New Delegates Orientation • Reasonable Workload Committee training • Safe Staffing (NHPPD/Ratios) training
34
Key Direction 1
• As 2015 was not a biennial general meeting year, nor
NSWNMA officers developed a program to visit and liaise with nursing and midwifery Action students in universities, TAFE Colleges and other educational institutions where nursing and midwifery education is delivered. The visits were to encourage associate membership of the NSWNMA and to build relationships with academics.
was there a sustained state-wide campaign, attendance numbers were lower than in the previous year.
Course Name
Times offered
Total Attendance
(Cancelled)
(Previous year)
BOAT 1 – Branch Essentials
4 (1)
35 (110)
BOAT 2 – Winning at Work and in Your Community
4 (2)
13 (30)
Healthscope and Ramsay BOAT
2
27 (new)
Health Care and the Economy
1
21(18)
3 (1)
20 (42)
Reasonable Workload Committee Training
19
158 (59)
Safe Staffing Arrangements
0
0 (75)
Total
33 (4)
242 (347)
Last year’s total
33 (5)
New Delegates Orientation
•
Between January and June 2016, 2,250 associate members joined through site Outcome visits to universities and TAFE Colleges. A further 250 joined online during the same period, resulting in a total of 2,500 associate members joining in the first six months of 2016.
• Currently 6,284
nursing and midwifery students are associate members of the NSWNMA.
• During
the past few years the professional relation ships with many Universities and TAFE Colleges has increased.
Transitional and New Graduate Recruitment Strategy Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members The 2016 Transitional and New Graduate Recruitment Strategy was planned and Action conducted in the early part of 2016 to recruit to the NSWNMA new graduate RNs and RMs employed in the public and private sectors.
• Participants continue to rate the courses as Strongly Agreed or Agreed in raising their confidence, know ledge and skills and in meeting their needs.
Recruitment
Recruitment has been strong with 1,618 new graduates joining on site and 323 Outcome online, totalling 1,941 recruited during the first six months.
Student Recruitment and Associate Membership Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
35
Key Direction 2
Be innovative in our advocacy and bargaining
N
ew challenges and environments require new thinking and continuous improvement of professional and industrial advocacy and bargaining. The NSWNMA will directly represent and organise members and their workplaces, as well as engage with the community and other key stakeholders, to achieve advancement in professional and industrial outcomes.
STRATEGIES 2.1
Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
2.2
Ensure that advocacy and bargaining aligns with our growing capacity to influence
2.3
Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance
2.4
Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes
2.5
Campaign to extend enforceable staffing arrangements for safe patient care into other sectors
2.6
Review NSWNMA approaches and processes for linking professional advocacy to organising and growth
2.7
Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups
36
Key Direction 2
Local Health Districts
Members notified the Association that the ISLHD was changing local rostering rules. Action Permanent full-time employees would be restricted to four requests for each roster period while part-time employees may be restricted to as little as one such request.
Hunter New England Local Health District The HNELHD sought to fill a 0.5 FTE EN vacancy at Barraba District Hospital with an AiN. Pursuant to clause 53(iv)(III) of the award, the LHD is required to progressively recruit toward a minimum of two RNs on duty in facilities of this kind during hours that the ED is open.
Further, signed waivers were being sought in relation to award matters, such as, the minimum breaks between shifts and the number of consecutive shifts that could be worked. These are said to then apply for a designated period up to 12-months.
Key Direction 2 Strategy 2.3: Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance
Action
The Association lodged a dispute in the IRC with the ISLHD regarding their actions and rollout. In relation to the waiver form, the IRC process led to modifications being required, including:
Following branch meetings and education on the award requirement, the branch carried a resolution confirming support for the recruitment of RNs to vacant positions.
1. The form is only filled in on a voluntary basis. 2. The waiver provisions are only valid for one roster period.
In August 2015 the Branch Secretary reported the positions were advertised as EN positions. The NSWNMA informed the Peel Sector General Manager of the award requirement to have two RNs on duty where there is a level 2 ED open 24 hours per day. Further, HNE Multi Purpose Services (MPS) and District Hospital branches were advised of their award staffing requirements and the need for constant vigilance to ensure safe staffing levels.
3. The waiver of these award rights can be revoked at any time prior to the next roster period. 4. The employer can only exercise this waiver on the grounds of emergency and/or service requirements and/or personal circumstances and, in all other cases, is compelled to offer a 10-hour break between shifts.
• In December 2015, management recruited to
• The
IRC allowed the modified form to be used by the ISLHD as part of a trial Outcome period ending April 2016. An audit was conducted at two hospitals (Coledale and Wollongong) with the results being positive for the Association.
the RN positions; members were concerned that the positions would be temporary contracts filled by junior RNs. The NSWNMA communicated with the Peel Sector General Manager insisting the positions be recruited as permanent positions to ensure a safe skill mix for staff and patients.
Outcome
• The ISLHD has agreed to a cap of 10 roster requests.
• On 24 December 2015 the Peel Sector General Manager confirmed that a second new graduate would be employed and become a permanent position.
• Since
these dispute proceedings commenced, other LHDs have attempted to introduce varying forms over this same issue. In those cases the Association has also notified dispute proceedings, with the view of using the IRC observations in this matter as a guide to a consistent state-wide approach.
• The Peel Sector has recruited several RNs to vacant EN positions at different MPSs over the past few months.
Illawarra Shoalhaven Local Health District Dispute regarding rostering guidelines issued
Western Sydney Local Health District Blacktown Hospital
This dispute arose with the ISLHD on the issuing of rostering guidelines.
In July 2015, staffing in the ED was found to be deficient with 10.0 vacant FTE positions (made up of 8.0 FTE RN and 2.0 FTE EN positions) as a result of WSLHD resistance to recruitment based on financial considerations. The failure of the WSLHD to actively recruit to nursing positions resulted in over 200 shifts being unable to be filled in the roster that commenced on 20 July 2015.
Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
37
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
Action
An extraordinary RWC was convened to escalate this issue to the Blacktown Hospital Action DoNM to provide a viable solution and that if no solution could be provided within 48 hours, the RWC would lodge a grievance with the LHD Executive.
The two branches at Cumberland – Western Sydney Nurse Managers Mental Health and the Cumberland Hospital – convened a combined meeting and endorsed four resolutions to escalate their safety concerns
to the DoN. The demands presented to the DoN were to close two beds in the Yaralla Unit; employ a security guard; cease the practice of sleeping acute patients in the rehabilitation cottages to avoid the midnight census; cap the patient numbers within the acute mental health units to reflect their respective bed numbers, and engage a suitably qualified company to completely review the Yaralla Unit.
•
The DoNM escalated the concerns of Outcome the RWC to the LHD Executive who in turn released funding to allow the immediate recruitment of 8.0 FTE RN positions; these positions were advertised and recruited.
NSWNMA organisers and branch officials were able to hold one-on-one conversations with potential and existing members.
• Hospital management, ED nurses and medical officers
• The
LHD agreed to close two beds in the Yaralla Unit and employ a security guard. The DoN immediately ceased the practice of sleeping acute patients in the rehabilitation cottages and advised all staff. The DoN agreed to cap the bed numbers for the acute units, but requested that the branches consider keeping the 34th bed in two of the units as emergency after-hours admission beds.
have since held discussions on how to manage future staffing issues.
Outcome
Cumberland Hospital On 13 August 2015, an Association member was seriously assaulted in the Yaralla Psychiatric Intensive Care Unit at Cumberland Hospital. Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
• The
LHD employed an independent company to review the Yaralla Unit. A discharge clinic has been opened to alleviate the over-census issues that were experienced on the wards, and WSLHD has placed the Mental Health Service as a high priority for rebuilding or redevelopment. Significant funding has been allocated to refurbish the existing Yaralla Unit.
Strategy 2.2: Ensure that advocacy and bargaining aligns with our growing capacity to influence Strategy 2.3: Ensure existing ratio systems are implemented and enforced properly through member education and member leader influence Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
Westmead Hospital
Key Direction 2 Strategy 2.6: Review NSWNMA approaches and processes for linking professional advocacy to organising and growth
Strategy 1.2: Identify new member leaders who can build their workplace influence
Work on the new multi-storey car park is expected to commence later this year. Action Many sites across the campus have been closed to staff parking as building of the new hospital at Westmead commences. Many nurses, particularly those who work Outcome the afternoon shift, find travelling to work frustrating. Car parking sites off campus have been sought and buses to transport staff are being arranged. Consultation con tinues with all unions on site.
38
Key Direction 2
Affiliated Health Organisation
The NSWNMA made an application to the Public Sector Remuneration Tribunal to Action increase rates of pay to reflect 100% of the NSW Award and subsequently conducted extensive negotiations on behalf of members.
