NSWNMA Annual Report 2020-21 by NSW Nurses and Midwives' Association

20 20 21

Year in Review

Brett Holmes, General Secretary

Message from the Assistant General Secretary

Judith Kiejda, Assistant General Secretary

Message from the President O’Bray Smith, President

CONTENT

Membership and Finance

COVID-19: an ongoing challenge

Work Health and Safety (WHS)

Industrial

The Public Health Award

The Service Check Register

SNSWLHD restructure

Paid parental leave

Rectifying “payroll issues”

More underpayments

Not a great retirement thank you

Achievements won through union agitation and support 12

Legal

WHS Response

Advocacy

Aged care

Winning better lives

Professional Advocate Role

NSW Maternity Services Alliance

NSW Aged Care Roundtable

MAJOR CAMPAIGNS

National Aged Care Campaign

Scrap the Wage Freeze

Award Claim 2021

Safer Hospitals = Safer Communities

BUILDING POWER

Association Member Training (AMT)

New graduate recruitment

Scholarships

Student Representative Program

Aged care

Public Health System

Private sector

ENFORCING RIGHTS

Public Health System

Private sector

Summary of Financial Information for the Year Ended 31 December 2020

Communications

New Agreements finalised by the Association

Culturally and Linguistically Diverse (CaLD) 38 Climate Change

Affiliations

Education

Professional Research

Collaboration

Submissions

Annexures 44

YEAR IN REVIEW Brett Holmes, General Secretary

It’s been another challenging year for nurses and midwives in NSW, amidst an insidious pandemic attempting to rattle our resolve. To best support members, the Association has maintained a focus on the goals within our three-year strategic plan. One year in, we are halfway towards achieving our membership goal of 75,000 and already growing our collective strength, empowering members to advocate for their rights. On a global scale, we should have celebrated the work of nurses and midwives for International Year of the Nurse and Midwife last year, yet tragically we mourn the thousands of health and care workers who have lost their lives to COVID-19. Every day of this pandemic, nurses and midwives have fronted up in response, despite the risks and personal sacrifice. Each one who has contracted COVID-19 is one too many and highlights the dangers they face keeping the public safe. Although fortunate to not have experienced the devastation seen in other countries, nurses and midwives in NSW have endured limited access to adequate personal protective equipment, a drawn-

2020 – 2021 Annual Report

out and confusing vaccine rollout and, for public sector workers, ongoing cuts to real wage outcomes with no improvements in working conditions. Our regional health services are in desperate need of more support and we welcome the Inquiry into Health outcomes and access to health and hospital services in rural, regional and remote NSW. Poor staffing and skill mix is the number one issue for members working in these areas with nurses and midwives routinely working in isolation, reliance on colleagues to provide unpaid on-call support, skill shortages, inadequate security and transport services, lack of medical cover and limited access to continuing education. The NSW government is relying heavily on nurses and midwives to carry, not just the responsibility of saving people’s lives, but also the economic burden in the aftermath of the pandemic. Cutting real wages and contracting the superannuation savings of nurses and midwives is morally disgraceful, callous, and makes no economic sense. It also threatens the sustainability of these professions for future generations.

It is reprehensible the government postures NSW as “gold standard” and “world class”, yet it cries poor to the federal government and admits our public hospitals are in record demand with emergency departments “copping it” under bed-block. Despite knowing this, the NSW government continues to put its health workforce on the backburner, rejecting our comprehensive claim for nurse-to-patient ratios and letting our health system, pay and conditions fall behind Queensland and Victoria. Growing evidence proves ratios do have clear health and economic benefits. According to independent research published in The Lancet, Queensland’s legislated ratios have saved 145 lives and up to $70 million in taxpayer dollars in just the sample wards and units since their implementation in 2016. In the aged care sector, we at least have bipartisan acceptance that staffing levels are inadequate and a commitment to mandate minimum staffing minutes. This is a significant gain in our campaign for ratios in aged care. We’ve seen some minor improvements, thanks to ongoing pressure from unions, supportive politicians and media, alongside the work of the Royal Commission into Aged Care, yet there is still a long way to go to reform the sector. The federal government has largely failed to commit to much of the detail within the Commission’s final recommendations. Mandated minimum staffing should commence now rather than in 2023, and a registered nurse should be on-site 24 hours, not 16 hours, a day.

Forcing providers to publicly disclose care minutes for residents is a positive step, as is the drafting of a new Aged Care Act. However, the lack of transparency and accountability by providers for their use of billions of taxpayer dollars is an absolute failure by the government. We will continue to advocate for change on these issues. After witnessing a tumultuous year for nurses and midwives, it’s been inspiring to see the dedication and commitment from members through these significant pressures. Our collectivism is shifting momentum and growing supporters. The bravery and courage of our members who have engaged and are continuing to engage in industrial action in the fight for shift-by-shift nurse and midwife to patient ratios in our public health system is ever inspiring. We have committed to a fight that must carry on until we win.

FAREWELL JUDITH I am deeply saddened to farewell our Assistant General Secretary, Judith Kiejda. A formidable nurse, midwife and trailblazing unionist, Judith has brought courage, passion, persistence and enthusiasm to her senior leadership role for 19 years. Judith will be dearly missed, although I’m sure she will continue to be a strong advocate for this union and our causes well into her retirement.

Queensland’s legislated ratios have saved

145 lives & ± $70 million

MESSAGE FROM THE ASSISTANT GENERAL SECRETARY Judith Kiejda, Assistant General Secretary Over the past year, the world has changed with nurses and midwives at the centre of those changes. There is no doubt it has been difficult for everyone but when you work on the front line and the enemy is a virus, the reality is it has the capacity to really rock your world. The constant re-emerging of the virus, unclear messages from the government and confusion around vaccines and their rollout certainly has had major impacts on the lives of many. Despite 2020 being the International Year of the Nurse and Midwife and the enormous effort made by all our members across all sectors, the NSW government, despite its platitudes, saw fit to ignore all that effort and show just how much public sector workers were worth in their eyes by attempting to freeze their wages. The NSW Industrial Relations Commission didn’t improve matters by awarding a 0.03% pay rise. How totally insulting.

2020 – 2021 Annual Report

Yet again, this year the NSW government refuses to see the heath system as it is and not how they wish it to be. In that vein, they have denied all our current claims, including the claim for minimum mandated nurse to patient ratios across the public sector and offered us another insulting pay rise of 2.04%. All this when economists and the Reserve Bank say for our economy to fully recover, we need real wage increases because when people have money to spend, the economy buoys. Not a concept the NSW government wishes to embrace. Not just because we are exasperated with a government that will not hear us. The community also needs to understand the critical situation of our health system. Of even more concern is that the government negotiators will not even agree to insert important guidelines – ICU staffing standards or the updated ACORN standards – into the Public Health System Nurses & Midwives’ (State) Award.

Now is when we put our stake in the ground and say: ‘Enough is enough!’. Not just because we are exasperated with a government that will not hear us, but the community also needs to understand the critical situation of our health system, which is putting professional responsibilities on the line. If members can’t see the importance of taking the government on, then this health system will be the legacy they leave for those nurses and midwives following on. It is our responsibility to ensure we have a safer system in which future nurses and midwives have the resources to care for patients safely.

FAREWELL This is my very last report. I have given notice of my retirement and consequent resignation to our Council and my last day in office will be 6 August. I commenced at the Association in April, 1994 as an Organiser and just over 27 years later it’s time to move on to another phase of my life and hand over to a new Assistant Secretary who will bring new ideas, a new vision and enthusiasm to our union. I have loved every day coming to work to represent nurses and midwives in this state. To be totally honest, there were some days I loved less than others but it was always a privilege and, to this day, I am humbled by the fact that I was entrusted by the membership to operate in this elected role for just shy of 19 years. Standing for election, I had two main aims. I was determined the Association should have a campaign fund that ensured we had the resources necessary to run big campaigns. I knew times were changing. We could see the decline of union membership broadly and I wanted our union to be in a position to run the best campaigns, without having to spend time working out the money. Enough people came to assist and we were successful. It’s called NursePower. My other wish was that we have an international presence. From a resolution put to conference by Brian Grant from Liverpool Hospital, we joined Public Services International (PSI) and through PSI, the nurses’ unions got together and formed Global Nurses United (GNU). My one wish yet to be fulfilled is the introduction of nurse to patient ratios in the public health system. It will happen,

however I have to leave the rest of that fight to the next generation of union leadership. I will still assist wherever I can. To conclude, I wish to thank every member, every branch official, every member leader as well as the staff of the Association who work extremely hard to make the working lives of our members better. My last thank you goes to my co leader: your General Secretary, Brett Holmes. He has always been my coach and mentor as I developed in this role. Brett always afforded me the space to push the edge of the envelope when it comes to campaigning, organising and enforcing industrial instruments. I believe I was always conciliatory in those asks but he says I was stubborn – never gave up – I say determined. In all honesty, it’s called organising. If I didn’t succeed the first time and felt it too important to let go, I would go away, regroup, come back with a different approach and ultimately achieve my aim. There were times I didn’t succeed but not many. Brett, I want to truly thank you for your generosity and leadership. Quite frankly, I don’t know how I’ll fit into my new world but what I do know is that this union is the biggest in NSW and the NSW branch of Australia’s biggest union. I could not be more proud to say I had the opportunity to contribute to that. To Brett and the rest of our union: I wish you all the very best in the future and thank you for the truly awesome opportunities this position has afforded me.

