NSWNMA Annual Conference Report 2017 by NSW Nurses and Midwives' Association

Report to

2017

Annual Conference

content

Report to 2017 Annual Conference

A Year in Review

Report to 2017 Annual Conference

Coral Levett, President

Brett Holmes, General Secretary

Judith Kiejda, Assistant General Secretary

01 02 03

Key Direction

Grow our capacity to influence

Be innovative in our advocacy and bargaining

Promote a world class, well-funded, integrated health system

Key Direction

Conclusion

04 05

Promote the Association as a significant and professional advocate for the health system and our members

Ensure our people and resources are aligned with our Vision

Brett Holmes, General Secretary

Summary Of Financial Information For The Year Ended 31 December 2016

70 annexure

71 Index

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Report to 2017 Annual Conference Coral Levett, President

Welcome to all the delegates here today attending our 72nd Annual Conference. Welcome also to our special invited guests, including life members. This conference is an opportunity for our elected delegates to come together, engage with each other, reflect on the previous year’s activities, debate policy and consolidate the direction our union takes for the year ahead. I hope you will enjoy your time with us and we look forward to your participation in both the formal and social program. 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. Association Council and Executive

Our 23 democratically elected nurses and midwives, including the General Secretary, the Assistant General Secretary and eight executive members are vested with the responsibility of managing the affairs of the Association according to our Rules. Since last year’s conference, one new Councillor – Lee Taylor, has joined us following an election at last November’s Committee of Delegates meeting. Lee filled the casual vacancy following the resignation from Council of Lyne Dine, a long serving Councillor who represented the private sector admirably. I would like to publicly acknowledge Lyne’s excellent contribution to Council and wish her all the best for the future.

Leading and managing this organisation continues to be an extremely challenging but important responsibility, and I acknowledge the continued strong leadership and the commitment of Brett Holmes, Judith Kiejda and the senior leadership team. I 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 team. Over the last 12 months, the Executive and Council have been involved with many NSWNMA and ANMF NSW branch core activities, including: • Transitioning the NSWNMA and the ANMF NSW branch to align with the changes to the Federal and State industrial laws; • Campaigning to improve and extend nurse to patient ratios; • Campaigning for RNs in Aged Care 24/7; • Campaigning to Build a Better Future in order to oppose coalition governments’ privatisation of our state and national assets; • Campaigning to reverse the abhorrent Liberal/Coalition government specific decision to privatise our valuable public hospitals in regional NSW; • Campaigning to Save Medicare; • Campaigning to keep the NSW government’s Hands Off Public Disability Services;

• Campaigning to save penalty rates and the meaning of our weekends; • Campaigning to save Paid Parental Leave • Supporting and promoting the introduction of Nurses & Midwives Health – a competitive new option for private health insurance for our members and their families;

• Authorising around $120,000 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 Association and the ANMF.

Professional Issues Committee

Edith Cavell Trust

• Attending and supporting the Sydney Alliance movement; • Active involvement as committee representatives in The Lamp editorial, the Professional Issues Committee (PIC), numerous Log of Claims Committees and Working Parties, and the 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 $110,000 was allocated this year. Congratulations

Association Council – meeting attendance Meetings held from September 2016 to July 2017 = 10 Alldrick, Annette

McCall, Liz

Brazil, Sue

McKenna, Lucille

Nicholson, Michelle

Cashman, Michelle

Clark, Gary

Noort, Richard

Gleeson, Tania

Rodgers, Kerry

Hibbert, Peg

Scott, Lorna

Holmes, Brett

Smith, Debra

Hopper, Lyn

Smith, O’Bray

Kiejda, Judith

Taylor, Lee

Lang, Debbie

Levett, Coral

Makepeace, Edward

go to the 35 members, including student members, who were successful with their scholarship applications for the 2017 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.

(* from November 2016)

White, Sue

Wilson, Gil

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. The PIC also oversees a number of specialist nursing and midwifery interest groups doing some great work. Thank you to all the members of the PIC for their ongoing contribution, including regular attendance at our meetings. Australian Nursing & Midwifery Federation (ANMF)

As stated earlier, it has become necessary for us to better consolidate the relationship between the NSWNMA and the ANMF NSW branch in order to meet new industrial legislation and to protect our members working in the Federal arena. The ANMF NSW branch forms a sizable component of the national ANMF collective of almost 250,000 members. We are the second largest member state in the country. In addition to the regular interactions at Federal Executive level by the state and territory ANMF branches and Federal Office, every two years delegate representatives from the states and territories meet to progress issues of common interest. The next Biennial Delegates’ Conference

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will be held in October this year in Hobart, Tasmania, and will involve representation from the ANMF NSW branch Council. It will focus on a range of issues the states and territories have in common, including: the pursuit for mandated nurse to patient ratios; the fight against privatisation of health services; the pursuit for a satisfactory staffing and skillmix arrangement in aged care, and many other issues important to nurses and midwives. Following this conference, the ANMF NSW branch will finalise the issues to take to this meeting on your behalf. Federally, the ANMF continues to have a strong and effective leadership with Lee Thomas as Federal Secretary,

Annie Butler as Federal Assistant Secretary and Sally-Anne Jones as Federal President. An ANMF election earlier this year saw Lorianne Sharp replace Maree Burgess as Federal Vice President. Lorianne is from the Victorian ANMF branch and was elected unopposed into the role.

Conclusion

It is with great pride that I stand before you as President. It is a privilege to work with such dedicated team of nurses, midwives, and support staff. This unionâ&#x20AC;&#x2122;s ongoing success and growth can be attributed to the extraordinary efforts by many people, both within the organisation and in our broader membership. The hard work carried out day to day by our delegates, branch officials and activists is extraordinary and I thank each and every one of you for your personal contribution. Our teams within the Association play a vital part in keeping this union relevant, successful and influential. We must continue to do everything we can to have our voices heard by those that need to hear them. To do this, we must continue to grow our membership, and in particular attract and foster activists â&#x20AC;&#x201C; for without active members we have nothing. I congratulate Brett and Judith once again on their exemplary leadership and their ongoing capacity to keep this union progressive and dynamic. Let us continue to work together to achieve a better deal for the nurses and midwives of NSW and the community we provide service to. I wish you all an enjoyable and productive 72nd Annual Conference. Coral Levett

President

A Year in Review Brett Holmes, General Secretary

The health sector was dealt a series of blows in the past twelve months but our willingness to provide a solution and support each other as a strong, united workforce has been extraordinary. Our collective voice has had a significant impact on both community and political thinking around the challenges we face, such as aged care staffing, the privatisation of our regional public hospitals and the ongoing battle to improve and extend ratios. As an Association, we are moving forward with you by aligning our resources to support our shared vision of a strong, sustainable healthcare system. We are almost half way through our five year strategic plan and already so much potential has been recognised within the Associationâ&#x20AC;&#x2122;s internal structure. A new team, tasked with educating members to become leaders, will pass on the expertise of our Organisers to those on the ground who are working with the issues branches face every day. We hope this empowerment will allow members to have better guidance in working with the Association to achieve optimum outcomes within their workplace. Our systems are also changing, with a new membership development system currently being rolled out that will allow us to better understand each member and provide the support and information needed to achieve our collective goals. This will assist the Association in realigning our communications to suit individual needs. We are also improving minor inefficiencies within our own organisation, to improve communication between teams in order to provide a more streamlined experience for our members, from member organising right through to strategic bargaining. It is important for us as the Association representing NSW nurses and midwives

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to acknowledge the changing workforce and be progressive in our operations in order to grow with our members. We hope these operational changes being introduced over the next few months will both improve the experience of members and redefine the Association as an innovative, forward-thinking union. Membership Growth

The Association has recorded a net increase of 536 financial members in the 12 months to 30 June 2017. This brings the Association to a financial membership of 62,778 at 30 June 2017, representing a growth of 0.86% for the 12-month period. Key Growth

• An increase in the Public Health System for the year (30/06/16 to 30/06/17) – up by 600 members (1.45%) • A decrease in Residential Aged Care for the year – down by 34 members (-0.34%). • An increase in Private Hospitals for the year – up by 139 members (2.44%) • An increase in Justice Health for the year – up by 18 members (2.64%) • A decrease in ADHC – down by 80 members (-9.01%) • Other sectors down by 107 members. • The number of PRD members has decreased by 530 for the year (30/06/16 to 30/06/17) from 6,959 to 6,429 (-7.62%) Finance

The NSWNMA is in a sound financial position, with the benefit of a 0.86% membership growth to 30 June and prudent expenditure. The Audited Accounts for 31 December 2016 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 $4,114,383 and a total comprehensive income attributable to members of $4,480,145 (compared to $3,594,514 in 2015). Our Net Assets, as at 31 December 2016, were $41,808,948, an increase of $4,480,145 from 2015. To ensure that federal Right of Entry permits could be maintained after the end of transitional recognition of the Association, 105 Association staff were transferred to the employment of the Australian Nursing and Midwifery Federation New South Wales Branch between 1 October 2016 and 31 May 2017. In the unaudited five months to 31 May 2017, we currently have a surplus of $2,039,936 which is

Branches: 444 New branches formed: 21 Branches formed: 18 Delegates: 663 Branch officials: 1,445

better than budget by $535,255. Our better than budget position is partly as a result of less fees being paid to ANMF NSW Branch for the period. Aged Care

In April this year, The Shooters, Fishers and Farmers Party introduced a bill to protect the requirement in the Public Health Act 2010 to keep at least one registered nurse (RN) in a nursing home at all times. The bill passed the upper house but was voted down by the Liberals and National party members in the lower house the day before International Nurses Day on 11 May. The NSW Government’s relentless attempt to pass the buck on this

Public Health System up by 600 members Residential Aged Care down by 34 members Private Hospitals up by 139 members Justice Health up by 18 members Other sectors down by 107 members PRD decreased by 530

issue to the federal government has made it difficult to get any kind of response from MPs or the NSW Health Minister. While we have been assured in the many standard responses from local Members that the current regulations will remain in place “until the NSW Minister for Health is satisfied any proposed changes to the national system will ensure continued high quality care and patient safety”, we are not holding our breath. While the Association and ANMF can continue to support the RN 24/7 campaign, we must now broaden our efforts to encapsulate the findings in the National Aged Care Staffing and Skills Mix Report. The research conducted by Flinders University and University of South Australia, in conjunction with ANMF South Australia, found residents are currently receiving 2 hours and 48 minutes of care per day on average, when they actually need 4 hours and 18 minutes. The report found about 30% of that should be provided by RNs, 20% from ENs and 50% from carers. Currently those numbers stand at 14.9% RNs, 9.3% ENs and 71.5% PCAs. The RN 24/7 campaign has been a very important campaign that has brought attention to the issue of the quality of care in aged care facilities but it is not the sole

solution to the very many other problems of residential aged care. This is why we must launch a national campaign for skill mix and staffing – to engage the federal government in ensuring improvements in overall staffing and funding for aged care. Ratios

In May we received an offer from the government in response to our log of claims for the NSW public health system Award. As expected, our request for an improvement of nurseto-patient ratios was ignored, just as it has been for the past six years. It is beyond comprehension that there is no indication from the NSW Government of its intention to take public health seriously and develop a future plan to ensure hardworking, dedicated nurses and midwives can deliver safe, quality care to an evergrowing ageing population. Members voted on the claim and collective analysis highlighted critical issues facing health. Key areas that need to be addressed include ratios, particularly in Emergency Departments (EDs) and regional areas, specialling and rosters. Since 2011, when we first achieved some ratios after an extensive campaign, there has been no significant improvement to ratios. International

research and local experience clearly show that ratios save lives and make good economic sense. At last year’s Annual Conference, you asked us to take the issue of specials to the community. In preparation for that we surveyed members across NSW to gather evidence that the system is broken. We know from our surveys to members on this matter that it is commonplace for no extra staff to be provided for patients who require one-on-one care. More often than not, when staff are provided, they tend to be less experienced. This year we expanded the previous Award claim on specials to include a call for mandatory provision of specials wherever clinically assessed as necessary in all wards and units (not just those with ratios). For the government to offer a 2.5% pay increase, yet give no consideration towards the persistent issues our nurses and midwives have been managing every day in their jobs, is disrespectful to our members. The state budget is healthy and our economy is growing, so there’s no economic excuse not to improve ratios. It is clear that we will be leading our members into a substantial campaign in the lead up to the next NSW state election as that appears to be the only real time that politicians listen to their constituents. We will need a very substantial commitment from the members to take action if we are to secure safe patient care.