Norfolk Island Hospital As a result of a series of parliamentary and government reports around its ongoing capacity to sustain services and standards of living for its population, Norfolk Island is the subject of reforms that saw it change from a selfgoverning territory to a local government type authority on 1 July 2016. Changes which will see Australian legislation enacted in Norfolk Island, in particular social security, Medicare, Pharmaceutical benefits and taxations measures.
Outcome
• Norfolk Island nurses’ pay and conditions
will be paid in accordance with the Public Health System Nurses’ and Midwives’ (State) Award from 1 July 2016 and a Federal Enterprise Agreement will be negotiated later in 2016.
• Staff will be paid out accrued entitlements as of June
30, so as to avoid these becoming taxable; and, new employment contracts will be offered.
Currently, Norfolk Island operates a small ‘hospital’ that provides emergency care to residents and tourists, along with 12 aged care beds and two dialysis chairs. The hospital has no accreditation for any further services such as theatres, maternity.
Aged Care Bupa Aged Care Services Preparation for Enterprise Agreement campaigning using new engagement processes to extend reach and to identify and grow the capacity of member leaders.
Nurses and midwives are currently paid 70% of the applicable rates in the Public Health System Nurses’ and Midwives’ Award (NSW Award). This has been the case since an agreement was reached with the Norfolk Island Government in 2006 because of their economic difficulties. From July 2016 residents became liable for Commonwealth tax and GST provisions, which significantly impacts livelihoods.
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
Action
39
Usual survey processes including online ‘SurveyMonkey’ techniques have been enhanced with greater strategic use of the survey process in Bupa (and similarly
The problem is widespread, and the Association and members continue to monitor enforcement of the EBA. Members are, however, continuing to complete the training in unpaid hours because of anxiety about their job security. Outcome
Kennedy Health Care Group Transfer of ownership to Estia Health Kenna Investments Pty Ltd (of the Kennedy Health Care Group) operated several aged care facilities in NSW. This company was acquired by Estia Health (Estia), who became the owner and operator, and thus the employing entity at the sites from 1 July 2016.
in Opal Aged Care) to engage a broader section of the membership and generate leads for activist identification. The survey was complemented by greater targeted use of SMS and email in conjunction with workplace visits.
Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups
• Outcome
Higher member engagement – 58% res ponse rate.
Key Direction 1 Strategy 1.1: Grow power and influence by increasing the number of NSWNMA members
• More representative and deeper data gathered through survey generation.
Strategy 1.2: Identify new member leaders who can build their workplace influence
• Future member leaders – the survey results revealed
Strategy 1.5: Ensure a focus on retaining as many members as possible
150 members as potential leads for deeper engagement; personal follow up was completed for each member.
The Association had been engaged for several months with Kennedy Health Action Care Group (KHCG) on changes to the provision of uniforms to nursing staff. This issue was overtaken by the sale to Estia with the transmission of business to occur on 1 July 2016. As a consequence, Estia sought to advance contracts of employment, to be signed by all existing staff, to take effect from that date. This was subject to a truncated period of communication and consultation, with some members claiming they had been provided only days to examine the contract’s contents, obtain advice, and then sign.
• A
number of new member leaders are conducting the claim endorsement vote in their own workplaces without hands-on organiser support; this is an improvement on previous campaigns.
Hardi Nursing Home Management Compulsory e-learning in unpaid time Members have been directed to complete online education modules, although all branches have reported that it is not possible to do so during paid hours. The employer monitors e-learning attendance and invokes disciplinary procedures for non-compliance. Inadequate sessions are rostered during work hours with members competing for scarce computer resources, completing the modules during breaks, after work or at home.
The Association in turn filed a dispute with the FWC to seek its assistance with the failure of KHCG (and by extension Estia) to properly consult with employees and the Association on the new offers of employment. The FWC directed the parties to have further discussions and isolate the issues of concern and remedies sought by the Association, while making some useful observations on aspects of the proposed Estia contracts.
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights The Association has corresponded with the employer and advised members of the Action provisions of the EBA. On-site managers have generally responded that they were unaware of the problem or that if the work was done at home, it was through individual choice.
Outcome
• At a further appearance before the FWC
on 30 May 2016, the Association was able to confirm that an agreed approach had been reached between the parties. This agreement would necessitate all staff being
40
Key Direction 2
• The NSWNMA won the legal proceedings
provided with an annexure to their new contracts of employment with Estia, that addresses the concerns raised by the Association.
Outcome
• The
Association has been encouraging members to sign the provided annexure to ensure it forms part of their employment contract after 1 July 2016.
and as a result the employer commenced bargaining; a proposed offer is now well-advanced.
• Legal
action was taken on the proviso of greater membership support; this occurred in the form of improved union density.
Mercy Health & Aged Care Group Mercy Place Albury
State Government Nursing Homes Framework Agreement Rescission of Agreement
Members identified significant workload issues because of staff vacancies and a significant breach of legislation in not maintaining a registered nurse on all shifts. Key Direction 2 Strategy 2.3: Ensure existing ratio systems are implemented and enforced properly through member education and member leader influence
Action
Members formulated a resolution that identified both short-term and long-term Action actions that would be taken if interim agency staff were not engaged, and RNs not returned to all shifts.
In late January 2016 the Ministry of Health wrote to health unions stating that they would formally rescind the 1997 State Government Nursing Homes Framework (SGNHF) Agreement with two months notice because it had “outlived its usefulness and relevance”.
There are still nurses employed at nine Outcome previously State owned aged care facilities (e.g. Calvary Retirement Community Cessnock, ex Allandale); these nurses retain their superior public health system wages and conditions, compared to colleagues in the same workplace. The cessation of the SGNHF Agreement could put these superior wages and conditions at risk.
RNs were reinstated on all shifts the day Outcome the resolution was received. Agency staff were engaged and approved while recruitment continued.
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
Moran at Little Bay Enterprise Agrement A member campaign was undertaken to achieve their first Enterprise Agreement. The employer is significant, in that they are one of the few aged care employers who has refused to bargain with their staff since the introduction of the modern Award in 2010.
Strategy 2.4: Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes The NSWNMA has advocated on behalf of members to retain the Agreement. Action The Branch at Queen Victoria Memorial Home at Picton met with their local MP. Additionally, the NSWNMA has sought legal advice and wrote to the Ministry seeking answers to a series of questions.
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights Strategy 2.7 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Members petitioned the company to begin bargaining and when they refused, the Action NSWNMA took action in the FWC to achieve a ‘majority support determination’ forcing the employer to bargain. Significant intimidation of staff occurred and the company engaged external solicitors who took a litigious approach to stop union actions.
The Ministry has replied to the Association stating that they were considering the mat Outcome ters raised; the health unions have success fully stayed the Ministry’s initial proposal.
41
The Whiddon Group – Aged Care Enterprise Agreement The Whiddon Group are a not-for-profit aged care provider with 21 facilities throughout NSW; the employer sought a one-year extension to the current Agreement to include a pay rise for 2016. Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights Strategy 2.5: Campaign to extend enforceable staffing arrangements for safe patient care into other sectors
Members were surveyed about accepting a pay rise or campaigning on a broader range of conditions for a totally renewed Agreement.
The Association conducted externallycommissioned focus groups, member Action meetings and an online survey of the whole membership to determine the key issues. As a result of intensive Organiser promotion and supporting communications, the Association received our highest ever survey return rate (60%) on the claim development membership survey, which identified three main issues for members: Fair Staffing. Fair Rosters. Fair Pay.
Members accepted the concept of a one year extension and the NSWNMA achieved a movement in the initial quantum proposed to 2%. The vote had a high turnout and staff voted 85% in favour of the proposed variation.
Members provided over 400 stories about workload problems that were used in campaigning.
Private Hospitals Healthscope Private Hospitals Enterprise Bargaining Campaign 2015
A campaigning committee was established with improved engagement compared to the previous campaign and, for the first time, three members participated as negotiators with NSWNMA officials.
A new Enterprise Agreement was approved by members at 12 hospitals in 2015. Critically, new employees (not those transferred from the Public Sector) at the new Northern Beaches Hospital (due to open December 2018) will also be covered by the proposed Agreement.
• Improved workloads clause giving greater Outcome
organising capacity to members.
•
Pay outcomes superior to public health system
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
From July 2016 Healthscope
Ramsay
Public Sector
EN*
$29.85
$29.62
$29.44
RN/M*
$42.52
$42.49
$42.21
*Thereafter/Highest level hourly rates as at July 2016. All rates rounded to nearest 2 decimal points.
• 12% total wage increase averaging 3% p.a. (additional increases for Educators).
• New
classifications for Enrolled Nurses with addi tional qualifications.
• Innovative
clauses including paid family violence leave (first in the private hospital sector bargaining)
42
Key Direction 2
•
separate to, and in addition to, first having to use personal leave for these needs; and commitment to a bully free workplace.