MESSAGE FROM THE PRESIDENT O’Bray Smith, President As a collective, you are not always sure what your shared dreams and goals are over a 12 month period. This time last year, Council approved the new strategic plan with clear goals of membership growth. Council has spent the last 12 months seeking to make important decisions on your behalf to improve the functioning of the Association. We have been delighted to see our membership growth exceed our targets. Council thank Association staff and our active members who continue to recruit and empower nurses and midwives to take a role in their profession’s future by joining our Association. The Association is currently over 73,000 members strong. We continue to be known as the largest union in NSW and a branch of the largest union in Australia. Your Councillors have been promoting the profession and fighting for better pay and safe staff ratios in the private, public and aged care sectors. As well as meeting with Members of Parliament, performing media interviews, speaking at rallies and representing you at inquiries, your Council has been attending to our business as usual: sitting on scholarship trusts, representing you at Log of Claims Committees and assisting members affected by floods and fires. However, the real work of Council is to have a vision for the Association and affect change that will improve not only the running of the Association but also the professions as a whole. The last 24 months saw Council look at Association rules and policies with particular governance surrounding the roles and actions of our Association and branch officials.

2020 – 2021 Annual Report

Council has said goodbye to Julie Goss, who recently made the move to Tasmania. Julie is a midwife and passionate activist, fighting for fair pay and conditions in the private sector. Julie was well known for her organising skills and quiet demeanour. Council has also said goodbye to Sylvia Moon. Sylvia is an energetic and powerful nurse from Wagga Wagga. Her honesty is greatly missed on Council. We wish both Julie and Sylvia well. In the last 12 months we have welcomed Lisa Barry, Kristy Wilson and Robyne Brown. Late last year Lisa joined Council, coming from Prince of Wales Hospital. Kristy Wilson is representing the rural nurses, coming from theatres at Griffith Base Hospital, while Robyne brings knowledge of the public and private health system having experienced the move from Mona Vale Hospital to Northern Beaches. All three new Councillors have undergone training in governance and financial management. The new education, along with their knowledge and experience as registered nurses, will help them make decisions on behalf of the membership. Over the next 12 months your council will continue to question, challenge and improve our functioning, to self-examine and fight harder for our membership. As you are fighting hard every day, advocating for your patients we too will fight for you, fight for your safety and your future. Council feel honoured to be trusted with this responsibility.

ASSOCIATION COUNCIL – MEETING ATTENDANCE Meetings held from July 2020 to June 2021 = 9

Brett Holmes

Judith Kiejda

O’Bray Smith

Lorna Scott

NSWNMA GENERAL SECRETARY & ANMF NSW BRANCH SECRETARY

NSWNMA ASSISTANT GENERAL SECRETARY & ANMF NSW ASSISTANT BRANCH SECRETARY

NSWNMA PRESIDENT & ANMF NSW BRANCH PRESIDENT

NSWNMA VICE PRESIDENT & ANMF NSW BRANCH VICE PRESIDENT

Attendance: 9 meetings

Michelle Cashman

Gary Clark

Edward Makepeace

Liz McCall

Kerry Rodgers

Sue White

Lisa Barry

Wing Besilos

Robyne Brown

Kate Goodman

Jocelyn Hofman

Lyn Hopper

Di Lang

Lauren Lye

Richard Noort

Meg Pendrick

Michelle Straub

Attendance: 7 meetings

NSWNMA EXECUTIVE MEMBERS & ANMF NSW BRANCH EXECUTIVE MEMBERS

Attendance: 9 meetings

Attendance: 8 meetings

Attendance: 9 meetings

COUNCILLORS, NSWNMA & BRANCH COUNCILLORS, ANMF NSW

Attendance: 8 meetings

Attendance: 6 meetings

Attendance: 9 meetings

Attendance: 7 meetings

Attendance: 8 meetings

Attendance: 9 meetings

Attendance: 4 meetings*

Attendance: 9 meetings

Attendance: 7 meetings

OUTGOING COUNCILLORS

Jill Telfer

Attendance: 9 meetings *Since 2 March 2021

Kristy Wilson

Attendance: 5 meetings^

^Since 2 February 2021

Julie Goss

Sylvia Moon

MEMBERSHIP AND FINANCE

73,039

TOTAL MEMBERS As at 30 June 2021

Increase of 4,054 (5.9%)*

48,432

10,485

7,684

3,537

Public Health System (54.8%)*

Residential Aged Care (54.1%)*

Private Hospitals (57.4%)*

Students new joins

835

243

5,360

Justice Health (51.1%)*

Public Service incl. FACS (642.7%)*

Other sectors (525.2%)*

FINANCIAL REPORT The Association remains in a sound financial position. Total membership income in 2020 was $45,577,152 (2019: $42,519,824), an increase of $3,057,328 (+7.2%). Net Assets as at 31 December 2020 were $48,596,464 (2019: $45,706,209). The overall 2020 result for the year was a surplus of $2,935,917 (2019: $298,383 loss). This favourable result was due to a number of key factors including a significant increase in membership income which can be attributed to increased new members joining and fewer resignations (possibly due to COVID-19) as well as the Association’s investment in its member system which better engages with and supports

2020 – 2021 Annual Report

* Variance for the period 30 June 2020 – 30 June 2021

members with their fee payments and keeping them financial. In addition, COVID-19 meant that many initiatives could not be undertaken which resulted in substantial cost savings, for example the cancelled in-person annual conference and minimal travel to face-to-face meetings with members. The Audited Accounts for the year ended 31 December 2020 are summarised at the end of this report and the full financial statements are available to members online in Member Central. The unaudited accounts for the five months to 31 May 2021, have a surplus of $2,549,696, a positive variance to budget of $1,323,616 and Net Assets of $51,277,317.

COVID-19: AN ONGOING CHALLENGE

200+

110+

WHS issues relating to COVID-19

Issues relating to problems with PPE

Winner of SafeWork Award for Outstanding Work Health and Safety Support to members in the changed working environment due to COVID-19

1,200+ New individual member inquiries regarding COVID-19, including inquiries on the vaccination rollout (July 2020 – June 2021)

In the last year, COVID-19 has remained a threat in everyone’s lives. While not at the tragic levels seen in many overseas settings, it has nonetheless continued to impact the working lives of members. Then came a clunky vaccine rollout that did not meet the expectations of the community.

ACHIEVEMENTS WON THROUGH UNION AGITATION AND SUPPORT Establishment of Fit Testing for P2 / N95 masks – agreement by NSW Health to implement

Updated national recommendations – people wearing P2/N95 masks should be fit tested

Updated Clinical Excellence Commission (CEC) guidelines – P2/N95 mask and eye protection when providing care within 1.5 metres of a suspected/confirmed COVID patient

PPE reviews with NSW Health and Clinical Excellence Commission (CEC) to update guidance material

Adoption of P2/N95 masks

Ministry discussions and vaccine rollout

In April, the Association wrote to NSW Health about ongoing concerns around PPE guidance and the failure of policies and procedures to protect nurses and midwives from airborne transmission of COVID-19. In June, the Clinical Excellence Commission (CEC) updated its guidelines, advising workers to wear a P2/N95 mask and eye protection when providing care within 1.5 metres of a suspected/ confirmed COVID positive patient, and also when providing care for patients with symptoms of acute respiratory illness in certain circumstances. In addition to this, new national recommendations state people wearing P2/N95 masks should be fit tested. The circumstances under which workers should wear a P2/N95 mask and eye protection were increased to include the following:

The Association has remained at the forefront of extensive discussions and dialogue with the Ministry of Health and Department of Premier and Cabinet regarding the governmental and health system response to COVID-19 and the consequent vaccination rollout. These discussions (and debates) led to several positive outcomes: ✔ Despite not being mandatory, public health vaccination appointments were to be scheduled during rostered hours, and if not possible, then paid the relevant rate

All healthcare workers providing direct patient care within 1.5 metres of a suspected or confirmed COVID-19 patient Based on assessment of risk of transmission when providing direct care within 1.5 metres of patients with acute respiratory illness This was a significant win in our campaign to protect nurses and midwives at work.