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Branch voting on the current 2.5% pay increase offer closed on 14 June. Given the current Government Wages Policy that is unlikely to change this year we have recommended accepting that pay increase and prepare ourselves for a very substantial campaign in 2018-2019. Penalty rates

The Fair Work Commission handed down its long awaited decision on Penalty Rates in Hospitality Retail and Pharmacy Awards as part of a four yearly review of Awards in February 2017. Employers, supported by the Federal Government, had pushed for cuts to weekend and public holiday penalty rates for these workers for years and the Fair Work Commission granted part of the claims. Cuts to penalty rates on Sundays and public holidays ranged from 25% to 50%, depending on permanent or casual employment. Attempts by unions and the Australian Labor Party to get the cuts overturned by Parliament were unsuccessful, as were attempts to get the Fair Work Commission to further delay and phase in the cuts. The Commission decided that the cuts would be implemented in

5% increments from July 1 2017 through to July 2020 for the Retail and Pharmacy Awards. Hospitality and Fast Food Awards will be phased in by 1 July 2019. Over the next three to four years, around 700,000 workers in the hospitality and retail sectors will receive cuts to their pay in a drawn out process that will result in more than $1 billion in lost wages for workers. We are being led to believe the decision to cut penalty rates will benefit the economy, but as consumer spending declines at a time of stagnant wage growth, it is likely to have a negative effect. This money that would ordinarily be injected back into local economies will now be going towards employer profits. Perhaps the most concerning result of the decision, is the erosion of the concept of a weekend and specifically

the importance of Sundays, which will arguably lead to the eventual disappearance of it being a special time for relaxation, friends and family. Once that becomes the norm it will be hard to argue that any worker working on weekends can be compensated for the adverse impact on family and wellbeing. The decision puts all workers at risk. Around the time of the inquiry, two employers in the aged care sector attempted to reduce the weekend pay in their enterprise agreements. Penalty rate cuts have put workers at the mercy of their employers, that have seen it as an opportunity to profit. Nurses in the public system who work nights and weekends regularly could stand to lose up to 30% of their take home pay, and 25% in the private sector if they work afternoon and weekend shifts regularly (based on national figures). This is a significant portion of a nursesâ&#x20AC;&#x2122; income and livelihood, which is why we can not afford to be complacent about the issue. The decision will also further disenfranchise women, young people, casual workers and the low paid and exacerbate inequality. Despite popular belief, the majority of both hospitality and retail workers are not students.

These people, who may be working a second job on the weekend just to make ends meet, rely on penalty rates to cover their day-to-day expenses. Workers will have to work longer hours to get the same pay they live on now. Anti-privatisation

Just a few short months after the 2016 NSW budget was delivered, the government announced it was inviting expressions of interest from private providers to redevelop and run five regional public hospitals: Goulburn, Bowral, Shellharbour, Maitland and Wyong. The â&#x20AC;&#x2DC;public private partnershipsâ&#x20AC;&#x2122; (PPPs) would essentially take hospitals out of public hands and gift them to private operators to run partly off the taxes we pay. The Association joined with Unions NSW, Health Services Union (HSU) and Australian Salaried Medical Officers (AMOF) in launching antiprivatisation campaigns as soon as the announcement was made. We staged rallies and community forums in each area. There was no consultation from the government, so it was important for health workers to engage the community on the issue and demand answers.

Nurses and midwives remain in the dark about their future working conditions and entitlements. A regulation introduced in June 2016, by then Premier, Mike Baird, terminated the redundancy entitlements of public servants who are transferred to the nongovernment sector. This meant only a two-year employment guarantee was offered in relation to the PPPs, with no opportunity to negotiate. After these two years, future employment will be at the mercy of the private operator. Campaigning swiftly succeeded in Goulburn after pressure was applied to then Assistant Minister for Health and Minister for Mental Health, Pru Goward. In 2017, we reignited the outrage. Public forums with government and Local Health District (LHD) representatives were organised, resulting in considerable support from the community and media against the privatisations. As a result, some government representatives stated that if the community was opposed and the model does not benefit public patients, they will not persist. Community outrage and consistent campaigning resulted in two incredible victories just this month, when the State

Government announced it would scrap plans to privatise Wyong and Bowral Hospital. We have succeeded with three of the five privatisations and will not stop until we have reassurance from the government that the two remaining public hospitals identified will remain in public hands. Northern Beaches Hospital redevelopment

It has been over three years since the NSW Government first announced the replacement of Manly and Mona Vale Hospital services with a new private hospital to be run by Healthscope. After many fruitless meetings with Northern Sydney LHD around staff transfer details, Unions NSW, the Association, HSU and ASMOF decided to have a case heard in the Industrial Relations Commission. Despite this, we still do not have the answers with just over a year to go until the new hospital opens to the public. Some of our requests were recently answered thanks to a petition created in consultation between Unions NSW, the Association, HSU and ASMOF. Soon after the petition gained momentum and on the eve of the Manly by-election, Association members received an email directly from the LHD, confirming the transfer payment be made available to Manly and Mona Vale staff transferring. It will be provided on a sliding scale, with a maximum of eight weeks at base rate of pay if permanently employed for six years or more. In addition, the Minister for Health, Brad Hazzard agreed to meet with delegates in June. While being sympathetic to the idea that workers should be no worse off, the Minister was unable to give any firm commitments to resolve outstanding concerns. He invited the unions to write to him again on the issues.

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We are getting closer to finding out some of the detail but the lack of transparency around the Northern Beaches PPP is an indication of the government’s unwillingness to disclose how these privatised models will operate for public scrutiny. The new owner, Healthscope is very willing to do publicity shoots of the new building for adoring media but contrastingly unwilling to release job matching arrangements for “fear of scaring” the potential employees. Review of Seclusion, Restraint and Observations in Mental Health

Following the release of shocking footage of a patient in a NSW mental health facility, the NSW Government commissioned an independent review into seclusion, restraint and observations. The Association welcomes the inquiry and acknowledges the work being done by many agencies to reduce the use of seclusion nationally. We agree with the direction of this work as it follows current international trends and best practice principles for patient centred care, trauma informed care and crisis prevention strategies. We hold the view that the use of seclusion and restraint can be reduced in NSW but only with the right support and resources in place. Seclusion is a necessary tool and needs to remain an option in mental health units but we also understand that too many nurses incur injury during restraint and seclusion procedures. We will be requesting the review panel pay close attention to skill mix, staffing ratios and whether appropriate training and supervision has been provided across all settings. We urge all members working in these environments to actively participate in the review and have developed 11 questions to reflect on when contributing within your own personal involvement with restraint and seclusion.

Informing the independent expert panel will go a long way to helping appropriate changes occur in mental health units. We hope this will help members working in mental health facilities feel supported and confident that they have the resources available to manage the reduction of seclusion and restraint in mental health units safely. Mental health nurses need to drive the changes required to help reduce seclusion and restraint across NSW and ensure the safety of mental health clients through evidence based best practice. I am concerned that if mental health nurses do not take a very active role in this review then we will see it overtaken by people of good intention but with no experience of the dangers faced by our members. Failures in following local policy and requirements for patient observations have very serious consequences for patients and disciplinary issues for our members, which is why it is so important to make our collective voices heard. Social Issues

The Association holds strong values around social justice and human rights and believes in a fair, just and equitable society for all people. Marriage equality

At last year’s Annual Conference members demonstrated their support for these values by passing a resolution to support the Association’s participation in the Australians for Equality national campaign for Marriage Equality. The expected process of a plebiscite has changed direction and it now appears that it

will need a change of government for any progress to be made. Compelling research identifies the health risks to those who are discriminated against on the basis of gender, sexual orientation or gender identity, including social isolation and poor self-esteem. Same-sex attracted, intersex and gender-diverse people do not exist on the fringe of society or in isolation; they are our members, family, friends, workmates and neighbours and deserve to be treated equally. Affordable Housing

Housing affordability is a growing concern for nurses and midwives who are being forced to move further away from their workplaces as rent and property prices continue to increase at an alarming rate. In order to help solve the problem, the Association surveyed members to understand how the issue is affecting them, their families and where they choose to work. As a result, a housing affordability reference group was established and it has provided valuable assistance as we work with the Sydney Alliance, Unions NSW and other interested groups in arguing for solutions to these problems. The Association is actively working with our members on these issues effecting change to the Inner West Council policy on housing and Parramatta Council’s launch of housing affordability policies. We have also been approached by developers who want our support for their concepts of key worker housing, both on a buyer model and a rental model close to health facilities. Climate change

President Trump’s recent move to pull out of the Paris agreement has renewed outrage in the climate change debate. Global warming has massive consequences on our

directly influenced our cultural change program towards alignment of resources and strategy with our 2020 vision. KDLT 2

KDLT 2 worked on the planning stages of the IT infrastructure, initiating surveys and conducting research to identify what system was best suited to the Association. This project is now being driven by KDLT 1 and the Association. health system and is giving rise to many health issues. Continuing our activism in this space is vital if we are to find a solution, which is why the Association is affiliated with the Climate and Health Alliance (CAHA) and the Global Green and Healthy Hospitals Network.

KDLT 2 is currently reviewing how the bargaining, organising and compliance activities of the Association might become more integrated and geared toward strategically identified goals. Work is also commencing as to how member activism and organisation should be encouraged, managed and structured.

Progress on the Strategic Plan

KDLT 3

The strategic plan, launched at the 2015 Annual Conference, steps out the Association’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. KDLT 1

KDLT1 initiated a project to overhaul the Association’s IT infrastructure in order to support organising for the 21st century. The new system, CORE (Connecting, Organising, Resourcing, Engaging), will go live in late 2017 and is in advanced stages of planning to be able to deliver the data analytics and capacity for greater focus on KDLT1 and KDLT2 in particular. KDLT1 has also initiated internal development of organising strategies by introducing the work of academic Hahrie Han to the organising and campaigning workforce. This has

In order to increase consumer knowledge and make the journey into aged care easier, KDLT 3 developed the 10 Questions to Ask project in consultation with the Association Professional team and The NSW Aged Care Roundtable – a group consisting of 19 organisations and individuals who want to improve staffing and outcomes in aged care. There are currently six leaflets available online at www.10questions.org.au, covering subjects such as GP services, staffing, cultural needs, palliative care, contracts and fees and facility and lifestyle in aged care. Another initiative of KDLT 3 is the Association’s involvement in a Reconciliation Action Plan

(RAP). A business plan has been developed that helps us commit to reconciliation in Australia by implementing and measuring practical actions that build respective relationships and create opportunities for Aboriginal and Torres Strait Islander peoples. The Association also participated in this year’s NAIDOC week and Reconciliation week. KDLT 3 is also developing short position statements/discussion papers on issues, such as violence in EDs and the dangers of asbestos. KDLT 4

To identify potential partnerships with organisations that share our vision and goals, KDLT 4 has developed a directory that will be integrated into our new membership management system, CORE. A calendar of relevant health events has also been identified to add to our campaigning and partnership work. As a result of the communications review, it was clear the Association needs both an updated social media style guide and risk management strategy, incorporating communications, corporate and financial plans. Both these documents are being created by the communications team with assistance from other relevant teams. A multicultural and gender equality action plan is a key consideration for the group with an aim to include these aspects in all Association campaigns. KDLT 5

A key piece of work undertaken by KDLT 5 was the development and implementation of a Staff Engagement Survey. As a result, values workshops will be undertaken to improve cross-team communication and a working group will be established to review overlaps and inefficiencies. Part of KDLT 5’s task is to improve the Association’s efficiency and make sure we are getting the most from our resources.