• 15% membership increase during campaign.
The ratios claim was unsuccessful however a step forward was made to include ‘Rostering Guidelines’ within the Agreement.
• During the campaign, the branch became aware of the
• Seven branches consolidated or formed during campaign.
deeper membership involvement needed to win ratios and the building of greater power that now needs to occur prior to the next Agreement campaign.
• First company-specific usage of the paid trade union
• Membership grew by 6% and a greater involvement of
Bathurst Private Hospital Enterprise Agreement 2015
Private Sector
• 70 activists identified.
theatre nurses was observed.
training leave in the existing Agreement.
Aspen Medical Dispute with Aspen Medical re cessation of services
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
Action
Aspen Medical has lost the contract to provide certain services to the Australian Defence Force (ADF) from 1 November 2016.
Bathurst Private Hospital management began the campaign stating that its operating costs needed to be reduced and the employer claimed reductions in entitlements.
Key Direction 2 Strategy 2.7: Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Key Direction 1 Strategy 1.5: Ensure a focus on retaining as many members as possible
•
The activist’s skills were enhanced with Outcome support from the NSWNMA and through member engagement, thwarting the emplo yer’s attempt to remove clothing allowances.
Aspen’s contract is due to expire on 31 October 2016 and management has advised Action nursing staff that their employment will be terminated at that date as there will be no transmission of business arrangements. All current staff are on fixed contracts expiring at that time. The successful contractors to the ADF are Medibank Health Solutions in Victoria and Health Care of Australia in all other states, except NSW where International SOS has been successful.
• A
successful Agreement with guaranteed pay rises and some improvement, such as a new family violence provision, were achieved.
Calvary Health Care Riverina Enterprise Agreement 2015
Key Direction 2 Strategy 2.1: Review and implement improved NSWNMA approaches and processes for collective bargaining and enforcement of rights
International SOS has requested expressions of interest from current employees regarding future employment from 1 November 2016. Unfortunately there has been no information provided on industrial conditions or rates of pay that will be payable after this date. A dispute will be lodged by the ANMF Federal Office regarding this lack of information and the potential of severance payments from Aspen Medical.
Strategy 2.5: Campaign to extend enforceable staffing arrangements for safe patient care into other sectors The critical issue for members was staffing levels. With the branch, a decision was made Action to claim nurse to patient ratios in the same terms as the current public health system ratios. This was an ambitious claim and only the second time the Association has claimed ratios in the private hospital sector.
Outcome
The ANMF Federal Office is coordinating Outcome dispute proceedings before the FWC as it is expected there will be no transmission of business proposed and, as such, all employees will be forced to seek new employment contracts with SOS.
• Pay and allowance levels are ahead of the
public health system, as are other significant conditions.
43
Key Direction 3
Promote a world class, well-funded, integrated health system
I
ncreasingly, health is becoming a defining political issue in our country and budget decisions impact on the delivery of care. The NSWNMA will be an effective advocate for delivery of quality outcomes of care in an ever-changing health system and influence policy and decision-makers to invest in prevention and universality.
STRATEGIES 3.1
Consult with NSWNMA members on their vision of an integrated health system
3.2
Identify the features of a world class, well-funded, integrated health system
3.3
Develop an education program for NSWNMA members and member leaders
3.4
Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members
3.5
Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
44
Key Direction 3
Education
• The students took part in many activities including new graduate recruitment and assisted with university visits, joining up many other students as associate members.
NSWNMA Education Program Key Direction 3 Strategy 3.3: Develop an education program for NSWNMA members and member leaders
• Students completing the program leave with a greater knowledge of trade unions and why they are important in society from an industrial, legal, professional and social justice perspective.
2016 Education Calendar The Member Education Calendar is de veloped annually and is open to members and non-members.
Action
Aged Care Nurses Forum
July 2015 to June 2016
Outcome
conducted 35 seminars 957 members attended Action
19
metropolitan seminars
The 2015 forums featured presentations Outcome on topics such as Palliative Care, Competencies in Aged Care and Dementia, Capacity and Decision Making.
16
regional seminars
Union Summer Program
Mental Health and Drug and Alcohol Nurses Forum
The aim of the program is to create an educational experience for further activism by engaging with associate members through the annual Unions NSW Union Summer Program.
Action
The 2015 forum was held on 16 October, and the 2016 forum is scheduled for 14 October, with presentations by the Aged Care Complaints Commission, Partners in Cul turally Appropriate Care and Leaders in Leading.
Action
•
The 2015 forum was held on 11 September and the 2016 forum will be held on Friday, 9 September.
The theme for the 2015 forum was: Ice: Where to from here? with presentations Outcome from numerous interested parties and agencies. The highly successful forum was attended by around 100 members.
Four nursing students took part in the three-week program designed to provide a greater understanding of how unions work and, in particular, gain insight into how the NSWNMA operates.
Outcome
45
Scholarships
For the 2016 academic year the Foundation provided 12 scholarships to assist nurses Outcome and midwives to attend conferences, short courses and degrees leading to the attainment of formal qualifications.
Key Direction 3 Strategy 3.3: Develop an education program for NSWNMA members and member leaders Strategy 3.4: Develop initiatives, affiliations and partner ships on issues that affect NSWNMA members
The Old Peoples Welfare Council Ltd
The Edith Cavell Trust The Edith Cavell Trust Scholarships support education through grants across a number Action of categories in the theory or practice of nursing and midwifery for graduates, postgraduates or continuing professional develop ment. Applications open on 1 May and close on 31 July each year.
Action
The Old Peoples Welfare Council Ltd (OPWC) provides funding for aged care nurses to undertake study relevant to the aged care sector.
In November 2015, the OPWC provided scholarships to 19 members from across Outcome the state to attend a two-day course in Sydney – Pain Management: Persistent and Cancer Pain.
For the 2016 academic year, the Trust provided 35 scholarships to assist nurses Outcome and midwives in attending conferences, short courses and degrees leading to the attainment of formal qualifications.
Bob Fenwick Memorial Mentoring Grants Program
Action
Lions Nurses’ Scholarship Foundation Lions Nurses Scholarship applications are open to eligible ENs and RNs to participate Action in a study tour or conference in Australia or overseas, or to study for a formal qualification at a recognised tertiary institution in Australia or overseas. Applications open on 1 August and close on 31 October each year.
Outcome
The NSWNMA continues management of the Bob Fenwick Memorial Mentoring Grants Program, in partnership with the NSW Ministry of Health Mental Health Drug and Alcohol Office.
• 20 mentee participants took part in the
pro gram for 2015, the highest number to date.
• The 2016 program is currently underway,
and again, the Association has secured 20 mentee placements across the state.
46
Key Direction 3
Consultation
The focus of the most recent meeting on 24 May 2016 was the RN 24/7 campaign Action and the implications of legislative changes and organisational responses from the NSWNMA, as well as the logistics of a federal campaign following the outcome of the Federal Government election. The Increasing Choice in Home Care discussion paper and the implications for aged care nurses and members of the community were also discussed.
NSWNMA Professional Issues Committee Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care The Professional Issues Committee (PIC) meets bi-monthly and consists of members Action and Councillors from all areas of the health sector. The PIC is also made up of a number of specific reference groups who meet regularly, with their membership consisting of members and Councillors working in the relevant field.
A topic for future meetings will be the direction of community-based aged care, including the emergence of UBER-style platform care agencies.
• The PIC provides invaluable advice to the
Outcome
Association’s Professional Officers on a wide range of professional issues. The committee also annually reviews the Association’s policies, position statements and guidelines that are scheduled for discussion and endorsement at Annual Conference.
Outcome
Members were invited to make submissions to the Increasing Choice in Home Care dis cussion paper, and to the NSW Ministry of Health review of the Public Health Act 2010.
Drug and Alcohol Reference Group
• In addition, the PIC provided comment on the review
Action
The Association’s Drug and Alcohol Reference Group gives members working in the drug and alcohol sector the ability to provide input on relevant drug and alcohol matters.
Outcome
The group discussed the negative media portrayal of “ice” in the community and the NSWNMA’s submission on Retention of Measures to Reduce Alcohol-Related Violence.
of ANMF policies, with an increased number reviewed during the past year.
Aged Care Reference Group The Aged Care Reference Group holds four to five meetings each year and is regularly consulted on government policy and contemporary issues affecting aged care. The group has the opportunity to influence decision-makers and the delivery of care, and advocate for the profession.
Mental Health Reference Group
Action
Members with an interest in aged care and/or currently working in aged care can nominate for the group that currently has 19 members.
47
The Mental Health Reference Group (MHRG) meets regularly throughout the year to discuss a number of issues affecting members.