✔ COVID-19 vaccine training program required by public health organisations was recognised as being work / paid time ✔ Nurses and midwives could still access paid special leave in certain circumstances, although not as broadly as advocated for by the Association ✔ The Association also continued to support vulnerable workers; ensure access to remote working if possible; and supported members with specific vaccination issues

Ramsay fit testing Member concerns over PPE prompted safety inspection at Lake Macquarie Private Hosptial with Ramsay agreeing to a fit-testing program at Lake Macquarie Private and extending to all Ramsay hospitals by April 2021. ✔ Fit testing win across all Ramsay hospitals

2020 – 2021 Annual Report

Healthscope fit testing ✔ Fit testing win at Northern Beaches Hospital, Prince of Wales Private & Newcastle Private

Ramsay Lake Macquarie COVID-19 Screening Station Nurses were being relocated from the wards to work at the COVID-19 screening station. This left the wards short staffed, put additional pressure on nurses that remained on the ward and their patients missed out. ✔ Members signed a petition for additional staff to stop nurses being taken from the wards to work on the COVID-19 screening station ✔ Additional staff were hired to cover the COVID-19 screening station, rather than nurses being relocated from the wards

Healthscope Hunter Valley Private, Campbelltown Private & Sydney Southwest Private Hospitals Members who were directed to take extended leave (AL, LSL, LWOP) because there was no work offered during the early part of the pandemic, won the right to work their contracted hours.

WHS RESPONSE The Association kept members informed around their rights and provided accurate work health and safety support through the following: ✔ Frequently Asked Questions (FAQs) on Member Central ✔ Sector-specific WHS and workforce updates on The Lamp online ✔ Facebook videos and Facebook Live Q&As addressing work health and safety and workforce issues ✔ Sector-specific emails with COVID-19 work health and safety advice ✔ PPE educational resources, including posters and social media sharables ✔ PPE Webinar with leading experts, Professor Raina McIntyre and Dr Michelle Ananda-Rajah, to educate members around the correct use ✔ Increased inbound call capacity to manage the volume of enquiries and workplace issues ✔ WhatsApp chat groups with branches for urgent updates ✔ Facebook Live Q&As by sector to answer member queries and share accurate information

✔ The right to work contracted hours

AGED CARE Single site employment during COVID-19 shutdown When the Commonwealth Government declared the Northern Beaches local government area (LGA) a “Commonwealth hotspot” on 18 December 2020, it triggered additional funding to Residential Aged Care Facilities (RACFs) to support and facilitate single site employment for those RACF workers who had employment at multiple locations, including those within the Northern Beaches LGA. The single site employment approach was designed to reduce the overall risk of an outbreak at a site as well as reducing the health risk for residents and workers in a hotspot. A key feature

was to maintain any worker’s total hours (and wages) despite working at the single site, i.e. a no net disadvantage approach. Announced in the week before Christmas, this led to frenetic activity and discussion occurring to ensure its speedy rollout. The Association was involved in these discussions and invited to participate in an Advisory Committee to facilitate the support and implementation of this single site employer initiative When the hotspot declaration was lifted, the Committee was able to work through and establish an appropriate transition timetable back to the status quo and pre-existing working arrangements that workers may have had across multiple sites.

WINNING BETTER LIVES

330

branches

2,071

branch officials

2020 – 2021 Annual Report

new branches approved

532

delegates

242

member leaders

MAJOR CAMPAIGNS

NATIONAL AGED CARE CAMPAIGN Over 240 expressions of interest received to the campaign training days 20 events were held across the state Over 4,000 sign ups to the campaign 80 media hits across online, print, tv and radio Government commitment to mandate minimum staffing and require providers to publicly disclose care minutes for each resident A new Aged Care Act

The Association has steadily built the National Aged Care campaign in NSW. The campaign is focused on achieving: 1. Mandated staffing ratios – minimum staffing levels and skills mix 2. Legislated requirements for clinical governance, leadership, and expertise 3. Legislated transparency and accountability measures 4. Guaranteeing workforce capacity and capability 5. Registration for unregulated care workers

The final report from the Royal Commission into Aged Care Quality and Safety was made public on 1 March 2021, making 148 recommendations. In response, the federal government: ✔ supported the recommendation for providers to publicly disclose care minutes for residents ✘ fell almost an hour short of care minutes needed to reform the sector ✘ only committed to 16 hours of RN care, instead of the minimum 24 hours on site recommended by the ANMF and Royal Commission. ✔ agreed with the need to draft a new Aged Care Act

SCRAP THE WAGE FREEZE 15,000 emails sent by members to MPs and Legislative Councillors (Members of the NSW Upper House) Labor, the Greens and almost all crossbenchers acted and pursued a disallowance motion against the wage freeze in the Upper House Over 300 businesses signed on in support of our campaign, proudly backing nurses and midwives by displaying our poster in their windows More than 60 NSWNMA branches protested the wage freeze across the state during a day of action More than 20 MP offices were visited 50 nurses and midwives protested outside parliament house (limit allowed by the Public Health Order at that time) 2,417 media stories about member activities ran across print, online, radio and television, informing the wider community and bringing attention to our issue

Together, the Association and public sector unions argued a 2.5% pay increase against the Berejiklian Government’s argument for 0% for the 2020 year for 400,000 public sector workers (1 in 10 workers in NSW). Following nine days of hearings, proceedings in the NSW Industrial Relations Commission (IRC) concluded on 12 August 2020. Disappointingly, the NSW IRC awarded a 0.3% pay increase in October.

2020 – 2021 Annual Report

We lodged a joint appeal to challenge the NSW IRC’s result in March, 2021, however, it was unsuccessful. In the NSW Budget handed down on 17 November 2020, the government went a step further, announcing it would cut the public sector wages cap from 2.5% to 1.5% in a policy they assert was expected to save $1.8 billion over the next three years.

AWARD CLAIM 2021 Organisers visited 35 hospitals and spoke with over 500 members to gather feedback

Member feedback showed that shift-by-shift ratios remains members’ number one issue, followed by a fair pay rise. The elected Log of Claims Committee met and developed a draft Log of Claims, which branches then endorsed. Our Claim seeks implementation of shift-by-shift ratios, a 4.7% increase to wages and allowances plus superannuation along with: ✔ Free permanent parking and access to spaces for all nurses and midwives ✔ Extend the Special allowance for Telephone Counselling to add Consulting ✔ Update and improve definitions: • New definition of Professional Standard • New definition of Assistant in Midwifery ✔ Annual Fit Testing for all nurses and midwives ✔ Safety in Outdoor COVID Testing Clinics ✔ Access to paid Pandemic leave for carers responsibilities On 15 April NSW Health provided an offer of 1.04% and the requirement for nurses and midwives to pay their own superannuation increase. They also rejected the entire 2021 Ratios and Conditions Claim, other than agreeing to a definition for Assistant in Midwifery.

The Association visited workplaces across NSW speaking to members to gauge their reaction. Overwhelmingly, members were angered and made the decision to hold rallies across the state. Branches held meetings on the week beginning 24 May to decide whether to accept or reject the offer. Branches unanimously rejected the offer. A record number of individuals voted through a new e-voting system. 98% of members who voted rejected the offer. On 2 June, seven branches met and took immediate action, from walking off the job for between one and 24 hours, closing beds, or doing both. Their action saw increasing numbers of branches meeting and deciding to take action to win shift-by-shift ratios. On Friday, 25 June the Ministry of Health advised that a new offer of 2.04%, plus superannuation would be lodged with the NSW IRC. Our members again rejected that proposal as it still rejected all other claims.

SAFER HOSPITALS = SAFER COMMUNITIES (Inquiry into Health outcomes and access to health and hospital services in rural, regional and remote NSW) Nine branches and 26 individual members made a submission to the inquiry Organisers conducted site visits at 70+ facilities to encourage participation and address local issues Three members from different sites joined a round table discussion in Dubbo with the Shadow Minister for Health Members from 5 sites were supported in providing evidence at the inquiry’s Public Hearings at Parliament House – Tumbarumba, Cobar, Tullamore, Canowindra and Gilgandra. Further hearings are to occur in the second half of the year Members from Lismore, Merriwa, Armidale, Griffith, Leeton, Warren attended the Parliament House specialty network with MPs on 7 June to speak on rural health issues Over 1,000 supporters have signed up to our Safer Hospitals = Safer Communities campaign

A key focus for Association members is the unsafe staffing in our Multi-Purpose Services (MPSs). Many of these sites have only two nurses on the evening and night duty. These two nurses, often without medical support on site, are responsible for aged care residents, acute beds and emergency presentations. An ED presentation requires both nurses to attend, leaving all patients and residents unattended. This is clearly not safe.

The remoteness of many of these sites leads to difficulties not only recruiting staff but also retaining them. There has been a flurry of resignations of RNs, causing a constant churn of vacancies in both MPSs and small sites, depleting not only the workforce but also critically impacting the available skill mix.

Safer hospitals

2020 – 2021 Annual Report

BUILDING POWER

FUTURE NURSES AND MIDWIVES New graduate recruitment 1,200 new graduates joined at a face-to-face orientations 149 new graduates joined via a virtual orientation 278 new graduates converted from students via email campaign

Student Representative Program 30 student representatives Students in nursing and midwifery at each university campus were invited to apply. Selected applicants are then trained to promote of the benefits of the union, membership and of relevant issues in nursing, midwifery and healthcare.