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Report to 2017 Annual Conference Judith Kiejda, Assistant General Secretary

Following the launch of our Strategic Plan at last year’s Annual Conference much has been done internally to ensure we give ourselves every opportunity to meet the important goals we have set ourselves.

Re-designed member training

Organising

Association Member Training (pre viously known as BOAT) provides three levels of training. Some training occurs in the workplace, other education is provided outside the workplace, however our first aim will be to bring the training to you if at all possible.

In recognising the necessity to grow our capacity to influence in a number of areas, the Association is investing significant resources into placing ourselves in the best possible position to not only increase membership overall in each of the sectors but to also grow the number of members who have the skills and knowledge to be leaders in the workplace. I believe that the ground work covered over the last year places us in an extremely good position to meet a number of Key Directions articulated in our Strategic Plan.

Since we met this time last year, our Member Organising (MO) team has been working hard on enhancing the way we provide member training.

• Branch Essentials reflects the old BOAT One and will provide the skills and knowledge needed to run a branch of the Association and to win workplace change. • Winning at Work takes this to the next level and examines the healthcare industry - how it is

funded and the global and local pressures on that funding. It also provides media and lobbying skills, and examines how we work with our local communities to win the sort of society we want to live in. • A key new feature is Leading Change. This is an intensive course for members who are ready to be a leader within the union movement and within the community. We’ll pair you up with an organiser, enrol you into ACTU training and support you through a mini organising campaign. The course is in its planning phase, so talk to your organiser if you are interested. The full programme and registration details are available from Organisers and from the website at www.nswnma.asn.au/ nswnmamembers

Enhanced structures

Internally, we’ve created a new pod within the member organising team. The Development Organising & Education Pod will work with members at strategic sites to provide the support needed to grow power in the workplace. The pod has two educators, supporting the organisers’ development and member education, and five Organisers who, in addition to current Organisers, will be out in the workplaces to help activate our members in our key campaigns. There are four pods in the organising team (Northern NSW, Southern NSW, Aged Care and Education), each with a Lead who is able to work with the team to ensure we are giving our organising staff the confidence they need to carry out their work. The traditional ‘geographic allocation’ of organisers will continue, yet they will now be assisted by Development Organisers, who will ensure any member leaders identified have the support they need to gain confidence in mobilising and organising around workplace issues. Recent campaigning history and negative changes to laws has shown us that success occurs when power is built at the base level. However, the climate is particularly

hostile at the moment and often ‘would be’ leaders shy away because they feel unsupported in enhancing their skills. We hope our investment in additional support will grow leaders in the workplace. Our Member Industrial Services Team (MIST) has also undertaken a restructure that we believe will enhance the service to our members requiring assistance with their individual matters, as well those members involved in the regrading of their positions, workplace restructures and numerous other important member matters. The team now has a Lead appointed to the Information Department, Northern, Southern and Western pods. The new structure is providing more support for team members and better opportunities for consistency and relationship building with members, branches and employers. The Security Roundtable

Delegates will remember the horrific shooting incident in the Nepean ED in January 2016 that sparked the largest ever investigation and remediation of ED health services in the state. It may seem to most that very little has changed, however, as someone who sits on that committee I can assure you there certainly is a lot happening. Unfortunately, the

audits conducted at 20 hospitals across the state in April/May 2016 revealed there were 57 serious and complex issues to be addressed. None of them an easy fix. While many of the issues relate to capital infrastructure, a number relate to education of staff and culture resultant from some less than appropriate customs and practices that are no longer relevant for a modern health system. Big ticket items need to be addressed and it cannot happen overnight. One of the things that will assist in shifting the culture around workplace safety is the understanding that everyone has a role to play – employers AND employees. As an employee, be aware of your surroundings: has someone left knife used to cut the birthday cake in a place where someone could easily pick it up?; are doors chocked open that shouldn’t be?; does your work have a policy that says you must wear a duress alarm? If so, do you comply? If there is a policy, you must comply – it’s not optional. Much effort is being put into education, whether it’s aggressive behaviour management or the new health security course now in place in TAFE. The programs have been thoughtfully put together and will be delivered via modern education techniques. From what I can see, they have been sensitive to comments from staff. The new MOU between NSW Health and NSW Police is a complex document that appears to satisfy the needs of both agencies when it comes to police dropping patients off. Some of the old practices will take some time to eradicate and I’d impress upon you all to be familiar with the document, so that if the new agreement has been breached it can be quickly referred to the LHD CE and the Police Local Command Officer for resolution.

16 Report to 2017 Annual Conference

There are minor capital works going on around the state in numerous facilities – in particular in rural and regional areas – to ensure the facilities have the best security locking up arrangements. Many places are receiving new duress alarm systems. The Ministry has taken back some authority for the safety of the system and policies are being tightened up with a monitoring process. Random checking will occur and breaches will be referred to the performance process. I can assure you that your elected officials attend every meeting and we are vigilant about progressing this project to a plan for a safe health system. However, a level of patience is required from all of us because as then NSW Health Deputy Secretary, Ms Crawshaw, said at our last conference, those audits exposed some serious issues and consistent inconsistencies across the state in relation to security. It will take some time to arrive at an acceptable conclusion. Global Nurses United

This coalition of international nurses’ organisations is functioning well and growing. We have had new nurses unions signing up, including New Zealand Nurses Organisation (NZNO), which has taken the total number of countries assisting in promoting our issues to almost 20.

Our annual meeting took place in September last year in Ireland. The first day was devoted to education around nurses and midwives working in conflict, with a most enlightening session around the Irish nurse history of The Northern Troubles, which is at front of mind given the current Brexit situation. As Australians, most of us have not had the massive challenge of working in conflict and it was very sobering to understand what that means and how easily all of us could be thrown into that situation. The issues of importance to all countries is the rampant attacks on public health systems, workers’ rights, mandated staffing incorporating an appropriate skill mix and adequate funding for public health. We will reconvene later this year for our 2017 meeting. Public Services International (PSI)

Health systems in nearly every country are being privatised at unprecedented rates and it seems like it’s almost impossible to stop it. We have had our subregional and regional meetings this year ahead of World Congress (held every five years) in November this year. The Program of Action (PoA) has been put together and is currently out for consultation. I am very pleased to see that the GUF has endorsed mandated safe staffing as

a key ingredient in the delivery of quality public health care globally. The global health campaign, Right to Health: a better future with #PublicHealth4All was also launched at this meeting and plays very nicely alongside our own anti-privatisation campaign here in NSW. We have also seen a very important process take place in Australia. PSI affiliates across the country came together to investigate the impacts of privatisation on the community. An independent panel of prominent academics were hired for the exercise and the launch of the report is imminent. The stories are awful. Primarily, those who need disability services have been impacted greatly, as have the people in certain areas where industry has been severely cut back or indeed annihilated due to competition/privatisation with no transition elements factored in for vulnerable people. The inquiry gives us evidence of what privatisation is doing to our society and its findings will be most helpful as we try to lobby decision makers for decent working conditions and better funding of our public services. In April, your union was invited to be one of six PSI representatives to work on a global tripartite meeting (governments, employers and workers) at the International Labour Organization (ILO) on the future of the health workforce. I was more than proud to represent the Association on this working party. It has been one the most difficult challenges I’ve had to undertake in my PSI role, primarily because it was an important meeting and I had to make it count for this union. The process was very enlightening.

The meeting had four discussion points which were canvassed with the aim to come up with a consensus document. The 53 government participants were much closer to the workers’ perspective than the employers, which was a pleasant surprise. Russia was the only G8 government represented, however there were numerous South American, Asia Pacific and European governments in attendance. All parties agreed the health workforce must be regarded as an investment not a cost and that access to quality public health is a right, not a privilege. Everyone also agreed health workers had to be given decent work, which includes security and workers’ rights. Australian Council of Trade Unions (ACTU)

As a Vice President on the ACTU board, I have witnessed a real shift in outlook since the election of Sally McManus into the role of Secretary. Sally’s background of organising and campaigning positions her well for the changes that must occur in the movement if we are to restore a just and fair society. While many didn’t appreciate her views when she was first elected, she was absolutely correct in her statement that our laws as they relate to workers are broken. Anything that allows people to die on the job because safety measures are compromised; allows employers to tear up workplace agreements with no redress; takes away penalty rates from certain workers; allows employers to get away with not paying employees properly – that’s called wage theft – MUST be challenged if we are to be a decent society. We’ve seen companies hire workers for just 60 hours a month, leaving the worker so poor that when they get a couple of shifts they can’t afford the fuel or tolls to get home, so they sleep on the tarmac at the airport under the luggage trailers.

Sally is passionate about our Medicare system and we need that passion to ensure the federal government stops picking at the edges of our health system. I am on a number of committees of the ACTU, which allows me to put the interests of our members directly to decision makers on both sides of politics. I am proud to be working with the two women who now lead the movement, one of whom is a nurse. Exciting times. Unions NSW

As President of Unions NSW, I have been highly impressed by the work of the current Secretary, Mark Morey. He has caused a shift in the outlook of state unions and, like Sally, is a union leader passionate about a just, fair society. He is committed to ensuring we keep public hospitals in public hands at the state level and wants to see the laws change that have capped public sector wages at 2.5%, with no way to argue for increased ratios, unless we pay for it from the 2.5%. I am honoured to represent Association members in this role. Delegates, the time has come for us to stand up, speak out, and make those decision makers accountable to us and not the other way around. This is our society and on our watch we must protect it for the future. Each and every one of us must play our part. The Lamp

We have recently updated the look of the magazine to keep it contemporary and make it easier to read. This communication is the one thing that goes into every member’s home and provides information on industrial issues relating to the professions of nursing and midwifery as well as societal issues that represent the values of our membership. It is well advised that our membership make every attempt to read The Lamp and be across the issues because I can assure you our politicians and employers do.

I would like to take the opportunity to thank all those responsible for putting this communication together, especially our members who make themselves available for comment, often in the knowledge that their contribution may not be well received at their workplace. Members should not allow themselves to be intimidated into not contributing to your own magazine. Brett and I absolutely understand the vulnerability some of our members feel when asked to contribute to The Lamp, particularly around contentious matters, however, the Association will support you all the way because it is your right to stand up for your patients and workplace rights. Conclusion

A huge thank you to each and every member and branch official for the amazing work you do at the workplace, for the numerous campaigns you contribute to in many ways, for working with us on industrial and professional matters and ensuring that we are growing our capacity to influence – be it politicians, governments, employers, our own communities and even your colleagues. Without your contributions we cannot do the work we do. I also want to thank all the Association staff for their diligence and commitment to our members and our organisation. The last two years has put particular emphasis on pursuing our strategic plan, which has often come with an increased workload, so I want to acknowledge that work and show my appreciation for their contributions. Finally, your General Secretary Brett Holmes has done it once again. His generous leadership of your union is displayed in some way at every meeting or consultation we have. Judith Kiejda

Assistant General Secretary

18 Key Direction 1

Key Direction

Grow our capacity to influence STRATEGIES 1.1 Grow power and influence by increasing the number of

Association members

1.2 Identify new member leaders who can build their workplace influence 1.3 Equip Association member leaders with the skills, knowledge and

confidence to lead members to use their influence

1.4 Grow the number of Association members actively engaged across the

health, disability and aged care systems

1.5 Ensure a focus on retaining as many members as possible.

* Association should be read to mean the Australian Nursing and Midwifery F-ederation NSW Branch and the New South Wales Nurses and Midwivesâ&#x20AC;&#x2122; Association

In order to win better outcomes for our members, the Association* must grow our influence. Influence comes when Association 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.