Submissions and Inquiries
•
Ongoing discussions with members on privatisation of mental health in relation to Outcome NGO-run projects moving into the mental health community sector across the state, and the push by the government for more NGO involvement in this sector.
Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
• Meeting with the NSW Chief Nursing and Midwifery Officer in August 2015 on the need to ensure adequate observation and comprehensive documentation of clients on clinical rounds.
• Lobbying
the Deputy Secretary, Governance, Work force and Corporate, NSW Ministry of Health during Sep tember 2015 on the compliance of LHDs with the Mental Health Act 2007. Concerns were raised in relation to Police Section 22 admissions not being transported directly to declared facilities and patients being left in undeclared EDs that lack the required resources.
Action
The NSWNMA continues to provide responses to key issues affecting members.
Outcome
Responses and submissions have been made to:
Australian Human Rights Commission Willing to Work, a National Inquiry into Employment Discrimination against Older Australians and Australians with Disability. The outcomes of the submission were included in the report provided by the Commissioner for Ageing and Disability that found 27% of over-50s experienced age discrimination, and a third of those had abandoned seeking work.
• Discussions
on undergraduate and post-graduate education in mental health.
• Opposition
to the employment of AiNs in highly volatile mental health intensive care units.
Inquiry into Elder Abuse in New South Wales
• Program
development for the NSWNMA Mental Health and Drug and Alcohol Nurses Forum 2016.
Midwifery Reference Group The Midwifery Reference Group (MRG) is convened regularly throughout the year Action to discuss a number of issues affecting members. The NSWNMA is seeking expressions of interest from skilled and experienced midwives to join and grow the MRG.
Who will keep me safe?
Elder Abuse in Residential Aged Care
The NSWNMA submission contained the outcome of a staff survey on elder abuse and implications of the findings. The NSWNMA also gave evidence at a public hearing as part of a union caucus.
Inquiry into The Future of Australia’s Aged Care Sector Workforce
•
The terms of reference for the Senate Community Affairs References Committee Inquiry are far-reaching and
Discussion with members assisted the Outcome NSWNMA to provide feedback on a num ber of standards, including Nursing and Midwifery Board of Australia Safety and quality framework for privately practising midwives; Registration standard: Endorsement for scheduled medicines for midwives; and Registration stan dard: Professional indemnity insurance arrangements.
• MRG members attended forums for the ANMAC Re-
entry to the Register Midwife Accreditation standards.
• The MRG was pleased to note that COAG has extend
ed the current exemption for professional indemnity insurance for privately practising midwives until 2019.
48
Key Direction 3
Work Health and Safety Violence in health facilities In January 2016, a near-tragic event in the emergency department at Nepean Hospital saw a police officer and a hospital security officer shot by a patient under the influence of methamphetamine. Following consi derable media and union pressure, the Minister for Health announced a Security Roundtable on violence in hospitals. Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
cover many issues impacting aged care members, including recruitment and retention of workers, workplace environments, remuneration and training. A public hearing was held in Melbourne on 28 April 2016. The Royal Australian College of General Practitioners again supported the retention of registered nurses in nursing homes.
Increasing Choice in Home Care – Stage 1
The first Security Roundtable was held on 8 February 2016, and focused on violence Action in EDs. The purpose of the meeting was to develop a shared understanding of the issues, and to arrive at an informed framework for future action and change to be endorsed by the Minister. This initial focus on EDs was not to diminish or ignore work in relation to violence that would be required throughout the health system. This was accompanied by the mention of other possible measures, including an audit of security in NSW Hospitals.
The Department of Health is undertaking a program of consultation as part of its aged care reforms. The views of members and community allies will be represented in the NSWNMA response to this consultation paper.
Independent Review of the Impact of Liquor Law Reforms in NSW The submission has been provided to the Hon Ian Callinan AC, outlining the Association’s position of support for the retention of measures to reduce alcoholrelated violence in the Sydney CBD, with the request to roll these measures out to other affected areas.
•
From the Roundtable, a 12-point Action Plan was developed. Some points were able Outcome to be implemented immediately while others were to be developed and put into effect, or to be the subject of review and research.
Draft NSW Perinatal Mental Health Mother-Baby Unit Model of Care Comments were provided to Perinatal and Infant Mental Health Program Manager, Mental Health and Drug and Alcohol Office, NSW Ministry of Health. The NSWNMA agreed that this type of unit was long overdue and that a robust and well-trained community-based nursing workforce would also be required.
• Following the first meeting of the Roundtable, the Peak
Statutory Review – Public Health Act 2010
• A report provided to the Committee meeting in March
Industrial Liaison Committee on Security was formed, comprising all public health unions and Ministry of Health senior officials.
The NSWNMA response focused on the appropriateness of the Act retaining a section on nursing home staffing given the interplay of poor staffing in residential aged care facilities, avoidable presentations to EDs, and extended admissions due to lack of appropriately-skilled staff to undertake post-admission care.
2016 on the development of each of the 12 points of the action plan showed significant progress in priority areas. The Committee meeting in May 2016 reviewed the completion of the snapshot audits. The next meeting is scheduled for August 2016.
49
on incident response to acts of physical aggression in EDs, and handover by police of physically aggressive individuals requiring treatment. The audit will recommend any strengthening of policies and procedures needed for EDs, in particular to adequately respond to behaviours of individuals, affected by alcohol or drugs, including psycho stimulants such as “ice”, presenting at EDs. MoH Update
• The
Ministry undertook a snapshot audit of EDs and presented the findings to the Peak Industrial Liaison Committee in May 2016. The findings were of considerable concern and confirmed that a significant amount of work in relation to security issues was necessary.
Action Plan arising from Security Roundtable 1. Deliver an intensive program of multi-disciplinary training of ED staff including nursing, security and medical staff in managing disturbed and aggressive behaviour and ensure each member of the multidisciplinary team is clear about their respective roles.
4. Establish a working group to recommend strategies to increase the professionalism of NSW Health security staff and how best to integrate their roles in a multidisciplinary response to patient aggression.
MoH Update
• The Ministry of Health conducted a number of workshops between March and May 2016 in Sydney and regional NSW locations to discuss the care of patients with Acute Severe Behavioural Disturbance presenting to EDs.
MoH Update
• The Ministry is working with the HSU to develop an education program to develop the professionalism of the security staff.
• The Ministry has advised that a training curriculum is expected to be completed by the end of June 2016.
5. Partner with TAFE to train existing security staff in a purpose designed security course for the health environment.
2. Improve workplace health and safety across NSW Health:
• Deliver a program to
engender a stronger workplace health and safety culture and ensure all staff, including junior doctors, nurse graduates and other rotating staff are adequately inculcated into the safety culture.
MoH Update
• The
Ministry is in discussion with TAFE on the development of a security training course specific to health. Positive feedback was received from the initial courses conducted, with planning underway for training over the next twelve months.
• Ensure
clinical unit and hospital managers are spe cifically trained to understand and give effect to their Workplace Health and Safety obligations and ensure their local workplaces have a zero tolerance to violence.
6. Sponsor the recruitment of a new intake of trainees to qualify as security staff through the health specific course and recruit and train further staff following consideration of the results of the security audit.
MoH Update
• The Ministry expressed concern regarding the workforce attitude to WHS across all facilities. The MoH has approached the Clinical Excellence Commission on the inclusion of workplace WHS culture in training health professionals as well as in university curriculums.
MoH Update
• The
Ministry approved the establishment of 15 new security staff positions that are to be in place by the end of June 2016; a number of training courses for security staff will also be conducted in quick succession to ensure consistency by mid-2017. The NSWNMA understands that the Ministry will review the effectiveness of the HASA position, to determine improvements that could be made.
3. Undertake a detailed security audit of selected metropolitan, regional and rural EDs. The audit will cover compliance with policy and mandatory training requirements, adequacy of ED design in managing aggressive patients, adequacy of security staff numbers, hospital liaison with local police
50
Key Direction 3
7. Establish a Reference Group of expert clinicians to develop specific patient management and treatment pathways, including disposition and transport options, for patients presenting to EDs under the influence of psycho-stimulants such as “ice”, both for immediate management and longer term referral and treatment.
11. Identify the circumstances in which security staff are able to exercise power to remove from public hospital premises individuals who are not patients and who are acting aggressively or who are otherwise causing disruption. MoH Update
• The Ministry advised that under the Inclosed Lands
MoH Update
• A reference group of 21 representatives has convened
Protection Act 1901, security officers are able to remove people from the premises.
to determine clear treatment pathways.
8. Immediately examine availability of Mental Health and Drug and Alcohol resources including the use of telehealth options for rural and regional areas for patients presenting to EDs under the influence of psycho-stimulants such as “ice”, both for immediate management and longer term referral and treatment.