98 students converted to financial members via an outbound call campaign

AGED CARE Member leader development 240 potential member leaders were contacted and those interested moved to the next level of development Webinar to network leaders across NSW held on a fortnightly basis: • 23 members attended the first webinar • an average of 13 regularly attend • 28 have attended two days of training Member leaders held events to raise community awareness and publicity Member leaders also underwent development in: • planning their activities • having powerful conversations • mapping their communities • speaking with the media • lobbying politicians Member leaders visited four politicians in their electorates and two delegations have met with parliamentarians in Canberra

2020 – 2021 Annual Report

PUBLIC HEALTH SYSTEM Networking Branches within their Local Health Districts Networking midwives and nursing specialties (mental health, ICU, MPSs) across the state

Blacktown Maternity Blacktown Hospital Maternity Service continued to be understaffed and unsafe, despite attempts by the branch to raise the concerns with the hospital management. On 11 November 2020, following the death/ stillbirth of four babies over 18 months, 20 obstetric doctors notified their intent to resign if safety issues were not addressed. Association officers conducted a site visit as a welfare check on members. The branch met that week with over 95 members (midwives and operating theatre members) voting to: • request a meeting with the WSLHD Chief Executive within 48 hours • require an urgent review of their BirthRate Plus® staffing levels • compile a list of staffing enhancements needed to ensure patient safety

Member leaders from Maternity Services met twice with LHD management over the next 48 hours with management offering of an additional 15 FTE midwives across the maternity service, however there was no offer for additional staffing for operating theatres. Members felt the offer was not sufficient and did not trust local management to implement what was required, so voted to take action. At 4pm that day, over 100 members walked out. This resulted in immediate action from management. After being ordered back to work members and Association officers met with local and district management representatives.

Proposed closure of

WINS 24 members joined the union and four new Branch Stewards identified An additional 13 FTE midwifery positions identified through the BirthRate Plus® review plus an additional CME Introduction of supernumerary swing shift and Team Leader A review of rostering best practice Improved and transparent leave planners Introduction of 12 hour pilot rosters Greater transparency around like for like replacement Overtime/casual/agency usage and sick leave Introduction of specific bereavement and healthy pregnancy midwife Review of models of care including introduction of targeted groups Implementation of learning needs analysis and plan Staff wellbeing strategies Maternity Services Reasonable Workloads Committee meetings established to address unresolved issues

2020 – 2021 Annual Report

Kurri Kurri Hospital Rehabilitation unit The Kurri Kurri Hospital Rehabilitation Unit was on the verge of being temporarily closed as a result of matters related to medical officer visiting rights. Members were deployed for 12 weeks around the hospital while unsuccessful negotiations were undertaken, resulting in members growing concerned about the significant impact on the community and surrounding hospitals. Members formed a branch and conducted a hospital-wide petition, which led to the unit being saved from closure. WINS A new branch was formed Over 150 petition signatures collected Three meetings held with LHD representatives over a week The unit is now operating at near full capacity Members are no longer being deployed and have after-hours medical access

Bungarribee House/Westmead MH

Wyong defeated planned reductions

Wards – defeated planned reductions

in NHPPD

Some wards at Wyong Hospital were due to convert from 5.5 NHPPD to 6 NHPPD. Members discovered the plan was to reduce the staffing levels on other wards, meaning an enhancement was doubtful. The branch identified member leaders on each of the affected wards to help: • collect data • share information • encourage colleagues to act The issue was taken to the Reasonable Workload Committee, which was unable to resolve the matter and so the matter went to grievance. In the meantime, the member leaders met with local MP, David Harris (ALP) and ABC News was ready to run a story on the cuts. Twelve members (RWC reps and from each ward) attended the grievance meeting and told emotional stories of the unreasonable workloads, including horrific accounts of nurses being assaulted and missed patient care.

Nursing management proposed to reduce staffing in Bungarribee House (Blacktown Mental Health Service) and Ward C4A (Westmead Hospital). Both are inpatient acute NHPPD mental health units, staffed slightly above the Public Health System Nurses and Midwives’ (State) Award 2019 minimums. The proposal included cutting the 10-hour night shifts and reducing staffing numbers during day shifts. This was occurring in the context of three nurses being assaulted in late 2019 and a further six nurses being assaulted in the space of five days in late October/ early November 2020. • Members, supported by the Association, attended a meeting with management in mid-October 2020 to discuss concerns regarding lack of consultation and documentation provided • Limited information was eventually provided by nursing management • Despite the Association and members raising serious concerns, management sought to proceed with the proposed cuts WINS Dispute proceedings before the NSW IRC forced management back to the consultation table

WIN Central Coast Local Health District (CCLHD) emailed a confirmation that the status quo of 6 Nursing Hours Per Patient Day (NHPPD) would remain, but with no commitment to the NHPPD after the redevelopment

Members stopped all proposed cuts to staffing Management committed to maintain staffing levels and shift lengths in both units

PRIVATE SECTOR Sydney Adventist Hospital During negotiations for the Adventist Healthcare Limited enterprise agreement, Association SAN branch officials engaged existing active members and member networks to mobilise nurses around key entitlement and staffing issues: • More than 30 nurses in the Day Procedure Centre attended a meeting with management and secured the reimbursement of annual leave and/or payment for leave without pay they were incorrectly directed to take during the elective surgery freeze earlier that year • At member meetings about Adventist Healthcare’s bargaining claim to cut existing agreement protections related to stand-down without pay, members agreed to ‘spread the word’ on the issue. The message was quickly received by management and the claim was withdrawn • Members were asked to participate in the Adventist Healthcare staff survey and provide honest feedback about staffing levels, resulting in significant negative survey responses on this issue. This was a key pressure point in shifting management’s opposition to the inclusion of mandated staffing levels in the enterprise agreement Building momentum around issues led to members winning on key issues including staffing. WINS Members won mandated minimum Nursing Hours Per Patient Day (NHPPD), with specials in addition to NHPPD, in their agreement for the first time, covering 1,280 nurses Members in the Day Procedure Centre reimbursed for incorrect direction to take leave during surgery freeze

St Vincent’s Private Hospital Serious workload issues and a lack of consultation around ward closures prompted branch officials to hold a branch meeting, attended by over 50 members. A branch resolution was passed requesting a review of staffing and patient numbers, inviting management to attend a further meeting to hear concerns directly from members. A further branch meeting was held two weeks later where members raised concerns and requested a response in writing from management. Following a memo to staff regarding a restructure, a third branch meeting was held and a further resolution passed, calling on management to consult on the changes. WINS Branch officials stepped up and have made great progress building power in the branch, undertaking mapping, creating a branch member email tree and identifying two representatives from all units 38 new members have joined since 1 May 2021 Members are engaged and actively preparing for Agreement negotiations later in 2021

Ramsay Lake Macquarie HSRs A Health and Safety inspection led to a request from the Branch for elected Health and Safety Representatives (HSRs). WINS Branch delegates negotiated expanded workgroups and number of HSRs Members won contested HSR election at Lake Macquarie Private Hospital with 77% of positions now held by members All HSRs to receive five days training to access all HSR powers

2020 – 2021 Annual Report

Healthscope

Newcastle Private

Healthscope offered a 1% pay increase for each year of the agreement and did not address concerns with staffing, breaks and fatigue management. For employees migrating from the Public Health System at Northern Beaches Hospital, the proposed agreement contained significant cuts to their current conditions. The proposed Agreement was put out to a vote over a five day period, commencing Thursday 17 December 2020; a ‘no’ was recommended. Thousands of Healthscope members voted down Healthscope’s insulting offer one week before Christmas. Negotiations have recently paused while Healthscope consider their next proposal.

The branch put forward resolutions requesting:

WINS 936 participants in Enterprise Agreement (EA) staffing levels postcard action 1,862 ‘VOTE NO’ QR code scans

Risk assessment in Oncology ward ✔ resulting in In Charge of Oncology receiving a meal break and In Charge allowance Midwives receiving on call meal breaks in Birthing Suite when only two staff are rostered in the unit ✔ resulted in $3,939.74 back paid to 24 maternity members Maternity Staff, in consultation with branch officials, developed a comprehensive workload and staffing submission which was put to senior nursing management. ✔ Maternity staff collected over 50 signatures of nurses, midwives and medical officers

261 new members throughout EA campaign

✔ Healthscope commenced two separate reviews and intervention of the Chief Nursing Officer

13 member leaders attended training

✔ This work is ongoing but has already achieved an interim increase to staffing on the maternity unit

19 new Branch Officials New branch formed at Sydney Southwest Private 26 new potential member leaders identified during bargaining campaign so far

ENFORCING RIGHTS

PUBLIC HEALTH SYSTEM Port Macquarie Base Hospital – surge beds, ED Member Leaders from three specialty areas met with the Local Health District DoNM after months of campaigning around workload issues and award breaches. Following five months of member branch activity at Port Macquarie Base Hospital around unsafe workloads and award breaches, members finally gained significant wins. WINS The employment of bed cleaners for the first time

23 new graduates were provided permanent full-time employment in their second year

A ward where there is 50% RN (14.65 FTE) and 50% EN (14.32 FTE) profile was reverted to the 82% RN, 15% EN and AiN 3% skill mix

Backfilling unplanned leave with the second midwife in the Special Care Nursery (SCN) ceased immediately

All casual and permanent part time employees were provided written correspondence asking whether casuals wanted to convert to permanent hours and if permanent part time employees wanted to increase their contracted hours permanently

2020 – 2021 Annual Report

Commitment was received to continue with the Reasonable Workload Committee process in order to address ongoing staffing concerns.