BUPA Aged Care Services Dispute – part-time employees and their contracted hours and shifts

Bupa introduced a new model of care, which resulted in changes/ reductions to shift times for part time employees, with consequential changes to contracts of employment. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.5 Key Direction 2: Strategy 2.7

Action

Various disputes were initiated by the Association in the Fair Work Commission (FWC) as a result of these changes. One of these involved a hearing to determine how the agreement provisions relating to the hours of part-time employees (both the number of hours and their predictability) applied to two particular employees. In the first instance, a single member of the FWC found favour with the Association’s

interpretation; however, this was overturned on appeal to a Full Bench of the FWC. Options of appeal are not available. Outcome

• Pleasingly, the decision of the Full Bench upheld the original interpretation that the contracted hours of work for part time employees needed to be recorded in writing, and could only be varied by agreement. However, in contrast to the original decision, it found in relation to the two employees who were the basis of this case, that changes to their pattern of work (roster) could be made via the consultation provisions in the agreement, with outcomes or changes being subsequently reflected in a posted roster. • As the Full Bench noted, its decision was how the agreement provisions applied to two specific employees and their circumstances. Therefore, it may not have any binding application to other employees and their particular circumstances (unless perhaps similar or identical).

20 Key Direction 1

the time, all full-time positions were removed from the roster and facility DoNs voluntarily forfeited their rights to RDOs.

Estia Health Enterprise Agreement Bargaining

The Estia Health NSW 2016 Enterprise Agreement was approved by the Fair Work Commission in April 2017. This Agreement covers 19 facilities, with employees previously covered by four different sets of pay and conditions. Notably, this bargaining campaign saw the first attempt by an employer to cut nurses’ Sunday penalty rates in NSW, however nurses held together to successfully defend this attack. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2

Action

Key Direction 2: Strategy 2.1, Strategy 2.2

Action

Estia entered bargaining with a very aggressive array of their own claims, most of which were withdrawn following sustained pressure from members. Estia’s proposed cuts included decreasing Sunday penalty rates; removing access to an independent umpire for resolving disputes, and a reduction in uniform entitlements. Outcome

An electronic survey identified major bargaining issues and members seeking to be involved.

• Member response to the survey was very high, ensuring the claims were widely felt.

A combination of face-to-face meetings and a comprehensive communications strategy ensured members received timely updates on the progress of negotiations and were able to provide input throughout. The Association’s communications aimed to efficiently distribute information to members and non-members across Estia. The Lamp (including a cover story), along with direct and targeted messaging via SMSs, emails, phone calling and social media via a new Facebook page were used specifically for Estia Association members.

• Increased pay rates and improved conditions. • Member leaders actively participated in negotiations. • Significant new member recruitment. • Identification and development of member leaders. • Member engagement via their dedicated Facebook page. • Pay and allowances to increase by more than 3% in the first year, and then 2.4% each year for a further two years. Reduction of hours and removal of RDOs

In February 2017 Estia announced that, because of low bed occupancy, a roster review would be undertaken of their facilities at Figtree, Merrylands and Kilbride, with a view to reduce costs and bring the staffing levels in line with current staffing levels at other Estia sites. At

Association officers met with Estia management and attended all individual meetings on the reduction of hours where members had requested support. During this process, the Association advised one facility to undertake an audit and inspection of unsuitable lifting equipment, which resulted in improvement at that site. More visits were organised to ensure members had a comprehensive understanding of the process and the successes achieved. Outcome

• The Association ensured all nonmanagement staff were able to reinstate their RDOs through a return of full-time hours. • It was agreed existing staff who had lost hours would have them reinstated as soon as possible, either when bed occupancy increased or when other staff left the company. • An equipment audit has been carried out at all three affected sites. • In the period since the restructure, most members have reported their hours have been reinstated as other staff have left the facility.

Family and Community Services Disability Services â&#x20AC;&#x201C; rollout of the NDIS

The rollout of the NDIS is gathering momentum and will commence affecting FACS nurses progressively from August 2017 onwards. This will occur via the powers vested in the Minister for Disability Services under the National Disability Insurance Scheme (NSW Enabling) Act 2013. This permits the (forced) transfer of current FACS employees to NGO providers who will be delivering services previously provided by FACS. Key Direction 1: Strategy 1.5 Key Direction 2: Strategy 2.4 Key Direction 3: Strategy 3.2

Action

The Association and members continue to make representations in all available forums to discuss concerns with the current framework and processes being utilised for the NDIS rollout, and the exclusion of the public sector from a much-needed service provider. This included a meeting with the Minister for Disability Services in March 2017, along with continuing discussions and negotiations with FACS and NSW Public Sector Industrial Relations (NSW Treasury) to resolve continuing concerns on the industrial arrangements and protections for transferring staff.

Outcome

providers and indicative timetable for the transfer of such services (and employment) to date:

â&#x20AC;˘ The NSW Government has announced the following new Current service/ location

New provider(s)/ employers

FACS Community Support Teams (various locations)

The Benevolent Society

Transfer date

1 August 2017

GROUP A Services

FACS-supported accommodation and respite services Location: Western NSW

LiveBetter Community Services (formerly CareWest)

1 September 2017

Location: Mid North Coast

Mid North Coast Disability Services (consortia of various existing NGO providers)

1 September 2017

Location: Illawarra Shoalhaven, New England, Northern NSW, Southern NSW and Sydney

House with No Steps

Location: Murrumbidgee, South Western Sydney, and Western Sydney

Northcott

1 November 2017

Location: Hunter

Hunter Valley Disability Services Ltd (consortia of various existing NGO providers)

1 December 2017

Location: Central Coast, Northern Sydney, Nepean Blue Mountains and South East Sydney (and Norton Road)

TBC

1 October 2017

TBC

GROUP B Services

TBC

22 Key Direction 1

• FACS has recently reiterated that the end of June 2018 continues to be the ‘deadline’ for completion of the transition of FACS services to NGO providers. Riverside Centre, Orange – New Model of Care

Despite repeated attempts to recruit RNs on a permanent basis, the facility has only been able to attract RNs on a casual basis leading to insufficient numbers of RNs to staff the service effectively. As a result, management proposed a new model of care. Essentially, the RNs will provide a ‘wrap around’ service to the group homes, leaving ENs and AiNs/ DSWs to operate the houses on a day-to-day basis. The model of care will be trialled for six months and then reviewed. Key Direction 3: Strategy 3.5

Action

Following branch meetings to discuss the proposal, and further documentation to the Association on the proposal, the union agreed that the model of care could be trialled. Outcome

• The new Chief Executive saw that the pilot model of care in this form was not acceptable to FACS as it was not within the confines of the award.

• FACS Executive proposed the following changes to the model of care: Recruitment of RNs will continue, but in the meantime the homes will be grouped into three clusters with a Residential Nurse Unit Manager (RUNM) over each. Three Project Officer positions have been created and expressions of interest sought from the current EEN Team Leaders to carry out these roles. A new roster commenced on 12 June 2017. The Reasonable Workload Committee has agreed to the model of care in its new form.

Healthscope Private Hospitals Member Growth and Development

In anticipation of the current Association Healthscope Enterprise Agreement expiring in 2020, an ongoing campaign in preparation of bargaining is well underway. This consists of a focus on growth and development of members, branches, and workplace leaders to grow power and influence. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2

Action Empowering members and ensuring employer compliance via Know Your Rights education

Know Your Rights flyers were developed as a direct result of ongoing workplace issues. They are a fundamental tool in the empowerment of members to assert Enterprise Agreement compliance, alongside Association Organiser support across Healthscope sites. Know Your Rights topics addressed: Contracted hours, Public Holidays and Annual Leave, Consultation for change, Roster rights, On call, and Workload matters. Local Campaigns

Enterprise Agreement enforcement activities this year were successful, exemplified by the introduction of ‘Time Off in Lieu of Overtime’ at many Hospitals. This condition was previously rejected by management and not available as an option for employees, but is useful for members to use during shutdown periods. Ongoing membership engagement, recruitment and increased visibility achieved through blitzes included: • July pay increase: Take a Break – celebrating continuing higher pay rates to the public health system. • Annual Holiday celebration: gift bags and BBQs – promoting an nual leave shutdown, Know Your Rights, Facebook promotion and celebrating enforcement compliance.

Education

Branch officials attended a joint training day with Ramsay Private hospital members to workshop increased branch strength for themselves and their workplace. Each branch compiled a branch development plan, which they will work to implement alongside Organisers. Branch Development

The focus has been on building greater branch power, confidence and influence at some key strategic Hospitals with branches. The Association is working closely with members at other strategic hospitals without branches on professional, industrial, workplace safety issues to identify and develop member leaders to fulfil the goal of forming a branch in the future.

The Facebook page has continued to attract increasing member engagement and reach with over 400 ‘likes’ since August. It provides an easy platform to increase reach and visibility to connect with non-members and encourage their participation and membership. Outcome

• Association visibility and presence continues to be strengthened. • Consolidated membership power, confidence and employer compliance. • Member leader development and increased membership growth.

Facebook

Hunter New England Local Health District (LHD)

Since August, the creation and promotion of the Association Healthscope Facebook page has provided a forum for members to connect across Healthscope facilities. It is an Association organising tool to connect, educate and raise awareness about issues for enforcement – Know Your Rights.

The Gunnedah District Hospital branch has commenced a campaign to introduce Nursing Hours Per Patient Day (NHPPD)/ Ratios on the General Inpatient Ward and for an RN to be rostered in the ED on the night shift.

This platform successfully encourages on and offline workplace discussions and organising on current issues.

Gunnedah District Hospital – Peer Group C Ratios Campaign

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3

Action

Regular branch meetings have been held to review the staffing levels at the hospital with the Reasonable Workload Committee notifying a grievanace to the LHD in September 2016. In January 2017, a branch resolution was endorsed by the Committee of Delegates requesting the Association seek a formal review by the Ministry of Health of Gunnedah District Hospital, to bring it in line with other NSW Peer Group C Hospitals that have NHPPD on their General Inpatient Wards. Members also visited their state MP, Kevin Anderson seeking support for ratios being implemented in their hospital. In April 2017, the branch passed a resolution supporting a Ratios Campaign to inform and educate their community about unsafe nursing staffing and patient safety concerns. Members held conversations with local business owners asking them to sign a pledge to support NHPPD/ Ratios in rural hospitals and particularly to introduce ratios into their own hospital. Members and leaders used a stall at the Gunnedah Easter Saturday markets to facilitate further conversations with their community about their Ratios Campaign and inform the community about their planned

24 Key Direction 1

Outcome

action on 4 May 2017. Members contacted local media outlets, other Association branches, and invited Kevin Anderson MP to attend the rally. Outcome

• Management agreed to roster two RNs on the night shift by the substitution of one EN position for an RN position, not by increasing staff numbers. Members realised that management would only improve nursing staff numbers or introduce ratios if they were forced to do so. • Members passed a resolution to conduct a Ratios Campaign in the lead up to the negotiation of the current Public Health System Award and to continue until the 2019 State Election. • Members’ experience and confidence grew while talking to their community as they gained support from local businesses to place their signed Ratio Pledges in their shop windows. • Members held a rally on 4 May 2017, which was attended by local members and branch members from Tamworth Base Hospital, Quirindi District and Werris Creek District Hospitals. Several community members walked with the nurses and local businesses cheered the group as they passed by. The rally received supportive local media coverage. • State MP Kevin Anderson contacted the branch following

the May activity and assured members he wanted to arrange a meeting to hear their concerns. • During the year, two member leaders were identified. Both leaders have grown in confidence and influence within their workplaces, showing their ability to lead members to use their influence for change. Both leaders and members understand the Ratio Campaign will continue up until to the next State Election, gaining momentum through their continued planned activity in their workplace and community. Hunter-wide Christmas toy drive

Association branches across the Hunter joined with the Newcastle branch of the Maritime Union of Australia (MUA) and organised a Christmas donation for the Children’s Hospital network. This action was undertaken as a way of engaging the membership, building goodwill during the Christmas season, and promoting a positive union message to the wider community. Key Direction 1: Strategy 1.1

• A haul of toys, books, and DVDs were collected and handed over to the donations team at John Hunter Children’s Hospital on 14 December 2016. This was achieved in conjunction with members of the Newcastle MUA branch, who raised $5,800 through their own fundraising efforts. The combined donation was well covered by local media.