12. Improve incident management reporting systems to ensure they are user-friendly, well-utilised and provide transparent management and feedback loops to staff making the reports. MoH Update
• A new incident reporting system is being tested and
anticipated to be rolled out later in 2016. The Ministry advises that many features are an improvement on the current system, such as the ability to save a record, to map incidents and provide better data reporting.
MoH Update
• The
Mental Health and Drug and Alcohol Office at NSW Health is seeking more information on the anecdotal advice related to the havoc caused by violent behaviour of patients in the ED; a report is to be provided to the August 2016 meeting of the Committee.
Protection of workers’ rights Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
9. Work with NSW Police to ensure arrangements adequately and consistently cover liaison, firearms safety, handover and incident response involving aggressive individuals presenting at public hospitals, including pursuing prosecution of offenders.
Work Health and Safety (WHS) and protection of workers from risks are essential for nurses and midwives and for the continuity and quality of health
Action
MoH Update
• The
Ministry is working with NSW Police on the Memorandum of Understanding between NSW Health and NSW Police, who acknowledge that it is in their best interests to have a co-operative arrangement.
wHS reported issues als mic tion control e ch Infec us o d % nt 3%
10. Examine whether legislative changes are required:
ual handling Man Wor ke nv H iro az nm ar e
which is already an aggravating factor when sentencing an offender convicted of assault, covers hospital security staff, and
Vi ol en
35%
13%
provide adequate legal protection to security staff who act in good faith and under the direction of health professionals, who require assistance in order to render lawful medical treatment or care of patients.
security
• to
and sion res gg ,a ce
• to make clear that a victim’s status as a health worker,
6
a klo or W
MoH Update
• Considerable
work is required with the Justice Department to review the various Acts and legalities that apply to health workers (particularly security staff) as well as patients and visitors to healthcare facilities.
d/ fa tig ue /sh ift w ork
51
24%
8%
sm en t
4%
as ar h d an ing Bully
SafeWork NSW and NSW Health Consultation
care services provided to the community. Members’ concerns relating to WHS issues were addressed through undertaking workplace inspections, communicating directly with management and working to support members to manage issues.
Key Direction 3 Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
•
Activity increased by 13% over the last Outcome 12 months with notable increases of incidents related to violence (31%), and workload/ fatigue issues (49%).
The NSWNMA and Unions NSW par ti cipated in consul ta tion with SafeWork Action NSW on issues related directly to health in cluding cytotoxic drugs, workplace violence, asbestos management, workers compensation arrangements and patient moving and handling.
• Of
all issues reported, 35% are related to violence, aggression and security. Other issues included bullying and harassment – 8%; workload/fatigue/shift work – 24%; manual handling – 4%; work environment – 13%; hazardous chemicals – 3%, and infection control – 6%.
• The
NSWNMA facilitated feedback on Outcome revised Cytotoxic Drugs and Related Waste Guidelines that will be available through SafeWork NSW and are anticipated to be adopted by NSW Health.
• The
Violence Reporting App received a total of 84 notifications since its inception in August 2015, 39 of which requested follow-up that has been facilitated. Some increase in usage of the App is noted in the past three months, however continued reporting via the App is recommended.
• NSWNMA
and associated affiliated unions are de veloping a position statement for a parliamentary inquiry into violence against emergency services personnel.
• An opportunity was provided to undertake a WHS ins
• NSWNMA officers have participated in meetings with
pection of a number of facilities to assist in identifying issues for members prior to occupation.
the State Insurance Regulatory Authority to discuss proposed changes to the Workers Com pen sation Scheme and associated legislation.
• As a result of union concerns about management of asbestos in health care facilities, the NSWNMA met with the Ministry and other unions on the Asbestos Peak Union Liaison Committee. The committee has revised the asbestos registers and management plans that will be made available electronically on LHD intranet sites.
The Violence Reporting App received a total of
84
notifications since its inception in August 2015
39 requested follow-up
that has been facilitated
52
Key Direction 3
• The
NSWNMA provided input to the NSW Health Manual Handling Special Interest Group and AusBIG – Australasian Bariatric Innovations Group. The group consults on equipment availability and suitability of use and associated techniques for the handling and movement of patients.
Community Issues Government and Community Relations Parking permits for community nurses Community nurses in metropolitan Sydney have experienced parking difficulties for over 20 years. The Sydney Alliance Inner West District, along with the NSW Cancer Council and St Brigid’s RC Parish, Marrickville have for two years been undertaking a community campaign for local Councils to introduce parking permits for home care workers.
A community campaign was built with key local allies to lobby the three local government areas (LGAs) of City of Sydney, Marrickville and Leichhardt Councils, to introduce a single care worker permit. Local community nurses told their stories and spoke at Council meetings to gain bi-partisan Council support. The campaign was supported and promoted by nursing management.
Key Direction 3 Strategy 3.4: Develop initiatives, affiliations and partner ships on issues that affect NSWNMA members
• A pilot scheme involving a single permit
Strategy 3.5: Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care
Outcome
A number of table talks were held at which the NSWNMA and the Cancer Council met Action with community nurses to hear their stories of how a lack of parking permits impacted negatively on their ability to provide timely and effective in-home care.
covering all three councils was launched on 1 October 2015. Since the launch, Canterbury, Strathfield and Ashfield councils voted to join the scheme.
• The Inner West district will work with other Sydney Alliance Districts on a state-wide adoption of this permit, similar to the disability permit.
53
Key Direction 4
Promote the NSWNMA as a significant and professional advocate for the health system and our members
T
he NSWNMA must be a viable organisation in the public arena and vocal advocates of health and industrial relations. Our reputation must be protected and our Values actively promoted as a way of enhancing the professional advancement and standing of our members in their workplaces. We will continue to strive to be an organisation relevant to all nurses and midwives, build relationships with key stakeholders and be an influential voice in the communities where our members work and live, as well as nationally and internationally.
STRATEGIES 4.1
Build and develop partnerships with key community, academic and political organisations to promote issues that define our Vision and Key Directions
4.2
Develop risk management strategies to uphold the NSWNMA’s reputation
4.3
Advance and promote nursing and midwifery as professions creatively and through multiple platforms
4.4
Ensure our Vision and Values are reflected in all our communications and actions
54
Key Direction 4
Establishment of a memorial
Outcome
Alice Cashin Memorial The Association became aware that an exceptional Australian World War I nurse – Alice Alanna Cashin – was buried in an unmarked grave at Woronora Memorial Park at Sutherland.
• Significant donations for the
memorial came from First State Super, Tradies Club Gymea, Patricia Staunton, St Vincent’s Hospital Darling hurst and Queen Alexandra’s Nursing Army Corp, United Kingdom. All of the donors were moved and supportive of having a memorial established to honour the heroism and work of Alice Cashin.
Alice Cashin trained at St Vincent’s Hospital, Darling hurst, completing her studies to become a registered nurse in 1900 and join ing the Australian Trained Nurses’ Association (ATNA). To further her career, she left for London in 1907. At the commencement of World War I in July 1915, Alice joined the Queen Alexandra Imperial Nursing Service Reserve with her first posting to manage a large surgical unit in Egypt. For her work in Egypt, Alice was twice mentioned in dispatches and was awarded the Royal Red Cross 1st Class Medal.
• A memorial ceremony will take place at 11am
on Tuesday, 11 October 2016 at the Woronora Memorial Park, Sutherland.
Environmental Issues Key Direction 4 Strategy 4.1: Build and develop partnerships with key community, academic and political organisations to promote issues that define our Vision and Key Directions
On 30 March 1916, Alice was Matron of the hospital ship Gloucester Castle when it was torpedoed. Alice defied the Captain’s orders and refused to leave the sinking ship until all of her 399 injured men and 33 nursing sisters were safely on lifeboats; she left on the last lifeboat. Alice received the Bar to her Red Cross Medal – the first Australian to receive that honour – for her heroism during World War I.
Environmental Health
Action
• A webinar session conducted on 4 August
Key Direction 4 Strategy 4.3: Advance and promote nursing and midwifery as professions creatively and through multiple platforms
Action
The NSWNMA has participated in a variety of environmental health-related activities and attended events during the past year.
Outcome
On hearing her remarkable story, the Association’s Council resolved to determine whether it was possible to have an appropriate memorial placed on her unmarked grave, and allocated $5,000 for the purpose.
2015 for the Global Green and Healthy Hospitals (GGHH) Network and the 2020 GGHH campaign for hospitals, sought pledges of support for sustainable health care.
• On 11 August 2015, representatives from the NSWNMA,
Public Health Association of Australia, the Climate and Health Alliance (CAHA) and the Australian Medical Students Association visited NSW Parliament House to meet with and educate parliamentarians about coal and the associated health risks. This delegation also visited the Ministry of Health and became involved in resolving some environmental health statistical issues.