Lismore ED and ICU The hospital had 40 FTE vacancies across the site, including 14 in the ED. There has been no increase in staffing since 2015, despite a marked increase in presentations. An emergency RWC meeting occurred on 19 February 2021 and a recommendation escalated to management to recruit 14 FTE vacancies as a matter of urgency. Members also proposed an additional Resuscitation nurse 24/7 on all three shifts plus an additional extra night duty shift seven days per week. Branch members: ✔ Met to support the Reasonable Workloads Committee (RWC) process setting out a plan if management did not agree to the Committee’s requests ✔ Wrote an open letter to management demanding the Chief Executive meet with the ED staff ✔ Almost 300 staff signed the letter, which was presented to the Chief Executive ✔ Progressed plans for a lunchtime rally when the Chief Executive declined to meet with them WINS An additional Nurse Practitioner seven days per week One additional Resuscitation nurse 24/7 The issue of the Night Duty Nurse is to return to the RWC for further discussion.

Lismore’s new ICU has been sitting empty for over nine months following a staffing dispute. Members at the site saw the new ICU as unsafe given the layout (single rooms with restricted line of site) and asked for an additional Cardiac Care staff, recruitment to vacancies and an additional Access Nurse. Through numerous meetings between members and management, the CCU and advertising issues were addressed, however the Access Nurse position was refused. • Members arranged a sign on letter to management, as did the medical officers. • Members provided the letter to management and proposed a lunch time rally. WIN Prior to the rally, management contacted the branch agreeing to the additional Access Nurse position.

Know Your Rights In order to educate and empower members on their rights in their Award, the Association developed guides around: • Top need to know Award Clauses • Take Your Breaks • Working 12 hour shifts • Continuing Education Allowance • In-Charge Allowance • On-Call Allowance • Are you eligible to be a CNS? • Safe Staffing & Unplanned Absences • Roster Waivers

PRIVATE SECTOR Ramsay Kareena Missed Meal Breaks

Fit testing at Healthscope

Ramsay was not paying missed breaks correctly. They systematically denied and delayed resolving the issue. Motivated by their member leaders, the Branch passed resolutions on the issue of underpayments of missed meal breaks. Seeing that more pressure was going to be needed to resolve the issue, the member leaders organised for over 70% of theatre nurses to sign a petition.

Following Healthscope member concerns regarding the use of N95/P2 masks, officers and branches advocated the immediate rollout of fit testing for all staff in high-risk areas. WIN Healthscope agreed and the Association is continuing to monitor compliance across Healthscope hospitals

WIN Members won back-payment of missed meal break allowances, affecting 186 nurses with known payments to 24 members, totalling $13,500

Ramsay underpayment of allowances Members were not always receiving their afternoon shift penalty. Through meetings and conversations, they got organised and provided the Association with the evidence required to secure backpay. It was established that Ramsay had a coding error in their pay system denying payment of the afternoon shift penalty in certain circumstances. WINS Members were reimbursed where they had been underpaid the afternoon shift penalty The coding error in the pay system was fixed to ensure members are now receiving the correct payment

2020 – 2021 Annual Report

Ward closures A number of wards at Healthscope hospitals remained closed over the Christmas or Easter periods for longer than the two-week period allowed for in the Enterprise Agreement. This resulted in uncertainty and dislocation for the staff of these wards, and some members reported being directed on leave. WIN Member advocacy ensured these wards reopened, and put Healthscope on notice that the limit on ward closures continues to be an important Agreement condition for members

COMMUNICATIONS

9,261

4,311

average visits per week to our NSWNMA WEBSITE

average visits per week to our LAMP ONLINE WEBSITE

7,145

VIDEOS PRODUCED

NEWS REPORTS across print, TV, radio and online

+ 31.86%

INSTAGRAM GROWTH

+ 8.12%

FACEBOOK PAGE GROWTH

+ 25.06% LINKEDIN GROWTH

738K

Total Engagements

27,449

Inbound messages responded

337,131

Facebook Lives impressions for strike actions

WORK HEALTH AND SAFETY (WHS)

1,180

WHS ISSUES dealt with by the Association in the year to date

155

WHS issues relating to VIOLENCE

The Association performed inspections and provided assistance at multiple sites including (but not limited to): Review of site plans and/or new facilities – Bungaribee House; Shellharbour High care; Bathurst correctional facility; MRRC field hospital; MRRC new clinic; St Vincent’s new PANDA, Lismore ICU, Tweed, Bowral hospital, Bulli hospital, Liverpool redevelopment, Westmead hospital, Maitland redevelopment, Wyong hospital redevelopment, Bankstown ED, Concord Mental Health, Burunji Adolescent Mental Health Support following violent incidents – particularly in mental health services Bungaribee House, Banks House, POW mental health, Cumberland, Nepean, HNE PECC, Older persons Unit and Maitland, Morriset, Nolan House, Gosford, Parkview, Bankstown Psycho-geriatric unit, Wyong ED Support on other WHS concerns, including matters such as – assistance regarding bullying/workplace culture related matters, community health caseloads, parking, TB outbreak, lead aprons, bariatric management, patient transfers, cytotoxics

2020 – 2021 Annual Report

540

WHS issues relating to BULLYING AND HARASSMENT

490

WHS issues relating to COVID-19 & ACCESS TO PPE

HSRs To support the process of empowering members in the workplace through the election of Health and Safety Representatives (HSRs), the Association has: Negotiated additional HSR positions at Macquarie Hospital, Sydney Community Mental Health, Lake Macquarie Private Hospital, and Waratah Mental Health Provided assistance in securing the provision of 5-day SafeWork approved HSR Training, on paid work time, through union providers Delivered SafeWork accredited HSR training Commenced identification of existing HSRs Instigated negotiation of workgroups to facilitate election of HSRs in a number of public, private and aged care sites Provided direct support and advice for HSRs in support of their role in the workplace

INDUSTRIAL ±80 DAY

NEW CONTACTS from individual members looking for advice and support are responded

1,200+

ADDITIONAL NEW CONTACTS from individual members on COVID-19 matters were responded and resolved (July 2020 – June 2021, on top of usual daily demand)

1,500+ DAY

OPEN ISSUES for members or workplaces receiving active assistance and support

±18,000

RESOLVED INDIVIDUAL CONTACTS AND ISSUES for members and workplaces, by providing information, guidance, or active support/representation

Supported 1,500 members during workplace fact finding/ disciplinary or performance management processes initiated by management

Assisted some 400 members with actual or threatened termination of their employment

Provided expert advice and input to over 250 restructures or workplace changes initiated by employers across public and private health, aged care and disability services

Assisted nearly 400 individual members with separate and individual payroll queries, most involving under/overpayments of salaries and allowances

Assisted 580 members with workers compensation issues, including help to obtain return to work/suitable duties, along with matters involving actual of threatened terminations due to alleged incapacity or incorrect payments

Provided 361 member referrals to NEW Law for assistance, including specialist support for various workplace matters, including representation with declined workers compensation claims

Not unexpectedly, the greatest number of contacts from members for information, advice or assistance in the last 12 months regarding an award or agreement was about the Public Health System Nurses’ and Midwives’ (State) Award.

OP te T r You

n contacts in the

Awa rd

11%

Clause 34 MATERNITY, ADOPTION AND PARENTAL LEAVE

14%

10%

CLAUSE 8 ROSTERS

Clause 4 HOURS OF WORK AND FREE TIME

WHAT YOU ASKED ABOUT The Public Health Award

Clause 30 ANNUAL LEAVE

Clause 37 SICK LEAVE

Clause 29 PART TIME, CASUAL AND TEMPORARY EMPLOYEES

Clause 32 FACS AND PERSONAL / CARER’S LEAVE

Clause 25 OVERTIME

2020 – 2021 Annual Report

Clause 33 LONG SERVICE LEAVE

Clause 27 PAYMENT AND PARTICULAR OF SALARIES

THE SERVICE CHECK REGISTER Fairness in Reach

2009

2013

Years of persistent peak level representations by the Association, along with individual disagreements with public health agencies over inappropriate use of the Service Check Register (‘SCR’), led to a Ministry of Heath review and change to the NSW Health Service SCR Policy Directive. It will now be reserved for the most serious of incidents in the workplace (and not an act of routine). This is a win for every member who wrongly suffered from being placed on the SCR. How good intention and policy lost its way ... but has been clawed back ... First policy directive (PD2009_004) issued on 30 January 2009. The First Report of the Special Commission of Inquiry observed “There was no requirement that checks be made of an applicant’s past performance and disciplinary history.” This PD made a direct connection between any “restriction” with a “serious disciplinary matter” or actions requiring a restriction of clinical privileges. Successor policy directive (PD2013_036) released on 31 October 2013. Wording changed so the SCR is to be used “when dealing with certain misconduct matters”. This includes any behaviour that “seriously breaches the expected standards...” and “misconduct matters”. This was soon read to mean the inclusion of most matters that involve alleged misconduct or the Code of Conduct. Any administrative action taken, no matter how benign, also triggered an SCR entry.