Illawarra Shoalhaven Local Health District Shoalhaven District Hospital

Theatre staff expressed their alarm that the sterilisation equipment was not operating correctly and as a result, were directed to use equipment that was sterilised at Wollongong Hospital and then transferred to Shoalhaven. Staff were apprehensive that this process would impact on the integrity of the sterilised equipment. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

Action

Nineteen members advised local management of their concerns, stating they would not scrub for theatre lists until they had received a policy or directive advising that it was safe for them to work under these new work practices, and it was safe to use equipment transferred and sterilised at another facility. Outcome

Action

Branch meetings were held across the Hunter and individual branches were asked to collect toy donations and promote this initiative at their facilities.

• LHD executive management met with members and addressed their concerns. • Several activists were identified through this action and nonmembers recruited.

Justice Health & Forensic Mental Health Network Forensic Hospital

Members reported concerns through the Union Specific Consultative Committee (USCC) in late 2016 and again in January, relating to violent incidents where nurses were assaulted. After a further serious incident, members took action and called for a range of interventions to ensure a safe workplace. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

• Members have nominated as HSR’s and have insisted that training be provided. • The Work Health and Safety (WHS) Committee has been forced to reconvene and consult. • A review of the model of care has been requested.

New graduate and transitional year recruitment

• The Association has pursued the facility regarding their failure to provide a safe workplace.

Associate member recruitment

The Association has used orientations and other opportunities across the state to connect with and recruit as many new graduate nurses and midwives as possible and to encourage existing AiN and EN members to update their memberships to RN/RM on completion of their degrees.

Key Direction 1: Strategy 1.1

Member Recruitment

Action

Members passed resolutions calling for a number of interventions to be implemented, including the provision of security officers, Health and Safety Representative (HSR) training, and a review of the model of care. Additionally, members engaged with SafeWork NSW, who subsequently issued Justice Health with a number of Improvement Notices. Members also responded to an extensive Association survey which will be used to demonstrate to both Justice Health and the Ministry of Health that members feel unsafe. Outcome

• Justice Health has been forced to implement a process of consultation.

Action

This recruitment strategy is to liaise with and visit as many education facilities to promote the role and function of the Association and encourage nursing and midwifery students to join as Associate members. Outcome 1,642 new associates joined from February to May 2017. 278 new associates joined online. Currently, the Association has 5,823 associate members.

The 2017 Transitional RN/RM (TRN) Recruitment Strategy was conducted with attendance at all public hospital and other orientations, to welcome new graduates to the profession and invite them to join the Association. Outcome 63 transitional year orientations were attended from late January to May. 1,220 new transitional nurses and midwives were recruited. 160 AiN/AiM and EN members updated their membership to RN/RM.

• SafeWork NSW is pursuing the Forensic Hospital with a view to prosecuting.

30 new members joined (non-TRNs).

• Justice Health has been forced to provide an explanation to both the Ministry of Health and to the Minister for Mental Health.

Of those who joined, only 32 had incomplete forms requiring follow up.

• These issues have been referred for discussion to the Ministry’s Security Roundtable.

The total number of TRNs joining or updating during this period was 1,653.

241 joined online.

26 Key Direction 1

Murrumbidgee Local Health District Wagga Wagga Rural Referral Hospital

The use of unfunded surge beds following the opening of the Wagga Wagga Rural Referral Hospital (WWRRH) in January 2016 resulted in the continued and excessive use of overtime, resulting in high levels of fatigue and sick leave. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

Action

The WWRRH Branch Executive held numerous branch meetings with resolutions passed in the interests of providing safe patient care. Additionally, the branch executive has conducted and attended ongoing meetings with the Wagga Wagga Health Service and Murrumbidgee LHD Executive. In efforts to cater for the increased ser vice demand, additional orthopaedic surgical cases took place between November 2016 and May 2017. Outcome

• The Wagga Wagga Health Service Executive believe activity over this winter period will be under greater control given the additional surgical cases scheduled between November and May. • It is anticipated that, secondary to targeted recruitment efforts, less overtime will be required over the winter period, therefore leading to less fatigue. • Members continue to be kept up to date and well informed due to their branch executives’ ongoing commitment to consult with Executive management on issues regarding safe staffing levels and provision of safe patient care.

Northern NSW Aged Care Branch Official and Activist Training

An education workshop was held in October in Ballina for local aged care members. Key Direction 1: Strategy 1.1, Strategy 1.2

Action

The Association provided aged care members with Branch Official and Activist Training (BOAT) which focused on power, one-on-one conversation skills, and recruitment. Outcome

• Six members attended and provided positive feedback. • Member leaders were identified. • Branch plans were formulated with a focus on recruitment and campaign conversations.

NSW Health Inaccurate ADO Accruals

The allocation of ADOs to nurses and midwives working in the NSW public health system has been a matter of ongoing dispute with the Ministry of Health and NSW HealthShare. Key Direction 1: Strategy 1.5 Key Direction 2: Strategy 2.7

Action

In the latter part of 2014, the Association was contacted by a number of members who had been notified by their LHDs that they had negative ADO balances. After some preliminary investigation, which revealed some clear anomalies, the

Association lodged a dispute with the IRC. While not resolving the matter initially, the IRC did recommend that ADOs should still be rostered for members who are in a negative balance. In subsequent discussions, the Ministry and HealthShare conceded that StaffLink, as it was configured at that time, was not including the extra annual leave provided to shift workers when calculating ADO entitlements. In addition, the 19-day shift counter built into StaffLink did not adequately deal with the calculation of ADOs for those working a combination of shifts. Resolution of the former issue led to 21,199 ADOs in total being credited to nurses and midwives across the state in November 2015. Discussions have continued since to resolve the appropriate accumulation of ADOs for members working mixed shifts. Outcome

• A resolution (finally) to the ADO accumulation for members working mixed shifts has been reached, in principle, with the workaround to be the subject to redesign work and subsequent testing. • While this solution is reliant on an audit approach, it will nonetheless enable members working mixed shifts to properly access their award entitlements to ADOs. • It is hoped that this solution may be available in the latter part of 2017. • Until the dispute is resolved completely, the directions of the IRC continue to be in force, i.e. an ADO for mixed shift employees should continue to be rostered each month.

Ramsay Health Care Member Growth and Development

In anticipation of the Association’s Ramsay Enterprise Agreement expiry in 2018, a continuing campaign in preparation of bargaining is well underway. This campaign consists of a focus on growth and development of the members, branches and workplace leaders, in order to grow the Association’s power and influence.

Stronger Branches Training

In November 2016, Branch Officials attended a joint training day with Healthscope Private Hospital Branch Officials to receive education on managing a branch and building branch power. Each branch formed a development plan which they, alongside Organisers, will work to implement. Corporate Campaign – Profit Announcement

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 2: Strategy 2.1, Strategy 2.2

In September 2016, Ramsay announced a record annual profit. A communications campaign, exploiting email and social media, was used to educate and increase member-awareness by highlighting Ramsay’s ‘for profit’ motive.

Action

Wollongong Private Hospital ‘Campaign Planning’ Training

Make MyTime Fair Campaign

In 2014-15 Ramsay replaced its paper timesheet system with a national rollout of Kronos Time and Attendance software (MyTime). The experience for staff has been a limited online swipe on/off system that can only be viewed on tablets located on communal hospital walls. With an already cynical workplace in relation to accuracy of pay, this has led to widely/deeply felt uncertainty with many members reporting routine underpayment. Members commenced a companywide campaign calling on Ramsay for fair online access. The campaign involved branches holding meetings and passing resolutions calling on hospital management for fair MyTime access. A resolution addressed to Ramsay’s head office was also supported at Committee of Delegates. A union petition then commenced, allowing for further one-to-one engagement and workplace mapping. In response, Ramsay met with the Association and agreed to provide staff with work and remote online access. The rollout of intranet access across all sites is ongoing.

Members in operating theatres (OT) have been experiencing long-term workload issues with under-staffing and chronic over-booking of theatre lists, leading to missed breaks, excessive overtime and fatigue. The branch has formed a Campaign Team involving member leaders from each OT section. The Campaign Team met off-site for a half-day training session with Association staff, and developed a campaign plan. The plan requires building union density and solidarity on campaign objectives, education and enforcement of Enterprise Agreement rights. The Campaign Team has been organising a sequence of actions involving planning, union meetings and an off-site campaign breakfast. Once majority support is built, the Campaign Team plans to collectively enforce a fair and safe workload. Local Hospital Campaigns

Branch and activist networks at Kareena, Wollongong, Warners Bay, Lawrence Hargrave, Nowra, Lake Macquarie and Westmead ran successful local campaigns on issues such as roster changes, enforcement of breaks, and excessive overtime.

Pay Rise Blitz

Branch and site celebrations were held using a Take Your Break Have a Kit Kat theme to celebrate the July 2016 pay rise, with pay rates remaining above the Public Health System. Facebook

A plan was formulated to increase reach and engagement of Ramsay nurses and midwives via a new Association Facebook page. The page has daily posts on professional, legal, union-wide issues, and Enterprise Agreement education, with more frequent posts during campaign periods. In less than a year, the number of page ‘likes’ has grown from 530 to more than 800. The most successful post was during the Ramsay 2016 annual profit announcement campaign, which reached 55,901 people and was shared 632 times.

Know your rights Education

A Know Your Rights campaign, designed to educate and empower members on their Enterprise Agreement rights, is ongoing. Flyers were developed addressing relevant topics such as Annual Shutdown,

28 Key Direction 1

Public Holidays, Rosters and Oncall, and were distributed through email, Facebook, activist networks, and workplace visits.

South Eastern Sydney Local Health District

Branch Development

Adult Community Mental Health (Northern Sector)

There has been a continued focus on building branch power, with member leaders being elected to Delegate positions during the 2016 BGMs. The Association has been working closely with targeted branches to build confidence and influence through local campaigns. Member Leaders

Member leaders were identified at target sites. Branch, group, and oneto-one education was conducted with member leaders on issues such as recruitment, power, and winning through campaigns. Six key member leaders have been selected to attend the member leader training in July 2017 at Association. Outcome

• The Make MyTime Fair campaign resulted in membership growth, development of branches and member leaders, and agreement from Ramsay to provide staff online access. • The local hospital campaigns provided an opportunity for branch and member leader development. • The pay rise blitz resulted in positive engagement and strong membership growth. • A greater reach to members and potential members through social media. • Increased Association presence (face-to-face and through various communication channels). • Strong overall membership growth. • Increased activist and member leader development. • Increased confidence and solidarity of the membership through local and company-wide campaign successes.