The Chief Executive Officer of the Southern Metropolitan Cemeteries Trust (SMCT) has donated, on behalf of the SMCT, the land adjoining Alice’s unmarked grave for a memorial. The Association undertook fundraising in order to have a bronze statue created in Alice’s image as well as a granite memorial, both to be placed alongside her unmarked grave.
• The Environmental Health Newsletter continues to be
delivered three times a year to an increasing number of nurses and midwives who are eager to obtain environmental health news.
55
• The
prioritise climate change. In addition, organisations such as GGHH continued to promote their 2020 Healthcare Climate Challenge to organisations such as hospitals and health care facilities.
NSWNMA was represented at the 4th Greening the Healthcare Sector Think-Tank held in Melbourne. A variety of speakers spoke of the increasing burden of climate change on health service delivery and their ability to meet that challenge. Organisations represented were CAHA and the Australian Healthcare and Hospitals Association (AHHA), and topics such as how organisations cope with engaging behaviour change for sustainability were addressed. A working group of nurses and midwives was established to seek information and share resources and ideas.
Sustainable Health Care Seminar
People’s Climate March A small number of NSWNMA members and staff attended the People’s Climate March Action at the Domain, Sydney on 29 November 2015. The NSWNMA attended as part of the Health Group, along with six other groups representing climate change.
Action
•
Outcome
• The NSWNMA also demonstrated its capacity to work
effectively on the vital issue of climate change with other organisations that have similar values.
Climate Change Conference, Paris
Outcome
• The
seminar was well-attended, providing impressive speakers, along with excellent and useful information. The participants were particularly interested in the message of the keynote speaker, who presented her experiences and introduced undergraduate nurses to sustainable health care concepts with her own ‘green team’ in her role as educator at Monash University. The presentations generated consideration of possible actions by participants in their work environments.
Climate change is an important issue for Outcome nurses and midwives who are committed to the health and wellbeing of society; the Association demonstrated its commitment by supporting the ideals of the People’s Climate March.
Action
On 15 April 2016, a Sustainable Health Care Seminar conducted by the NSWNMA, in partnership with the Sydney Local Health District was held at RPAH.
• A
The Paris Climate Change Conference was held in December 2015 in Paris, France. Many Australian health professionals and other world leaders attended.
further environmental health seminar will be programmed for 2017.
• As a result of the seminar, the NSWNMA has been
invited to attend the August 2016 Sustainability meeting at RPAH to encourage more interest in sustainable health care.
Christiana Figueres, head of the United Nations Framework Convention on Climate Change, urged ministers of health to
56
Key Direction 4
South Western Sydney Local Health District
Action
suggests questions to ask when choosing a residential aged care facility as a way of drawing attention to the need for registered nurses in aged care.
In March 2016 an opportunity was provided to the NSWNMA by the-then DoNM of SWSLHD, Jacqui Cross, to address DoNs and NUMs on environmental health issues.
Aged and Community Services and Leading Aged Services Australia – State Conferences
Networking was achieved and the Association was optimistic of some undertaking on Outcome environmental health within the SWSLHD. It is hoped that other LHDs will also take up this approach.
• Key messages from the conferences included: • the government’s intent to enhance systems
that enable self-regulation of the aged care sector and encourage competition-driven quality improvements;
• the change of emphasis in complaints management
Key Partnerships
towards local resolution through the development of a statutory education function for the Aged Care Complaints Commissioner;
Key Direction 4 Strategy 4.1: Build and develop partnerships with key community, academic and political organisations to promote issues that define our Vision and Key Directions
• brokerage services for community-based care and UBER-style service development, and
• implications for the sector of recent budget cuts to
Developing partnerships with key organi sations and attending conferences and Action symposiums helps to further develop and maintain relationships while providing an opportunity to keep the Association informed on contemporary aged care, mental health and WHS issues and developments.
Mental Health Sector Conferences and Symposiums
Aged Care Roundtable – a group established by the Outcome NSWNMA, that shares a mutual concern about aged carE
• The NSW Agency for Clinical Innovation (ACI) Mental
aged care.
• The
National Mental Health Conference focused largely on the NDIS and provided insight into how mental health and associated funding will be provided as a package to supplement daily activities of clients as the NDIS rolls out across NSW. Health Network was established by the ACI to work with clinicians, consumers and managers to design and promote better health care for NSW.
• Most of the roundtable members agreed to be signatories on two letters in support of the RN 24/7 campaign.
• The
Digital Health Show was an opportunity to see how new digital technologies are transforming the future of health care.
• The
roundtable will explore the development of an information leaflet for community members that
57
• The NSWNMA conducted a workshop on Mental Health
Sustainable Funding of Public Hospitals
in the Workplace for the Independent Education Unions NSW/ACT Conference held on 16 October 2015.
The NSWNMA attended a think tank on Sustainable Funding of Public Hospitals Action convened by the Australian Healthcare and Hospitals Association (AHHA). This event occurred on the background of public hospital funding cuts, a tax reform discussion and also the discussion regarding the reform of federalism. Discussion focused on questions such as:
ACTU and Unions NSW WHS Conferences
• Invitations to present at both conferences afforded the
Association an opportunity to showcase the Mental Health and Drug and Alcohol Nurses Forum outcomes, resolutions and partnerships with fellow unions, and to demonstrate the Violence App. In addition, the NSWNMA acknowledged the industrial award achievements relating to domestic violence leave put in place by the union.
• should
responsibility for the funding of public hospitals rest with only one level of government - the Commonwealth or the States and Territories - and how would this affect the setting of operational targets?;
2nd International Conference on Asbestos Awareness
• alternative models of financing reflecting the evolving
• The
elements of the national strategic plan for asbestos awareness and management were discussed and incorporated into actions implemented by NSW Health at the Peak Union Asbestos Liaison Committee.
nature of coordinated care and the use of hospitals;
• how can the financial gains from avoiding preventable hospitalisations and reducing delayed discharges be shared across sectors?
The Australian Association for Manual Handling of People Biennial Conference and Australasian Bariatric Innovations Group (AusBIG) meetings
•
Value within the health care provided was identified as an important element of health care reform. The challenge of increasing chronic disease, multicomorbidities and how the health system responds to these pressures was also a consistent theme raised by participants.
Outcome
• Innovations and techniques related to patient handling
that may be incorporated into best practice were demon strated, and methods of integrating patient handling programs into clinical care programs were discussed.
• The
advantage of regional decision-making, along with the necessary associated funding, was recognised to ensure that local responses can be tailored to the needs of their populations and individual patients.
• There was also acknowledgement that a single fund
for coordinated care would assist in controlling costs and resolving accountability issues. By better aligning interests across the health sector, there is the potential to improve patient care and also achieve system efficiencies. www.ahha.asn.au
Healthcare in the future The NSWNMA was represented at the Think Tank – Looking Over the Horizon: Action Where to next for the Australian Health System? The think tank provided an opportunity for guests to hear presentations from those within the health sector on insights and opinions, and contribute to a discussion on how to work together towards challenges health care is likely to face in the near future.
58
Key Direction 4
•
Although the details remain undecided, there was broad agreement among par ticipants that realising the vision of a fitfor-purpose health system will require transitioning from:
Outcome
• A provider-driven system predominately propelled by information asymmetries and fee-for-service financing to a system where providers undertake shared decision-making with consumers.
• A system with limited accessibility and transparency of
information to a data-driven system where patient and system data is utilised to target care, ensure the best use of resources and achieve better patient outcomes.
• Consumers
are already taking steps to manage their own health and better navigate the health system. Increases in health literacy are facilitating a democratisation of knowledge, which is enabling patients to participate in shared decision-making. Importantly, shared decision-making is not equivalent with the foundational ethical principles of informed consent and patient autonomy. While these ethical principles were considered necessary, they are not sufficient to increase patient participation to the level that translates to new models of care and better health outcomes. www.ahha.asn.au
• A lack of continuity of care across different health
care providers and complementary sectors to a collaborative system where connectivity facilitates integration with different parts of the health sector and other relevant sectors such as aged care, disability and education.
• A system focused on responding to chronic health
conditions at the end of life, including sometimes futile care, to one focusing on preventing chronic disease from the beginning of life with consumers using increasing information and technologies to achieve self-monitoring and healthier lifestyles.
Government and Community Groups
• Technology is not necessarily a saviour of the system,
The NSWNMA has continued regular attendance at meetings with government Action and community groups, such as the Nursing and Midwifery Office Mental Health Nurses Advisory Group, NSW Council of Social Services (NCOSS) of NSW Health Policy Advisory Group, NSW Farmers Rural Mental Health Network, Welfare Rights Centre and the NSW Education Department. The meetings provide an opportunity to have input into key directions of the community and government groups, while keeping the Association informed of developments that may affect members in relevant community sectors.
but instead, an enabler of change. The think tank heard how the use of emergent technology is already playing an increasing role in the health system. This is unlikely to reverse. As such, both high and low cost technologies have a role to play in the future of the health system, providing they are evidence-based and individualised. Concerns remain regarding funding mechanisms that will best actualise the opportunity provided with the rapid advances in health technology. There was also consensus for the need to move beyond the myth that technology is intrinsically complicated, as simple selfmonitoring can be as effective as more complex systems.