2014 15

Placement on the SCR becomes almost routine and a form of punitive action of itself. Association becomes increasingly involved in disputes about SCR entries and their appropriateness.

2016 18

Association makes repeated representations to the Ministry of Health regarding concerns with how the SCR is being used. Certain cases are escalated and result in recognition of its inappropriate use.

2019

Breakthrough! Ministry agrees to open up a review and rethink the policy directive. Association jumps to (again) make extensive representations.

2020

2021

COVID-19 hits. Some momentum lost. However, during the year an amended draft is circulated by the Ministry. This confidential working draft is a significant advance and is targeted toward serious misconduct or when a decision has been made to suspend or terminate the staff member or suspend/cancel clinical privileges. Association provides further feedback. Nearly there... Result: PD2021_017 released on 24 June!

SNSWLHD RESTRUCTURE After years of stop/starts, members land a better outcome The Southern NSW Local Health District (‘SNSWLHD’) commenced a restructure four years ago, reaching across its full breadth of services. It was a series of concurrent restructures that waned as changes occurred at CE level of the SNSWLHD. After significant consultation and agitation/ feedback from members and branches across the LHD, the Association was successful in positively influencing the outcomes adopted by the SNSWLHD. However, in late 2020, the LHD threw a spanner in the works, informing the Association it would retreat from previous understandings as to how affected staff would be managed and redeployed. In short, the LHD stated it would not be actively exploring/ facilitating the redeployment of employees affected by the restructure, including those whose substantive (deleted) positions would be considered equivalent to new positions – as anticipated in PD2012_021 (Managing Excess Staff of the NSW Health Service). A dispute was quickly escalated to the Industrial Relations Commission of NSW (‘IRC’), which the Ministry of Health was roped into. RESULT: Following lengthy conciliation before the IRC, the LHD agreed to explore priority assessment in relation to the positions within the scope of the dispute. This included the option to offer some affected staff corresponding roles in the new structure.

RECTIFYING “PAYROLL ISSUES” With the assistance of member activists, the Association detected breaches in relation to the accrual of annual leave across NSW by one the of the larger aged care employers in the state. After the Association was contacted by a member activist, it was clear many employees had not been accruing an additional week of annual leave as per their right under the relevant agreement. At the same time, members also raised other issues in respect of unpaid entitlements.

2020 – 2021 Annual Report

PAID PARENTAL LEAVE “Other parent” Last year’s NSW Budget made passing reference to improving the paid parental leave benefit to assist primary carers in returning to the workplace. After several months of asking and then negotiating, we now have a new additional entitlement in the NSW government sector for the “other parent”. In summary, the parent with primary responsibility for care will continue to have access to 14 weeks paid leave and other leave entitlements/ return to work arrangements as set out in relevant awards. The other parent will be permitted to access two weeks paid leave at the time of birth, adoption or surrogacy, and in addition, a further 12 weeks of paid leave during the first 12 months after the birth, adoption or surrogacy, provided they assume the primary responsibility for care during that time and that their partner (the original primary parent) has gone back to work. This is to take effect for birth, adoption or surrogacy occurring after 1 July 2021. RESULT: 13 weeks additional paid leave for the “other parent”. This builds on the improvements achieved by unions in recent years and reflects principles of fairness, inclusion, the need and benefit of supporting both parents/carers in that important first twelve months.

Once requests were made for payslips to assist in quantifying the problem, the CEO of the aged care provider announced they were bringing in an independent auditor, conceding “longstanding payroll issues that have impacted some of our Aged Care employees, and which have recently come to light”. RESULT: Some employees received additional annual leave as well as back pay for other entitlements not paid. A great outcome due to the vigilance of members.

MORE UNDERPAYMENTS Branch activists worked with the Association to detect breaches in relation to the payment of public holiday entitlements across NSW by another large employer in NSW. After several disputes meetings with the employer, it was conceded: ✘ underpayments state-wide had occurred in relation to payments on public holidays being non-complaint with the agreement ✘ no recognition of locally gazetted half day public holidays in the pay system RESULT: To the credit of the employer, once identified and the magnitude of the problem identified, they meticulously went about remedying the shortfalls.

NOT A GREAT RETIREMENT THANK YOU Following retirement, a member contacted the Association after a couple of decades of work in the public health system as a casual. At that time, she noted her statement of service (and the period to calculate her long service leave (LSL)) seemed short. The Association quickly accessed all the history and circumstances of her near two decades of employment, did the sums, and believed she was entitled to more. This was due to periods or gaps in her service due to significant life events being unfairly excluded. It completely ignored that under the Long Service Leave Act, the meaning of continuous service had to give reasonable consideration to the facts and circumstances in each case. Authorised absences did not detract from service. RESULT: Several thousand more LSL dollars to help with the member’s retirement.

LEGAL 570% INCREASE

The number of CASES AND ISSUES managed by the Association’s Legal Officers Legal Officers provided assistance in a wide range of matters, including:

Advice and/or representation for members involved in Coronial Inquests

338 ISSUES

(5119%)

Since July 2020 there has seen an enormous increase for assistance with statements

Advice and representation for members where they are the subject of a notification or complaint

103 ISSUES

(539%)

The Health Care Complaints Commission (HCCC)

185 ISSUES (532%)

NMC – Nursing and Midwifery Council

185 ISSUES

Management of:

Failure to escalate

Medication errors

Misuse of prescription medications, alcohol as well as illicit drugs

Failure to appropriately document clinical care

Inappropriate relationships with patients and professional boundary

Inappropriate use of social media

Inappropriate access of medical records and many more

Many of these members were represented by our legal team at the NMC and the less serious matters resulted in the imposition of conditions on registration or diversion into a non-disciplinary performance and/or impairment pathway.

2020 – 2021 Annual Report

ADVOCACY PROFESSIONAL ADVOCATE ROLE

NSW AGED CARE ROUNDTABLE

The Association has developed a new Professional Advocate role for engaged members wanting to use their voice to advocate for their profession(s) within their context of practice. Although still at development stage, so far 20 members have been identified as leaders in their field and some have already provided expert witness on behalf of the Association at NSW inquires and consultations.

Meetings increased to monthly to reflect the amount of joint work undertaken with key stakeholders in advocating for aged care nurses and assistants in nursing.

They may be involved in some of the following activities: Media Skills in reviewing/contributing to submissions Expert advice/opinion Providing evidence to relevant inquiries and reviews Providing education about their area of practice

NSW MATERNITY SERVICES ALLIANCE The Association initiated the formation of the NSW Maternity Service Alliance, comprising consumers, midwives, academics, and professional and industrial groups. Wrote to Minister Hazzard requesting information, including the availability of midwifery models of care in NSW and number of midwives who work in these models Had a Question On Notice from the Alliance put to Minister Hazzard Developed a ‘What is a midwife?’ document, identified future work to promote midwifery care and advocate for midwives and women in NSW

Collective advocacy regarding rural and remote aged care workforce shortages was agreed at a meeting attended by 16 members representing 11 stakeholder organisations Roundtable organisations have attended as witnesses and given evidence to the NSW Select Committee Inquiry into the provisions of the Public Health Amendment (Registered Nurses in Nursing Homes) Bill 2020 in favour of retaining and extending current legislation to require a Director of Nursing and registered nurse on duty at all times in every residential aged care facility in NSW Members of the Roundtable collectively made a submission to this Inquiry Successful in requesting delay to repeal of s104 of the Public Health Act NSW (2010) that requires a registered nurse and director of nurse in nursing homes Development of 10 Questions to Ask leaflets for those accessing home care services The Australian Government Department of Health is promoting the 10 Questions to Ask series through the MyAgedCare website and has linked the availability of the leaflets as evidence of compliance against quality standards required of residential aged care facilities. A Department of Health newsletter also went out to aged care providers and stakeholders promoting the series

CULTURALLY AND LINGUISTICALLY DIVERSE (CALD) We increased the amount of professional support provided to our Culturally and Linguistically Diverse (CaLD) members and created a new professional reference group for CaLD nurses and midwives. Membership currently stands at 44. The Association signed on to the national Racism.It Stops With Me campaign and produced resources for members to combat racism in the workplace Members have participated in filming for, and contributed to the development of online Bystander Action education Members were instrumental in developing a CaLD Branch Essentials education program on 8 and 9 June 2021. The course ran at capacity Members comments will be considered in the NSW Health Bullying and Harassment Policy, which is being revisited at the end of 2021 Members were successful in securing a review of the NSW Health Bullying and Harassment Policy and their input will be sought by the NSW Ministry of Health when this occurs second half of 2021

in the

CLIMATE CHANGE Received a Gold Climate Leadership Award for 2021 Part of the Climate Change Action Reference group Convened an Internal Environmental Committee, which commenced a carbon environmental audit for 2021 Member of Better Futures Australia Health Working Party with the Climate and Health Alliance

2020 – 2021 Annual Report

As a result of interest in research undertaken in the Hunter region around the transition from coalfired power to renewable energy, the Association is now involved with other like-minded unions and the Labor Environmental Action Network (LEAN) in the Hunter Jobs Alliance (HJA). The HJA has been formed to support Hunter workers through the promotion of good, low energy, renewable jobs. Three projects – Tomago green steel, Solar Schools and Cleaning up Fly Ash Dams have been chosen and currently the Association is on the Solar Schools working party.