The restructure of the Community Mental Health service in the Northern Sector of SESLHD proposed the co-location of five clinical teams at two sites and, although adding five additional staff, proposed a decrease in six of the teams to seven FTE. Key Direction 1: Strategy 1.4, Strategy 1.5

Action

The Association commenced consultation with members and was made aware of the numerous concerns regarding the location of the teams and the physical constraints of the work environment, staffing and hours of work. Outcome

• Each team will be multidisciplinary, with client allocation determined by clinical expertise and client requirement. • Where the direct report is not a nurse, operational clinical staff will be managed by a clinical manager and report to their relevant professional head. Clinical managers will report to the Community Services Manager. • The core hours for the service will be 08:30-17:00 hours Monday to Friday. The afterhours support will be provided from across the five teams. • A proposal for the renovations of the amenities at Maroubra, including the kitchen and dining room refurbishment, is to occur in June 2017.

Prince of Wales Hospital

A restructure was proposed by the hospital’s Chief Executive to realign clinical specialities within reporting lines. Members expressed their concern for the potential increase in their workloads and that of their Co-Directors. Key Direction 1: Strategy 1.2, Strategy 1.3, Strategy 1.4

Action

The Association met with branch members, the NUM and nurse manager members, which was facilitated by the DoN. Nurse Manager members submitted a consultation letter to management where they raised issues regarding the potential increase in workloads. The response provided did not satisfy members and the Association followed up with a secondary consultation letter. Outcome

• A formal response to the latest correspondence has not been received however the consultation period has expired and the restructure will proceed. • The outcome of any response letter now will not affect the implementation of the restructure, however the first consultation response secured a review of workload and practices six months after the introduction of the restructure.

Southern NSW Local Health District Chisholm Ross Centre – Introduction of AiNs on night duty

The introduction of AiNs on the night duty roster was proposed by management.

Outcome Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.5

Action

Members passed resolutions against this proposal based on their concerns around an inappropriate skill mix. The branch worked as a team and emphasised to their colleagues the importance of being united. Members gathered data regarding the number of admissions and the number of incidents that had historically occurred overnight. Outcome

• The branch remained firm in their opposition, resulting in the matter going to a dispute. • The information gathered highlighted the difficulties of a reduced skill mix and the impact on the workload of the night duty staff when there is a staff shortage. • The LHD withdrew the proposed change in the night duty roster. Eurobodalla Operating Theatres – Moruya and Batemans Bay Hospitals

Because of understaffing, permanent part-time staff had their rights infringed by being rostered on-call, including on days off. The branch considered the interest of members and the LHD proposal to move from a five-day to a seven-day roster. The LHD has been attempting to resolve the on-call issue, a long held practice over a number of years. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.5

Action

Members recommended the formation of a working party to review their issues and arranged a ballot of staff with the majority voting to maintain a five-day roster.

• The roster was changed to comply with the Public Health System Award and all staff (both part-time and full-time) are to be rostered free from on-call, prior to their days off. • Agreement was reached to retain a five-day roster, however this could change if staffing numbers are reduced. South East Regional Hospital

Since the opening of the new hospital in Bega in March 2016, the branch has continued to monitor the increased patient demand against available resources. Key Direction 1: Strategy 1.1, Strategy 1.3 Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.3

Action

Throughout the past year the demand for services continued to expand, increasing pressure to flex up beds beyond the planned number of staff recruited to beds. This has placed enormous pressure on a limited casual pool and staff required to work additional hours and/or overtime. Additionally, the staffing availability did not always allow staff replacement for unplanned leave events. The LHD was pressured to roster and recruit to 100% occupancy on the medical and surgical wards and employ agency staff to fill vacancies. There were multiple problems being experienced at the site across all staffing groups and the Ministry of Health announced a review into the commissioning, operation and management of the hospital.

Western NSW Local Health District Bathurst Health Service

The recruitment of 1.6 FTE midwifery staff had not been implemented by management following the 2015 Birthrate Plus review. Members were concerned that outpatient services were incorporated into the general maternity unit workload, which was impacting on care given to antenatal and postnatal patients. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 3: Strategy 3.5

Action

The branch passed a resolution calling on the Minister of Health, the local MP and the LHD Chief Executive to release funding to implement best practice models for maternity care at Bathurst Hospital. Outcome

• Funding was released by the LHD Executive, and the Bathurst Health Service was able to provide a dedicated antenatal clinic five days per week rather than a service of two to three days per week. • Permanent midwifery staff members were employed to the clinic, which allows for continuity of care rather than on the ad hoc basis previously rostered from the maternity unit staffing profile.

Outcome

Nyngan Health Service – Anti-violence Campaign

• A review was undertaken in April 2017 and a report on the findings published on 16 May 2017. Members are reviewing the report, inclusive of the 10-point plan, and will consider their response.

Nurses at Nyngan were greatly distressed over several months of episodes of extremely violent and intimidatory behaviour from outpatients under the influence of alcohol and drugs. One episode,

30 Key Direction 1

Outcome

• Member leaders articulated their concerns over patient safety and the loss of senior leadership on the night shift with the deletion of this clinical NUM role. • The position was retained and recruited within a short time frame. Western NSW Mental Health

which destroyed part of the ED, raised WHS concerns around the adequacy of security in rural and remote Multi-Purpose Services. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5 Key Direction 3: Strategy 3.4, Strategy 3.5 Key Direction 4: Strategy 4.1, Strategy 4.2

Action

Nurses met and resolved to have an open meeting with both the Police and Local Government representatives to garner support from the community in responding to violent activity, given many rural towns do not have 24-hour police coverage. The branch sought assistance from the Association to commence a community awareness campaign around violence towards emergency personnel. Outcome

• Funding enhancements from the Ministry of Health have been allocated to a number of smaller sites in the Western NSW LHD as a result of increased lobbying by the Association Executive at the Security Roundtable meetings. Nyngan has secured thicker safety glass and a video intercom system; new duress systems are to be installed by the end of July 2017.

• The Mayor and the local Council passed a resolution seeking the LHD Chief Executive apply pressure to employ a third staff member on the night shift. At this time, this request has been denied. • A community awareness campaign was launched in May, with media attention on violence in health facilities. It supports the Ministry of Health’s position towards zero tolerance of antisocial and violent behaviour, and builds on the Protecting People and Property Policy Directive. It is hoped that other facilities will support this Anti-Violence Campaign across all nursing sectors. Orange Health Service

Management proposed the deletion of a clinical NUM position from the ED on night duty and replacement with an RN8. Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

Action

ED-focused branch meetings resulted in resolutions opposing the deletion of the clinical NUM position. This resulted in a disputes grievance meeting with the LHD DoNM.

The Western NSW Mental Health restructure continues throughout the district. Changes have been implemented at Orange Community Mental Health where the district has partnered with a non-government organisation, Likemind, to deliver community mental health. Nurses have been retained by the LHD for operational management and employment conditions. The LHD is now addressing the Dubbo and North Western regional areas with planned changes to the delivery of Community Mental Health and reduction in beds at the Mental Health inpatient unit at Dubbo Base Hospital by realignment of the bed base to a 10bed recovery model and a 10-bed acute patient service. The LHD states it will not be funding the current High Observation beds as these are not designated Ministry of Health HDU beds. There has been an overall reduction in mental health beds at Bloomfield Hospital with a number of long term residents (16 patients) having been placed in supported community residential accommodation. The adult acute admissions unit has implemented a ‘surge’ strategy whereby 16-beds are staffed, however the capacity sits at 20 beds. Key Direction 1: Strategy 1.2, Strategy 1.3 Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.5

Action

Continued consultation around service changes is occurring with a number of Mental Health branches and their members. Changes that have been implemented, such as at the Orange Community Mental Health model, have not been sufficiently evaluated at this time. Outcome

• Branches have been empowered to continue to monitor and participate in facilitated meetings in order to provide consistent pressure not to allow further erosion of public mental health services. • Members are working with the Association in order to secure better outcomes for patient safety.

Western Sydney Local Health District Westmead Hospital – Ratios campaign Key Direction 1: Strategy 1.1

Action

Westmead members gathered outside the hospital on 26 May 2017 seeking support for improved ratios not only at Westmead Hospital but all hospitals across NSW. Members used the theme “cut the red tape” for their action, and attached red tape to their uniforms. Outcome

• The government has an opportunity to cut its own draconian laws, that is, “cut the red tape” and provide the additional nurses needed to improve safe patient care. • Nurses understand this action is the start of a longer campaign against the State Government to change its position and improve ratios. • The branch distributed nearly $1,000 in hampers to all wards and units on the day. • The branch executive collected these funds over recent months from recruitment rewards as a way of thanking their colleagues for their support of this action. Westmead Hospital – car parking

Westmead Hospital proposed a car parking fee increase from $3 per week to $15 and then to $22 in late 2017, without prior consultation with staff. The main concern of members was around paying the increased

fee with no guarantee of a car parking space. Key Direction 1: Strategy 1.5

Action

The branch held a number of meetings during 2016 and the relevant unions – the Association, HSU and ASMOF – filed a dispute with the WSLHD in the IRC in late December 2016 with further hearings in January and February 2017. Outcome

• The Commission approved the fee increase to $15 effective from 8 March 2017 following a detailed weekly audit by the hospital that indicated adequate parking is available to staff. • The unions are currently in discussion with WSLHD management, with the meetings chaired by the IRC’s Commissioner Newell. These discussions are ongoing as it is the intention of the LHD to implement a new policy on car parking that will apply to all facilities across the LHD. • Agreement is now being sought between the LHD and unions on issues such as a definition of what constitutes part-time employment (as part-time staff pay a reduced fee compared with full-time employees) and access to other sites, which will form the basis of the new LHD-wide policy on car parking for staff.

32 Key Direction 2

Key Direction

Be innovative in our advocacyand bargaining STRATEGIES 2.1 Review and implement improved

Association 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 Association 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

New challenges and environments require new thinking and continuous improvement of professional and industrial advocacy and bargaining. The Association 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.

Public Health System 2017 Public Health System Award claim

A 2017 Award claim was developed, endorsed and served on the Ministry of Health. A pay offer has been accepted by Branches, with the ongoing ratios campaign to continue. Key Direction 2: Strategy 2.1, Strategy 2.5

Action Claim preparation, Log of Claims Committee and endorsement

A ‘working group’ of expert member clinicians working in outpatients settings was convened to develop a ratios/staffing claim appropriate to that sector. The outcome of this research and proposed claim was presented to a Log of Claims Committee (the Committee) for consideration, alongside a number of other proposed Award claims. The Committee consisted of the President Coral Levett; elected Delegates Deidre Guthrie, Jane Cotter, Sharon O’Connor, Stan White and Natalie Ellis; Councillors Lorna Scott and Michelle Nicholson; the General Secretary, Assistant General Secretary and staff. The Committee considered all resolutions relating to the Public Health System Nurses’ and Midwives’ (State) Award since the previous Award claim and was presented with extensive assessments on the legality, practicality and achievability of these potential claims. A small number of proposed claims were not supported by the Committee, with the affected initiating Branches being advised. After thorough consideration, a final

list of claims was recommended to Branches in March 2017 by both the Committee and also the Association Council. The proposed Award claim, including the expanded ratios claim, was unanimously endorsed and subsequently served on the Ministry of Health. In addition to the new outpatients setting claim, a 2.5% per year increase was claimed, the existing ratios improvement claims and an expanded claim for specials provision were claimed, and the following conditions improvements were also sought: Ratios-related claims

• Improve ratios in all NSW hospitals to the same level as Group A city hospitals. • Introduce ratios in paediatric and neonatal intensive care units. • Introduce ratios in EDs, EMUs and MAUs. • Introduce ratios in intensive and critical care units. • Introduce a ratios-equivalent system in community and community mental health. • Extend ratios to more mental health units, and improve ratios in specialised mental health hospitals. • Introduce ratios for short stay wards – High Volume and Day Only. • Introduce ratios for Drug and Alcohol units – Inpatient and Outpatient. • Introduce guaranteed staffing arrangements for non-Birthrate Plus maternity services. • Introduce guaranteed staffing arrangements for outpatient clinics. • Employ an additional 275 Clinical Nurse/Midwifery Educators. • Employ Assistants in Nursing/ Midwifery only where clinically appropriate. • Replace the ‘midnight census’ for nursing hours calculations with a system that accurately reflects patient numbers.