• There
was acceptance that there is a need for the workforce to evolve. Health professionals need a new approach to problem solving and thinking critically as improving health service delivery and workflow will require staff to ‘solve non-routine problems creatively’. There was broad agreement that for this evolution to occur, health services management will need to shift leadership to the front line. This may also require changes to funding models to facilitate a culture change. Again, consideration might be given to how technology can be used as an enabler to support solutions to workforce challenges.
• Attending
community-based organi sation meetings assists in developing Outcome relationships with community-based organisations that have a similar ethos to strengthen the NSWNMA’s political standing.
• The
NSWNMA has been providing support to the Public Service Association in relation to the health care procedures that School Learning Support Officers are being asked to perform, as outlined in the training manual.
59
Key Direction 5
Ensure our people and resources are aligned with our Vision
T
he NSWNMA is committed to valuing and developing our staff and managing our resources to enable it to achieve its Vision and Key Directions. Resources are managed in the best interests of NSWNMA members who have placed their trust in good governance of their union
STRATEGIES 5.1
Further build a workplace culture embedded in the Values of the union
5.2
Organisational governance systems are continually developed and evaluated
5.3
Define roles and relationships within and between NSWNMA teams in line with the Vision and Key Directions
5.4
Implement a workforce development plan that focuses on the education and training required to deliver the Vision
5.5
Develop a systematic review of planning and resources against the Vision and Key Directions across all teams within the NSWNMA
60
Key Direction 5
Governance Systems developed and revamped
Identification of key risk areas such as Payroll Tax and workers compensation where one Outcome team is responsible for producing reports and returns whilst the other is responsible for the payment. These processes have been overlapped to provide greater certainty of accurate calculation and payment.
Audit processes Key Direction 5 Strategy 5.2: Organisational governance systems are continually developed and evaluated
Staff Education
The processes for the Audit for 2015 were altered this year to provide a more structured approach to the:
Action
Education and training undertaken
• identification of, and tracking of audit tasks;
• naming and cataloguing of audit related work
papers and documents; and,
• accountability for quality of work Outcome
Strengthened the audit trail.
Financial Reporting Standards
Action
Outcome
In addition, the Association voluntarily adopted the Fair Work Commission reporting standards producing a more detailed set of Financial Statements.
The NSWNMA has commenced the process of conducting a skills and needs analysis to identify future training requirements needed across the organisation.
More transparent financial statements with greater accountability to the membership.
Key Direction 5 Strategy 5.4: Implement a workforce development plan that focuses on the education and training required to deliver the Vision
Review of internal processes Action
Outcome
With the appointment of a new Financial Controller, the Association has commenced a further review of internal finance processes and procedures and has commenced the work on moving to digital finance records.
The NSWNMA provides professional development opportunities for staff Action through attendance at conferences and courses that will enhance the knowledge and skills required to effectively represent and service the membership.
More efficient and cost-effective workflows.
Outcome
Review of systems and practices
Action
The main group of programs run over the last 12 months have been:
• Craft of Organising* • Organising Foundations*
With Finance and Payroll as separate teams, cross-team communication is vital. The interfaces between the teams have been reviewed by the Financial Controller and the Manager, Employee Relations & Payroll.
• Lead Organiser Development* • Organising for Safer Workplace* • Negotiation Skills for Organisers* • Organise 2015 (Conference held in September 2015)*
61
• Leading Campaigns^ • Annual Labour Law Conference 2016# • Communications In-Service • Mandatory Reporting In-Service • Leadership Development Trainingº • Cyber Security Awareness Training (all staff) NSWNMA Employee Scholarship In addition to optional and mandatory training courses that are provided, the Action NSWNMA also invites all employees to apply for an annual Scholarship Award, which has the aim of encouraging their professional development in the areas of: union organising and recruitment; Industrial Relations; recognised nursing qualifications; general and specialised administrative roles; management skills and; attendance at a recognised conference or seminar. The Scholarship Committee (made up of Council and external representatives) Outcome awarded three scholarships to NSWNMA employees for the calendar year 2016 to assist with tertiary studies relevant to their positions at the NSWNMA.
* courses / conference attended by Organisers specific to the Organiser role ^ held in house and attended by 15 staff members in the Organiser/ Industrial Officer role # attended by Industrial Officers specific to the Industrial Officer role º attended by the Elected Officers and team managers
62
Key Direction 5
Conclusion
S
Public service unions and our members need to decide how long we put up with the NSW Government decree before we can act for change.
ince the 2015 Annual Conference, the NSWNMA and the rest of the union movement have been in campaign mode. Pursuing the Build a Better Future objectives of: retention of universal health care under the flag of Medicare; workers rights, such as penalty rates; a decent education system; preservation of public services; and a dignified retirement.
Privatisation remains solidly on the agenda of the NSW Government with the latest budget heralding the creation of the “Contestability Unit� within Treasury. Clearly every service is at risk of being measured up for privatisation and to make it all that much easier the Government has removed rights of redundancy payments for any service they give to the private sector that requires a continuing workforce, like disability services.
Importantly we have continued with a very solid year of community and political campaigning to retain the legislative requirement for Registered Nurses 24/7 in aged care facilities delivering high and complex care. The decision of the NSW Minister to ignore the community and parliamentary support does not bring this campaign to an end but it does mean that we transition this campaign into the national campaign for safe staffing ratios in aged care. We have started this with our first claims for ratios in Opal Specialist Aged Care and BUPA aged care. Experience tells us that this will be a difficult battle and getting what we ask for and what residents need and deserve will need more than one claim, more than one bargaining attempt and most likely a political environment conducive to such an outcome.
The continued development and progress of our 2020 Strategic Plan is critically important to keep the union on track and focused on being relevant to our membership as well as bargaining, a powerful union that can meet the needs of members, both in their workplaces and in their community. We must be in the best possible position to assist and engage our members in bargaining new and improved agreements in all sectors and give power to our members to enforce their personal and collective rights. Our Union must continue to be nimble and move with the ever-changing political and industrial landscape. The expansion of the role of the NSW Branch of the ANMF, as the federal representative of members from 2017 and the employer of staff required to have a right of entry power, is just one of those changes.
In our public health system the battle to enforce the ratios we have won and to expand on them continues. Again, the political environment is critical to any expansion of ratios. Our next round of faux bargaining under the NSW State wages policy restrictions will occur in 2017.
63
Acknowledgements
The staff of the Association are embracing the challenges of our strategic plan and have made an extraordinary effort in the recent Federal election to do whatever they could to deliver outcomes in the interests of our members, whether in their day to day role or on the campaign trail working for a better future. I thank each and every one of them for their contribution and I hope that delegates here will join with me in recognising their efforts.
I wish to acknowledge and thank Judith Kiejda for her ongoing joint leadership of this union. Judith has stepped up to take on the responsibility of being the President of Unions NSW, a mark of the respect for Judith and our union. Our executive office team of Maggie Potts, Alyce Gillespie, Kerry Halliday and Chantel Miller continue to make very important contributions to the running of the union. Judith and I cannot do our job without their dedicated assistance. A special thanks to Miriam Galea who has provided PA relief in our office for a significant part of the year.
Finally, I want to thank all of our Branch Officials for their efforts throughout the last twelve months, especially the activists who have put their heart and soul into the campaigning in their local areas as part of their branch or Local Union and Community groups. I thank the members for continuing to put their trust in us all. We do not take that for granted and will maintain our efforts to act in their best interests.
I thank all of the Councillors for their contribution and the sacrifices they make to offer their time and energy to the proper functioning of the Association. Coral Levett’s leadership as President of the Association continues to be exemplary. Judith and I value Coral’s independent views and counsel on the tough issues, it is very welcome and respected.
Brett Holmes General Secretary
The Senior Leaders Group have stepped up another notch this year adding Co-Chair to our Key Direction Leadership Teams that help to steer our Strategic Plan, as well as managing and leading their teams in the day to day management of their portfolios. Their leadership of their teams is what delivers outcomes for members and I thank each and every one of them for their efforts and support.
64
Report to 2016 Annual Conference
New South Wales Nurses And Midwives’ Association
Summary Of Financial Information For The Year Ended 31 December 2015
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.