AFFILIATIONS Our union is part of the broader union movement with its affiliations to organisations such as Unions NSW at state level, The Australian Council of Trade Unions (ACTU) at the national level, and the Public Services International (PSI) and Global Nurses United (GNU) at the international level. We are also affiliated to other organisations that keep the Association informed on and engaged in the health aspects of issues such as climate change, trade, tax systems and privatisation.

Unions NSW The Assistant General Secretary is the President of Unions NSW and the Association has other Officers involved in a number of Unions NSW committees. The Association often takes a leading role in any broad union campaigns and this was most recently demonstrated in the NSW government’s freeze on wages of all public servants last year. Given the recent decision of the government to reduce the 2.5% cap even further, Unions NSW affiliates understand the need to campaign to inform the community that wage increases are needed to drive our economy into full recovery. There is a notion in the workforce broadly that now is not the time to ask for wage increases when others lost their jobs in the pandemic, however we know that those people won’t get back to work unless the economy is healthy and employers hire more people. It’s also fair to say the NSW government has the resources to pay public servants fair wages and we must pursue wage increases both as members of our own Association and as an affiliate of Unions NSW.

Australian Council of Trade Unions (ACTU) The Assistant General Secretary holds one of the eight Junior Vice President positions on the Executive of the ACTU. The ACTU was instrumental in the establishment of JobKeeper and the increased supplements to JobSeeker when the pandemic hit. It was also the ACTU who pushed hard to achieve free childcare for a substantial period during the pandemic. They are now fighting hard to make that free childcare a reality in Australian society going forward. We know women were the biggest losers in the fallout of the pandemic and the ACTU, under the leadership of President Michele O’Neil and Secretary Sally McManus, worked tirelessly to ensure there are opportunities to improve womens’ working lives and work towards equality in the post pandemic world. Their five point plan to a better Australia is available on the ACTU website.

Public Services International (PSI) The Association Assistant General Secretary occupies the female titular positions on the PSI Executive for our region – Oceania. This position also represents women at the global level. The pandemic put a halt to all face to face meetings, so Zoom meetings were undertaken. Given the time zones, it meant meetings attended by the Association are held close to midnight. We have persevered and attended the meetings as required. The main topic at every meeting has been the pandemic and its impact on health organisations globally. PSI’s close connection with the International Labour Organisation (ILO) and World Health Organisation (WHO) has resulted in extra meetings to ensure all affiliates know the latest information on the pandemic as well as the situation on vaccinations and other COVID related matters. Our affiliation has been most beneficial during this time. PSI with the Association and ANMF produced three reports following the forensic investigation into the tax practices of the for-profit and not-forprofit aged care providers. This led to the Royal Commission into Aged Care Quality and Safety seeking extra input from our reports to inform some of their recommendations to the government on aged care. It’s projects like this that make our affiliation to the Global Union Federation (GUF) meaningful, providing us with real ways to make a difference. While the pandemic and all its challenges have been the main topic of discussion this year, the PSI campaign to adopt the ILO Convention c190 on Violence and Harassment, which aims to eradicate violence and harassment in the world of work, is still underway and was the main issue covered by the World Women’s Committee. The Association is a participant in the current campaign to get this Convention ratified in every country. Australia has not ratified and we must ensure it does, particularly given the inflamed situation in this country.

Global Nurses United (GNU) This is a group of over 30 nurses’ unions across the world who meet annually to discuss issues of importance to their members. The last year has been particularly difficult for nurses’ unions around the world as they advocate for their members during the pandemic. Australia has not suffered the adverse effects of the pandemic like many other countries and we certainly did not lose health workers to the pandemic through the course of their work. 1500 nurses have died worldwide and the situation continues. Nothing will return to anywhere near normal until the world majority is vaccinated.

EDUCATION

5,257+

REGISTERED across Association education sessions

Ongoing restrictions around COVID-19 required the Association to continue to deliver education to members via online videos and webinars. Our webinars regularly attract over 200 registrations per session. With the easing of restrictions, face-toface education recommenced, reaching capacity within metro locations. Education sessions are being held in the following regional locations: Wollongong, Newcastle, Maitland, Wagga Wagga, Lismore, Tweed Heads, Orange, Merimbula and Tamworth. Supporting early-career nurses and midwives was a key focus for Professional Officers to grow and strengthen our professions. The Association offered three free series of webinars for students, new graduates and early-career nurses and midwives.

Flying start – securing a new grad position Webinar series for 3rd year students 2,368 potential new graduates attended 100% felt supported by the NSWNMA during the new graduate application process 78% of attendees found the series very helpful 100% would seriously consider joining the NSWNMA once they started working

2020 – 2021 Annual Report

An education session was delivered to

300+ STUDENTS

at The University of Sydney Master of Nursing program

The topics covered were: • Applying for Gradstart • Interviewing: expectations as well as presentation • Applying for Registration with the NMBA

Transition to practice for New Graduates 545 registered over the 3 sessions This was a follow on from the Flying Start series. Three sessions were run over two days to assist new graduates in transitioning to their workplaces.

Kick Start your Career The first webinar held in April had 237 registered Another series of webinars developed for Early Career nurses and midwives. Topics were developed in consultation with the public sector GradStart Coordinators. Five webinars are being offered between April 2021 and December 2021.

Other webinars Other than the series for new graduates and early career nurses, the following webinars were produced and presented by external presenters from July 2020: Trauma Informed Care – 287 registered Determining Credibility: Cut through the noise to determine the truth – 774 registered Talking about vaccination: Vaccine hesitancy and conversations with empathy – 890 registered Manage parent infant clinical intervention: Relational trauma – 176 registered Allergies 101 – 389 registered

ASSOCIATION MEMBER TRAINING (AMT) 245 members attended an AMT course The Association ran reduced AMT sessions over the 2020-2021 period due to restrictions on face to face training. However we still delivered our four main workshops: • Delegate Skills • Branch Essentials • Winning at Work • Industrial Relations Basics In addition, AMT offered two new courses: Youth Network Training A two day workshop aimed at unionists under the age of 35. It focused on union history, campaigning, international unionism and developing leadership skills CaLD Branch Essentials A specific Branch Essential workshop designed to meet the needs of culturally and linguistically diverse (CaLD) union leaders. Education was provided around visas and the law, by-stander action and discrimination Both new courses ran at student capacity and further sessions are planned for later in 2021.

SCHOLARSHIPS Older People’s Welfare Council (OPWC) 1 scholarship awarded to the value of $2,000

33 applications

6 1 scholarship awarded to the value of $1,839.56

The final round of this scholarship awarded an Enrolled Nurse working in aged care studying their Bachelor of Nursing. This is the final round of OPWC aged care scholarships. The Association would like to thank the OPWC for their generous donation to make these scholarships possible.

Only three applications went to consideration as the remainder did not submit complete applications or did not apply for a suitable course that meets the criteria of Activism, Campaigning or Public Advocacy.

Lions Nurses’ Foundation

United in Compassion Medicinal

2019, 2020 academic year

Cannabis Nursing Conference 2021

117 applications

6 18 scholarships awarded to the value of $49,005 This round of Lions scholarships did not accept applications for conferences and seminars due to COVID-19.

Edith Cavell Trust 2019, 2020 academic year 142 applications

6 53 scholarships awarded to the total value of $84,390, however 11 applicants declined offers leaving 42 accepted scholarships to the value of $67,890

Roz Norman – 2 Scholarships awarded

2020 – 2021 Annual Report

209 applications

6 20 scholarships awarded to the total value of $20,000

Bob Fenwick Mentoring Grants Program Due to the impact of COVID-19, the Program Steering Committee recommended postponement of the 2020 Program round. The 30 mentee and 16 mentor applications for the 20 positions will be reviewed later this year, with successful applicants undertaking placements later in 2021, if NSW Health COVID-19 restrictions allow.