34 Key Direction 2

• Staffing for specials to be separate and in excess of mandated ratios or rostered staffing. Pay and conditions claims

• 2.5% increase in wages and salary related allowances per year (next increase due July 2017). • Pay superannuation to nurses and midwives on paid parental leave. • Pay nurses who provide clinical advice when not rostered to attend work. • Increase sick leave to 15 days per year. • Pay Higher Grade Duties for every shift. • Increase the minimum notice for displaying rosters from 2 to 4 weeks. • Staffing for specials to be separate and in excess of mandated ratios or rostered staffing. Award discussions and pay offer

Discussions were held with the Ministry of Health in March-May 2017 to advocate for members’ claims. The Ministry of Health did

not receive ‘bargaining parameters’ from the central government until May 2017 and when this occurred the sole issue that formed the offer to members was a pay increase. The government continues to flatly refuse to improve ratios or any other existing Award conditions without a corresponding reduction in conditions to achieve a ‘cost neutral’ ‘trade off’. Outcome

• The augmented Award claim was served upon the Ministry of Health in March 2017 and a response that rejected all ratios and other conditions claims was received in mid-May 2017. • A pay offer of 2.5% for the year from July 2017 was received, with Branches voting to accept the pay increase offer. • The General Secretary thanks the Log of Claims Committee members for their commitment to the membership, and willingness to provide clear direction and reach recommendations in consensus.

Christadelphian Homes Enterprise Agreement Bargaining

Christadelphian Aged Care and its lawyers took an unprecedented and highly aggressive approach in bargaining for a new Enterprise Agreement. This ‘union-busting’ approach made the negotiations very difficult and extraordinarily time-consuming. The employer sought to remove or reduce 17 conditions, including: • one week’s annual leave. • the reasonable workloads clause. • nurses’ picnic day. • reduction of uniform allowance. • ability to arbitrate disputes, and • added a proposal to enable the employer to transfer employees between facilities for a part or full shift. The Christadelphian Aged Care Enterprise Agreement 2016 was approved by the Fair Work Commission on 5 July 2017.

Members will receive back-pay to October 2016 and a further pay increase from July 2017. Key Direction 2: Strategy 2.1, Strategy 2.2 Key Direction 1: Strategy 1.1, Strategy 1.2

Action

employees between facilities for a part or full shift. • Membership increased by 50%. • Two new Association branches have been formed. • Education and development of member leaders. • Member leaders actively participated in negotiation meetings. • In one week, the petition was signed by over 400 employees (out of 540 nurses employed at Christadelphian).

A bargaining survey of members was promoted through facility visits, SMS and email, with member leaders tasked with encouraging other nurses to complete the survey. New member leaders were identified through workplace visits, off-site meetings, and through the Bargaining Organising Committee. A petition was created, with nurses asking for a fair agreement and the withdrawal of the employer’s proposed cuts to annual leave, nurses’ picnic day, workloads and transfer of employees between facilities. Member leaders were tasked with securing signatures at their facility. Information on bargaining was regularly provided to members through SMS, email, flyers, Facebook, and robo-calls with key messages on the vote. Outcome

• A high response rate from members was received to the bargaining survey. • Due to member pressure, the employer retracted from the proposed cuts of one week’s annual leave and uniform allowance entitlements, and withdrew its proposal to transfer

• In the last year there have been a large number of matters relating to the inappropriate use of social media, particularly in publishing and sharing information not in accordance with evidence-based advice regarding vaccinations. In response to these notifications the Nursing and Midwifery Board of Australia released a position statement on nurses, midwives and vaccination to make clear the expectations of the regulators on those who are registered.

• Three WHS representatives were elected under the Health and Safety legislation, enabling WHS inspections to be conducted at two facilities.

Legal representation before statutory bodies

• An article was published in The Lamp with new member leader stories and photos.

Action

Member Representation Emerging legal and professional issues Action

In the course of advising members, Association legal officers have identified a number of trends in notifications made to the regulatory bodies. These issues are affecting members in significant numbers and members need to be aware of their professional obligations relating to conduct and performance. Outcome

• Over the past few years, there continues to be issues with the observation of patients within mental health facilities. The Association’s legal officers work with the professional officers to ensure the findings and recommendations of coroners, as well as the decisions of tribunals, are used where possible to educate members about these issues.

Key Direction 2: Strategy 2.7

Association legal officers provide legal and professional advice and advocacy to members before the relevant professional and statutory bodies. Outcome

• For the period July 2016 to May 2017, advice and representation was provided to 804 members in relation to various legal matters including: Australian Health Practitioner Regulation Agency (AHPRA) – 115 matters/enquiries Health Care Complaints Commission (HCCC) – 137 matters/enquiries Nursing and Midwifery Council (NMC) – 122 matters/enquiries Coronial inquests – 140 matters/enquiries Miscellaneous – 290 matters/enquiries (e.g. advice relating to civil and criminal matters relating to employment).

36 Key Direction 2

Legal Tribunals

Nepean Blue Mountains Local Health District

Action

Association legal officers are utilising the NSW Civil and Administrative Tribunal (NCAT) by representing members who are appealing decisions regarding their registration. The Association takes action and supports members in the face of unreasonable and unjust decisions.

Mental Health – Introduction of change

A new security service at Nepean Mental Health Triage and Assessment Centre was implemented without consultation with staff.

Outcome

• To date, all decisions appealed have been able to be settled with a favourable outcome achieved for those members prior to the matter being heard by NCAT.

Ministry of Health & Northern Sydney Local Health District (LHD) Northern Beaches Hospital redevelopment

The NSW Government has contracted Healthscope to build and operate (and be the employing entity of staff) a new Northern Beaches Hospital located at Frenchs Forest. This new hospital would be in lieu of public health services currently provided at Manly and Mona Vale Hospitals (although residual services may remain at both). Key Direction 2: Strategy 2.7 Key Direction 3: Strategy 3.4 Key Direction 1: Strategy 1.5

Action

Unions NSW and public health unions continue to seek definitive answers on a number of longstanding (global) issues related to this redevelopment. In the

Key Direction 2: Strategy 2.2

Action

preceding few months, members have participated in joint union meetings; completed petitions and surveys; and had a meeting with the Minister for Health. Outcome

The Association sought consultation with the LHD in the form of a Union Specific Consultative Committee (USCC), following a branch resolution seeking urgent action. Outcome

• The recent actions by members had an immediate effect, with long outstanding information being received regarding the transfer payment, along with certain feedback regarding employment entitlements and conditions to be maintained.

• The first USCC was held on 23 January, the second on 25 January and a third on 6 February 2017. Concerns from members on security risk assessment, security staffing profile, rostering and workloads were raised and resolved at these meetings.

• Disappointingly, feedback is still outstanding on a number of other matters, including choices regarding enforcement options around certain transferring terms and conditions of employment (i.e. the two-year job guarantee and application of certain policies during that period).

• An independent security risk assessment was requested by the unions and was completed by O’Connor Marsden and Associates and provided on 20 February 2017. In the interim, the standing assessment was re-written and eventually a risk assessment consensus reached.

• These outstanding matters were discussed at the meeting with the Minister, attended by workplace representatives. As a result, this ministerial level dialogue would continue to discuss and hopefully try and resolve some of these outstanding matters.

• The Centre opened as planned on 8 February 2017, with agreement from the branch and the HSU. A review of this service is due six months after the opening to ensure workloads and other issues raised at the USCC meeting have been resolved to the satisfaction of all staff.

• The LHD was advised at the last Joint Consultative Committee (JCC) that the unions must be informed, in writing in accordance with the respective awards, of any future changes to service provision such as this and prior to the implementation of any change.

NSW Government By-elections: North Shore, Manly, Gosford

On 8 April 2017, the three NSW electorates of North Shore, Manly and Gosford went to the polls. Premier Mike Baird had recently stepped down as Premier after a tumultuous 2016 and possible swings against the government were anticipated in the seats of North Shore and Manly. Independents in the electorates of Manly and North Shore, as well as the Labor candidate from Gosford, strongly supported Association issues and signed a pledge with the Association providing some support of those candidates. Given the short by-election campaign timeframe, the Association was unable to make contact with all 26 candidates. Key Direction 2: Strategy 2.4

Action

The Association ran an issuesbased campaign focusing on nurse-to-patient ratios, keeping public hospitals public and more transparency and consultation with nurses and midwives. • Letters were sent to candidates who showed an interest in healthcare issues in each electorate. • Meetings between local members and the candidates in support of our issues were arranged to discuss the concerns of members

in those electorates. This included Liesl Tesch (Labor) in Gosford, Kathryn Ridge (Independent) in Manly and Carolyn Corrigan (Independent) on the North Shore. • Supporting pledges with a list of Association issues were designed for candidates to sign and memes were created and posted on the Association Facebook page. • The Association designed and distributed its own campaign materials in the three electorates, including flyers urging voters to put public health first, along with supporting statements. • Emails and texts were sent to members in the electorates with information about the health issues that the Association and its members had identified. • Phone-banking for the electorate of Gosford was undertaken a few days prior to the by-election.

• Paid and free media accompanied the Association’s by-election campaign. Outcome

• The candidates who supported Association issues polled well, with Labor candidate Liesl Tesch winning in Gosford, Independent Kathryn Ridge coming a close second in Manly with almost 40% of the votes, and Independent Carolyn Corrigan narrowly defeated after obtaining over 45% of the votes. • A long-held dispute over transfer payments to health workers at Manly and Mona Vale hospitals was resolved during this period due to Association campaigning efforts for the byelection, as well as actions taken by members around transfer negotiations concurrently in these two hospitals.

38 Key Direction 2

NSW Health Multiple disputes re In-Charge of Shift Allowance

The Association is in dispute with various LHDs regarding the nonpayment of the in-charge of shift allowance in various settings. Key Direction 2: Strategy 2.7 Key Direction 1: Strategy 1.5

Action

The Association has noticed many parallels between the work being undertaken by these members and the work that was undertaken in the case the Association successfully arbitrated in the IRC regarding Concord Hospital. Outcome

• The Association has filed at least two disputes in the IRC in relation to this matter, with one remaining on foot. • Attempts to engage with the Ministry of Health to prevent the unnecessary duplication (and expense) of arbitral proceedings on established case law has not been successful. • As a result, it appears each dispute that is unable to be resolved by LHD level discussion will require arbitration, with the production of evidence and hearing days allocated: an unfortunate approach that is both time and resource intensive.

NSW Ministry of Health

NSW Parliament

Working with Children Check

Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016

Phase 2 of the NSW Health Working with Children Check (WWCC) implementation has commenced, as per Schedule 1 of the Child Protection (Working with Children) Act 2012 and complementary Child Protection (Working with Children) Regulation 2013. Key Direction 3: Strategy 3.4 Key Direction 2: Strategy 2.7

Action

Phase 1 in the NSW Health WWC implementation drew to a close on 31 March 2017 for the LHDs of Hunter New England, Central Coast, Mid North Coast, South Eastern Sydney, and Northern NSW. Phase 2 has now commenced for the remaining LHDs/networks, and already some of the same problems have resurfaced regarding a blanket approach to those requiring a WWCC. Outcome

• The Association is making representations, as required, regarding Phase 2, and if necessary, is escalating issues to the Ministry. • The Association has again reminded a number of LHDs that a blanket approach (i.e. all nurses need to have a WWCC) is not appropriate or consistent with the legislation or advice from the Ministry. • Some administrative difficulties occurred during Phase 1 when the name of the WWCC clearance was different to the name used for employment. In this situation members should ensure the clearance can be verified as relating to the person employed.