Summary of Financial Information For the Year Ended 31 December 2015 2015 $
Membership revenue
2014 $
32,447,655 31,054,940
NursePower fund subscriptions
3,605,315
3,438,225
Other income
1,497,561
2,202,598
TOTAL INCOME LESS TOTAL EXPENDITURE RESULT FOR THE YEAR
37,550,531 36,695,763 (34,812,453) (33,887,367) 2,738,078
2,808,396
Net fair value movements for available-for-sale financial assets
(91,663)
(226,842)
Remeasurement of retirement benefit obligations
948,099
(888,368)
3,594,514
1,693,186
TOTAL COMPREHENSIVE INCOME ATTRIBUTABLE TO MEMBERS BALANCE SHEET AS AT 31 DECEMBER 2015 TOTAL EQUITY
37,328,803 33,734,289
Represented by: Current assets
20,470,549
Non-current assets
29,307,691 28,783,238
TOTAL ASSETS
49,778,240
45,971,595
Current liabilities
10,855,844
9,872,753
Non-current liabilities
1,593,593
2,364,553
TOTAL LIABILITIES
12,449,437
12,237,306
NET ASSETS
37,328,803 33,734,289
17,188,357
A copy of the Financial Report, including the Independent Audit Report, may be found on the Members page of the website www.nswnma.asn.au or can be obtained upon written application to: Brett Holmes, General Secretary, New South Wales Nurses and Midwives’ Association, 50 O’Dea Avenue, Waterloo 2017.
65
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 rela tion to the organisation. (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.
Auditor’s certificate We certify that the above Summary of Financial Information is a fair and accu rate summary of the Report, Accounts and Statements of the New South Wales Nurses and Midwives’ Asso ciation for the year ended 31 December 2015. Our Independent Audit Report to the members dated 5 April 2016 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.
Daley & Co, Chartered Accountants
Michael Mundt RCA FCA, Partner 5 April 2016 Wollongong Liability limited by a scheme approved under Professional Standards Legislation
INDEX
Private Hospitals
Content 3 Report to 2016 Annual Conference 4 NSWNMA Council and Executive 4 NSWNMA Council – meeting attendance 5 Edith Cavell Trust 5 Professional Issues Committee 5 Australian Nursing & Midwifery Federation (ANMF) 5 Conclusion 5
A Year in Review
6
Introduction 6 Membership Growth 7 Finance 7 Federal issues 7 Build a Better Future campaign 9 Aged Care 9 State issues 10 Aged Care Bargaining 11 State Budget 11 Staffing and skill mix issues 11 Ratios victories in Queensland and Victoria 12 NSW Government anti-worker laws 12 Progress on the Strategic Plan 13
Report to 2016 Annual Conference
14
Organising for Strength 14 Community Organising 14 Campaigning to enforce our entitlements 14 Global Nurses United 15 Public Services International (PSI) 15 Australian Council of Trade Unions (ACTU) 16 Unions NSW 17 The Lamp 17 Conclusion 17
Key Direction 1: Grow our capacity to influence 18 2016 Federal Election NSWNMA Campaign Penalty rates campaign Save our Weekend
NSW Health Inaccurate ADO Accruals Code of Conduct Non-Emergency Patient Transport Recognition of overseas qualifications/ service for salary purposes
NSW Government NSW Department of Family and Community Services
Local Health Districts Hunter New England Local Health District John Hunter Hospital Maitland Hospital Scott Memorial Hospital Singleton District Hospital Tamworth Rural Referral Hospital Mid North Coast Local Health District Dispute: Pre-employment health assessments Northern Sydney Local Health District Hornsby Ku-Ring-Gai Hospital South Eastern Sydney Local Health District Voluntary Redundancy Program and Disaggregation of Services Prince of Wales Mental Health Services South Western Sydney Local Health District Campbelltown Hospital Fairfield Hospital Sydney Local Health District Royal Prince Alfred Hospital (RPAH) Western NSW Local Health District Restructure – Mental Health Services
19 19 20 20
21 21 21 21 22
22 22
23 23 23 24 24 25 25 26 26 27 27 27 27 28 28 28 28 29 29 30 30
30
Ramsay Health Care North Shore Private Hospital Activist education and power building MyTime payroll system inadequacies
Aged Care
30 30 31 31
31
Allity Pty Ltd Coastal Waters Residential Aged Care Facility & Bayside Aged Care Facility Bupa Aged Care Services Dispute regarding consultation of major change Calvary Health Care Riverina Education and Recruitment Columbia Holdings Confidentiality and Reporting Agreements Opal Specialist Aged Care Engagement project State-wide introduction of Alcohol and Other Drugs policy
NSWNMA Member Development Branch Official and Activist Training 2015-16 Program
31 31 32 32 32 32 33 33 33 33 34
34 34 34
Recruitment 35 Student Recruitment and Associate Membership Transitional and New Graduate Recruitment Strategy
Key Direction 2: Be innovative in our advocacy and bargaining Local Health Districts Hunter New England Local Health District Illawarra Shoalhaven Local Health District Dispute regarding rostering guidelines issued Western Sydney Local Health District Blacktown Hospital Cumberland Hospital Westmead Hospital
Affiliated Health Organisation Norfolk Island Hospital
Aged Care
35 35
36 37 37 37 37 37 37 38 38
39 39
39
Bupa Aged Care Services Hardi Nursing Home Management Compulsory e-learning in unpaid time Kennedy Health Care Group Transfer of ownership to Estia Health Mercy Health & Aged Care Group Mercy Place Albury Moran at Little Bay Enterprise Agrement State Government Nursing Homes Framework Agreement Rescission of Agreement The Whiddon Group – Aged Care Enterprise Agreement
Private Hospitals
39 40 40 40 40 41 41 41 41 41 41 42 42
42
Healthscope Private Hospitals Enterprise Bargaining Campaign 2015 Bathurst Private Hospital Enterprise Agreement 2015 Calvary Health Care Riverina Enterprise Agreement 2015
Private Sector
42 42 43 43 43 43
43
Aspen Medical Dispute with Aspen Medical re cessation of services
Key Direction 3: Promote a world class, well-funded, integrated health system
43 43
44
Education 45 NSWNMA Education Program 2016 Education Calendar Union Summer Program Aged Care Nurses Forum Mental Health and Drug and Alcohol Nurses Forum 66
45 45 45 45 45
Scholarships 46 The Edith Cavell Trust Lions Nurses’ Scholarship Foundation The Old Peoples Welfare Council Ltd Bob Fenwick Memorial Mentoring Grants Program
46 46 46 46
Consultation 47 NSWNMA Professional Issues Committee Aged Care Reference Group Drug and Alcohol Reference Group Mental Health Reference Group Midwifery Reference Group
Submissions and Inquiries Australian Human Rights Commission Inquiry into Elder Abuse in New South Wales Inquiry into The Future of Australia’s Aged Care Sector Workforce Increasing Choice in Home Care – Stage 1 Independent Review of the Impact of Liquor Law Reforms in NSW Draft NSW Perinatal Mental Health Mother-Baby Unit Model of Care Statutory Review – Public Health Act 2010
Work Health and Safety Violence in health facilities Action Plan arising from Security Roundtable Protection of workers’ rights SafeWork NSW and NSW Health Consultation
Community Issues
47 47 47 47 48
48 48 48 48 49 49 49 49
49 49 50 51 52
53
Government and Community Relations Parking permits for community nurses
53 53
Key Direction 4: Promote the NSWNMA as a significant and professional advocate for the health system and our members
54
Establishment of a memorial Alice Cashin Memorial
Environmental Issues Environmental Health People’s Climate March Climate Change Conference, Paris Sustainable Health Care Seminar South Western Sydney Local Health District
Key Partnerships Aged Care Roundtable Aged and Community Services and Leading Aged Services Australia – State Conferences Mental Health Sector Conferences and Symposiums ACTU and Unions NSW WHS Conferences 2nd International Conference on Asbestos Awareness The Australian Association for Manual Handling of People Biennial Conference and Australasian Bariatric Innovations Group (AusBIG) meetings Sustainable Funding of Public Hospitals Healthcare in the future Government and Community Groups
Key Direction 5: Ensure our people and resources are aligned with our Vision
55 55
55 55 56 56 56 57
57 57 57 57 58 58
58 58 58 59
60
Governance Systems developed and revamped 61 Audit processes Financial Reporting Standards Review of internal processes Review of systems and practices
Staff Education Education and training undertaken NSWNMA Employee Scholarship
61 61 61 61
61 61 62
Conclusion 63 Acknowledgements 64
New South Wales Nurses and Midwives’ Association Summary of Financial Information for the Year Ended 31 December 2015
65
Report to 2016 Annual Conference
FOR MORE INFORMATION
NSW Nurses and Midwives’ Association 50 O’Dea Avenue, Waterloo NSW 2017 8595 1234 (metro) 1300 367 962 (non-metro) 9662 1414 gensec@nswnma.asn.au www.nswnma.asn.au
Report to 2016 annual conference