PROFESSIONAL RESEARCH

COLLABORATION

SUBMISSIONS

• Providing NSW input to inform the ANMF responses to the Royal Commission into Aged Care Quality and Safety

• Select Committee on the impact of technological and other change on the future of work and workers in New South Wales

• Disability royal commission

• Upper House Select Committee Inquiry into the Public Health Amendment (Registered Nurses in Nursing Homes) Bill 2020

• Contributed to development of SafeWork NSW draft Code of Practice managing psychosocial risks • Participation in SafeWork NSW funded research project – Violence in NSW Hospitals – systems thinking program • Consultation with Ministry re security risk assessment • Participation in development/review of Australian Standards/International Standards • Rural and remote inquiry • Inquiry into healthcare facilities for South West Sydney • Support for Advancing Implementation of Nurse Prescribing in Australia AIMS-Aus Study • Provided NSW input to inform the ANMF response to NMBA, Aphra and ANMAC consultations

• Finance and Public Administration References Committee on the current capability of the Australian Public Service (APS) • Ministry of Health Consultation on draft Extreme Behavioural and Psychological Symptoms of Dementia Project Report • The Health Standing Committee Inquiry into family domestic and sexual violence • The Australian Commission on Safety and Quality in Health Care (ACSQHC) consultation on the draft National Safety and Quality Health Service Standards (2nd edition) User Guide for Multi-Purpose Services Aged Care Module • Submission to Legislative Council Committee Inquiry into the current and future provision of health services in the South-West Sydney Growth Region • Submission to the Independent Planning Commission on the Narrabri Gas Project (SSD 6367) • Submission to Standing Committee on the Environment and Energy: Current inquiries into the Climate Change Bill 2020 • Submission to the NSW Health Regulation and Compliance Unit: Information sharing for reportable incidents

ANNEXURE 1

SUMMARY OF FINANCIAL INFORMATION FOR THE YEAR ENDED 31 DECEMBER 2020 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 STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 DECEMBER 2020 2020 ($) 2019 ($) Membership revenue 44,654,489 40,393,833 NursePower fund subscriptions 922,663 2,125,991 Other income 2,659,577 2,926,166 Total income 48,236,729 45,445,990 Less total expenditure (45,300,812) (45,744,373) Result for the year 2,935,917 (298,383) Remeasurement of retirement benefit obligations (45,662) (53,330) Total comprehensive income attributable to members 2,890,255 (351,713) SUMMARY BALANCE SHEET AS AT 31 DECEMBER 2020 Total equity 48,596,464 Represented by: Current assets 19,714,935 Non-current assets 36,446,990 Total assets 56,161,925 Current liabilities 7,255,919 Non-current liabilities 309,542 Total liabilities 7,565,461 Net assets 48,596,464

45,706,209 21,864,135 30,734,698 52,598,833 6,600,552 292,072 6,892,624 45,706,209

Information to be provided

Report of the Independent

to members or registrar

Auditor on the Summary

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

Financial Statements to the

2020 – 2021 Annual Report

members of the New South Wales

SUMMARY FINANCIAL STATEMENTS The summary financial statements do not contain all the disclosures required by section 510 of the Industrial Relations Act 1991 [NSW] or Australian Accounting Standards. Reading the summary financial statements and the auditor’s report thereon, therefore, is not a substitute for reading the audited financial report and the auditor’s report thereon. THE AUDITED FINANCIAL REPORT AND OUR REPORT THEREON We expressed an unmodified audit opinion on the audited financial report in our report dated 13 April 2021. Our Independent Auditor’s Report to the members 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. COMMITTEE OF MANAGEMENT’S RESPONSIBILITY FOR THE SUMMARY FINANCIAL STATEMENTS The Committee of Management is responsible for the preparation of the summary financial statements. AUDITOR’S RESPONSIBILITY Our responsibility is to express an opinion on whether the summary financial statements are a fair summary of the audited financial report based on our procedures, which were conducted in accordance with Auditing Standard ASA 810 Engagements to Report on Summary Financial Statements.

Daley Audit

Nurses & Midwives’ Association OPINION The summary financial statements which comprise the summary balance sheet as at 31 December 2020 and the summary statement of profit or loss and other comprehensive income for the year then ended are derived from the audited financial report of New South Wales Nurses and Midwives’ Association for the year ended 31 December 2020. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

Stephen Milgate 13 April 2021, Wollongong

Partner

Liability limited by a Scheme approved under Professional Standards Legislation A copy of the Financial Report, including the Independent Audit Report, is available to members on the Member Central portal accessed via www.nswnma.asn.au. Members can obtain a hard copy by emailing the General Secretary, NSWNMA at gensec@nswnma.asn.au or calling 1300 367 962.

ANNEXURE 2

NEW AGREEMENTS FINALISED BY ASSOCIATION Name of Employer Abel Tasman Village Association Ltd Anglican Care - Diocese of Newcastle Anglican Community Services Ashford Ageing Care Facility Inc Australian Croatian Cardinal Stepinac Association Limited Australian Nursing Home Foundation Limited Autumn Lodge Village Inc Banksia Villages Ltd Bankstown City Aged Care Limited Baptist Care NSW & ACT Barraba and District Retirement Homes Association Incorporated Berrigan and District Aged Care Association Ltd Booroongen Djugun Aboriginal Corporation Bundaleer Care Services Ltd Bupa Care Services Pty Limited Carrington Centennial Care Ltd Charingfield Limited Christian Brethren Community Services Christophorus House Retirement Village Clarence Village Ltd Coffs Harbour Legacy Welfare Fund Cooinda Coonabarabran Limited Cootamundra Health Care Co-operative Limited Cowra Retirement Village Ltd Crookwell/Taralga Aged Care Ltd Cypress View Lodge Limited Deniliquin Nursing Home Foundation Ltd Dougherty Apartments Retirement Housing Project Dubbo RSL Aged Care Association Finley Regional Care Limited Great Lakes Aged & Invalid Care Association Ltd Gulgong Hostel Association Inc Gundagai and District Hostel Accommodation Inc Hay Senior Citizens Association Illaroo Co-operative Aboriginal Corporation Illawarra Diggers Aged and Community Care Ltd Inasmuch Community Ltd Indochinese Aged Care Limited Juliana Village Association Ltd Kanandah Retirement Ltd Koonambil Aged Care Ltd KOPWA Limited Kurrajong & District Hospital Society Inc Lee Hostel Committee Inc Lutheran Aged Care Albury Mark Moran Group Maroba Limited

No. of Sites 1 15 35 1 1 4 2 1 4 25 1 1 1 3 32 1 1 3 1 1 1 1 1 1 2 1 1 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 1 2

Sector

Aged Care

Admin. increase 3 3 3 3 3 3 3 3 3 3 3 3 3 3 New Agreement New Agreement 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 New Agreement 3

Name of Employer McLean Care Mackellar Ltd Merton Living Limited Multicultural Aged Care Illawarra Ltd Opal Specialist Aged Care Our Lady of Consolation Aged Care Services Ltd Port Stephens Veterans and Citizens Aged Care Ltd Presbyterian Aged Care NSW and ACT Quirindi Retirement Homes Ltd Residential Gardens for Spanish Speaking Frail Aged Limited Royal Freemasons Benevolent Institution Royal Flying Doctors RSL Lifecare Salvation Army Sapphire Coast Community Aged Care Ltd Scalabrini Seventh-day Adventist Aged Care (North New South Wales) Ltd Siena Management Services Pty. Limited Sisters of Mercy of the Parramatta Congregation St Andrews Village Ballina Ltd St Basils’ St Joseph's Aged Care Facility for Religious Limited St Luke's Care Ltd St Vincent's Health Australia Stroud Community Lodge Inc Tenterfield Care Centre Limited The Pioneers Lodge Ltd Timbrebongie House Inc Tocumwal Lions Community Hostel Limited Touriandi Inc Trustees of the Roman Catholic Church Diocese of Lismore Trustrees of the Maronite Sisters of the Holy Family United Protestant Association of New South Wales Limited Uralba (Carcoar) Incorporated Waratah Respite Centre (Mid North Coast) Inc Whiddon Woolgoolga and District Retirement Village Ltd Woy Woy Community Aged Care Ltd Yass Valley Aged Care Ltd

No. of Sites 3 1 1 41 1 2 9 1 1 23 2 34 18 3 7 3 1 1 1 � 1 1 6 1 2 1 1 1 1 9 2 21 1 1 10 1 1 1

Western Health Alliance Ltd

Family Planning Fresenius Hunter Primary Care Northcott Serco Asia Pacific St Luke's Care Ltd Adventist HealthCare Limited Lifehouse Australia T/A Chris OBrien Lifehouse Ramsay Health Care Australia Pty Limited St Luke's Care Ltd

3 5 3 12 19 1 2 1 32 1

Cura Day Hospital Group

Subee Pty Ltd

2020 – 2021 Annual Report

Sector

Aged Care

Medical Centres & GP Services

Other

Private Hospitals Private Sector Day Procedure Centres Private Sector Specialist Services

Admin. increase 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 New Agreement 3 3 3 3 New Agreement New Agreement 3 3 3 3 3 3 3 3 3 3 3 3 3 New Agreement 3 3 New Agreement New Agreement New Agreement New Agreement New Agreement New Agreement New Agreement New Agreement 3 New Agreement New Agreement New Agreement

The NSW Nurses and Midwives’ Association acknowledges the Gadigal of the Eora Nation, the traditional custodians of this land and we pay our respects to the Elders both past and present.

NSW NURSES & MIDWIVES’ ASSOCIATION 50 O’Dea Avenue, Waterloo NSW 2017 PHONE 8595 1234 (METRO) 1300 367 962 (NON-METRO) FAX

9662 1414 EMAIL gensec@nswnma.asn.au

www.nswnma.asn.au Authorised by B.Holmes, General Secretary, NSWNMA

NSWNMA Annual Report 2020-21

Articles inside

Message from the Assistant General Secretary

Advocacy

Year in Review