This disallowance motion is to be debated in the NSW Parliament. Key Direction 3: Strategy 3.4

Action

The NSW Baird Government, without any prior warning or consideration to consult, had the Government Sector Employment Amendment (Transfers to NonGovernment Sector) Regulation 2016 (Regulation) gazetted. The Regulation further eroded the rights of government sector workers whose role may be subject to privatisation. Unions NSW and affiliates have agitated with cross bench members of the NSW Legislative Council to support a disallowance motion on the Regulation tabled by the ALP Opposition. Outcome

• After numerous adjournments, this debate is yet to occur. NSW Legislative Council’s Standing Committee on Law and Justice First review of the workers compensation scheme

The NSW Legislative Council’s Standing Committee on Law and Justice conducted its first review of the workers compensation scheme. Key Direction 2: Strategy 2.2, Strategy 2.4

Action

The Association made a comprehensive submission to this inquiry, arguing more needs to be done to ensure employers abide by their obligation to provide suitable work to injured workers. The Association also appeared and gave evidence to the Committee, emphasising the devastating impact of section 39 of the Workers Compensation Act 1987 (NSW) which provides for the cessation of weekly payments of compensation after five years. Outcome

• The Final Report was released in early March 2017 and the Association’s submission and evidence were noted approvingly. • The Committee recommended that clearer data regarding return to work outcomes be collected and workers affected by section 39 be identified and subjected to intensive case management to provide opportunities before the expiration of weekly benefits. • These recommendations, however, do not go far enough.

Opal Specialist Aged Care Enterprise Agreement Bargaining

The Opal (NSW) Enterprise Agreement 2016 was approved by the Fair Work Commission in August 2016 following a robust bargaining round. This was the first time the Association had made a claim for mandated ratios in aged care. Key Direction 2: Strategy 2.1, Strategy 2.2, Strategy 2.5 Key Direction 1: Strategy 1.1, Strategy 1.2

Action

Extensive member research was conducted through focus groups, workplace visits, and a member survey. Throughout the bargaining campaign, there were regular visits to facilities and meetings via teleconference of the Bargaining Organising Committee to provide updates and to receive feedback from members on the bargaining campaign. Member leaders attended an education day at the Association,

focussing on their role in achieving a better Enterprise Agreement. New communication tools were utilised, in order to increase the reach to members and nonmembers. This included a cover story in The Lamp, launching the bargaining campaign for ratios, targeted messaging through SMS and email, a Facebook page especially for Opal members, and the translation of key messages (written material and video) into Nepali, Tagalog and Mandarin – the first language of the identified three main cultural groups employed at Opal. A dedicated email address was also set up to enable members to directly communicate with their Association bargaining team. Outcome

• Unprecedented member engagement in the member survey with over 68% of members responding and 112 members identifying themselves as wanting to be involved in the bargaining campaign. • The message from members was consistent: better staffing and better pay were the key issues for members. • The extensive research and high survey response enabled the development of a comprehensive and thorough mandated ratio claim. • The Enterprise Agreement delivered the first step towards mandated ratios being included in an aged care agreement with:

40 Key Direction 2

a commitment that the standard roster will provide safe staffing for quality care of residents and a fair and reasonable workload for staff; a commitment to replacing staff absences to ensure the standard roster is filled, and where an employee identifies these commitments are not being met by Opal there is a process that outlines how to address the issue.

• Members were comfortable to share their stories through the Association Opal email address, which provided valuable information during negotiations.

• Increased pay rates and improved conditions in a legally enforceable Enterprise Agreement, with no cuts to conditions.

Metropolitan sites An organising plan has been in progress since August 2016 to grow membership, increase member leaders, form branches to ensure that over 50% of sites have branch coverage, and to continue to manage issues that have an impact company-wide.

• RN-led model of care confirmed in the Enterprise Agreement. • Growth in membership. • Identification of new member leaders. • Member leaders actively participated in negotiation meetings. • High participation and engagement in member Bargaining Organising Committee teleconferences.

• Increased staffing on afternoon shift at some facilities occurred during the course of negotiations. • New bullying clause included in the Enterprise Agreement bullying had been identified as a major issue for members.

Examples of the major issues that the Association continues to monitor are random and general alcohol and drug testing, workplace safety, workloads and skill mix in Opal’s standardised roster.

Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.5

Action

Association officers conducted a cycle of visits for the purpose of recruitment and education of members. Training programs were developed for on-site and off-site training. Data was collected by the Association in relation to staffing to the standard roster and complying with the new EA clause requiring the employer to replace staff absences. Further data collection is required to form the evidence base. Outcome

• In seven months (August 2016May 2017), 90 new members were recruited. • In the same period, 24 new activists were identified. • Member leader rating of existing member leaders has been increased. • Health and Safety Representatives were appointed as a branch initiative. • Six new branches have been formed and four more sites are in development. • Four Peer-to-Peer education programs were planned with three proceeding. • Data collection has commenced for branches agreed to by branch resolution.

Save Our Weekend campaign Penalty rates

On 23 February 2017, the longawaited decision by the Fair Work Commission regarding penalty rates was handed down reducing Sunday, late night and public holiday penalty rates in the hospitality and retail sectors. The collective union movement’s response was swift and scathing of this decision. Not only was there outrage that the decision had wound back decades of progression in workers’ rights and threatened the livelihoods of those who need it most, but also that the decision would have a flow-on effect to other industries. The fears were not unfounded. Further legal analysis undertaken by the ACTU confirmed that nurses and midwives working in some parts of the health and aged care sectors were also at risk of losing their penalty rates and entitlements. The legal findings state that much of the reasoning relied upon in the penalty rates

decision could be adopted when reviewing awards in other industries including workers in aged and healthcare (particularly non-essential care) and nursing, where it is not deemed to be in an ‘essential service’. The legal findings are a clear warning that nurses, midwives and assistants in nurses, particularly those working in the lower-paid aged care sector are, in fact, vulnerable to the loss of penalty rates. Fears were realised when national health provider Sonic Health Plus attempted to cut the Sunday penalty rates of its nurses by a staggering 25%. The company’s proposal is the ‘start of the slippery slope’ for nurses working in socalled non-essential areas of health service delivery. Key Direction 2: Strategy 2.4

Action

As part of the coalition of unions who are involved in the Save Our Weekend campaign, the Association quickly responded via free media, social media and The Lamp to highlight the

Association’s displeasure at the Fair Work Commission decision. The Association participated in a National Day of Action to protect these attacks on worker rights. Workplace resolutions with pledges of support were also distributed to all delegates so branches have the opportunity to vote and commit to fighting these unfair attacks on workers’ conditions. The Association will also continue to promote any digital campaigns or online actions executed by the peak bodies of the ANMF or the ACTU. Outcome

• Swift social media action around the Sonic Health Plus proposal resulted in the issue going viral and a back down by the employer. Furthermore, a delegation of nurses nationally, including a member from NSW, met with the Opposition leader, Bill Shorten, to highlight the financial impact a loss of penalty rates would have on nurses. • Any social media action prosecuted around penalty rates draws attention and there is a clear engagement on this issue by members.

42 Key Direction 3

Key Direction

Promote a world class, well-funded, integrated health system STRATEGIES 3.1 Consult with Association 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 Association members and member leaders 3.4 Develop initiatives, affiliations and partnerships on issues that affect

Association members

3.5 Advocate and influence decision makers on key issues that affect

Association members and the delivery of care

Increasingly, health is becoming a defining political issue in our country and budget decisions impact on the delivery of care. The Association will be an effective advocate for delivery of quality outcomes of care in an everchanging health system and influence policy and decision-makers to invest in prevention and universality.

National Aged Care Staffing and Skill Mix Project ANMF report

Following on from a Senate inquiry into the Future of Australia’s aged care sector workforce, the ANMF released the National Aged Care Staffing and Skills Mix Project report in December 2016.

November 2016, arguing the need for the Federal Government to look at reinstating the requirement to support RNs in federal legislation. • The following month, key findings from the ANMF study found: Residents should receive an average of four hours and 18 minutes of care per day compared to the 2.84 hours currently being provided; 2.84 hours received

National Aged Care Staffing and Skills Mix Project Report 2016 Meeting residents’ care needs: A study of the requirement for nursing and personal care staff

Key Direction 3: Strategy 3.2

Action

The project is the first of its kind in Australia and has collected evidence relating to the need for a staffing methodology that considers both staffing levels (the right number) and skills mix (the right qualification) for residential aged care. The comprehensive study developed an evidence-based complexity profile, tested the elements of care associated with the resident profiles, determined what care interventions were being missed and confirmed the need for, and structure of, a staffing model for residential aged care.

4.3 hours needed

A skills mix of 30% RNs, 20% ENs and 50% PCAs is the minimum skills mix to ensure safe residential care. • The Association will run a longterm campaign from 2017 to the federal election in 2019 that draws on evidence from this study. • The campaign will follow on from the Association’s RN 24/7 campaign and call on the Federal Government to legislate staffing ratios in aged care, including the requirement to have RNs on site at all times in high care facilities across the country. A skill-mix r eq

• Association officers, including the General Secretary, presented to the Senate Standing Committee in

30% 50% RNs

20% ENs

PCAs

t en

• The Association made a submission to the Senate inquiry into the Future of Australia’s aged care sector workforce, which provided 20 recommendations based on information obtained from members.

ui re

Outcome

44 Key Direction 3

Association regarding safe staffing and skills mix in residential aged care facilities.

Aged Care Campaigns

• The campaign will continue through the ANMF federal aged care campaign strategy, focusing on safe staffing and skills mix.

RNs 24/7 in Aged Care

Robert Brown, the Shooters Fishers and Farmers Party MLC, introduced a Private Members Bill to reinstate the requirement in the NSW Public Health Act for a registered nurse to be on duty at all times in any residential aged facility with high care residents.

10 Questions to Ask project Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.3, Strategy 3.4, Strategy 3.5

Key Direction 3: Strategy 3.4

Action

Section 104 of the NSW Public Health Act (2010) remains in place which secures registered nurses in NSW nursing homes; however, the NSW Government continues to indicate it will not retain this piece of legislation. A Bill was introduced by the Shooters, Fishers and Farmers Party late in 2016 to block this decision. This was passed by the Upper House on 4 May 2017 however, was voted down in the Lower House on 11 May 2017.

Association officers continue to engage members of the NSW Aged Care Roundtable, a group which formed by the Association consisting 20 organisations and individuals. The main focus of the roundtable has been to develop a series of consumer information leaflets 10 Questions to Ask, furthering the work of the federal

• Further leaflets are also being developed with external organisations focusing on issues such as oral and dental health, dementia, and Aboriginal and Torres Strait Islander specific needs.

IT’S YOUR RIGHT TO ASK

IT’S YOUR Questions to AskRIGHT TO ASK

ABOUT

LOGO VARIATIONS

ABOUT

Horizontal logo

Stacked logo

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

LOGO VARIATIONS

Horizontal logo

CLIENT

Palliative Aged Care Network NSW

PROJECT Branding Concepts

DATE

21.02.2017

ROUND 1

Stacked logo

Horizontal logo

SARAH MARSDEN GRAPHIC DESIGN

Stacked logo

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

by a regulatory body. Licensing ensures professional standards are maintained and protects the public. Assistants in Nursing (AIN)/Care Workers/ Care Service Employees (CSE) are unlicensed. They provide most of the care in residential facilities and community but their level of training is variable.

PALLIATIVE AGED CARE NETWORK NSW

www.10questions.org.au ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

important to ask the right questions when looking for a home.

PALLIATIVE AGED CARE NETWORK NSW

Service (TIS) Assistants in Nursing (AIN)/Care Workers/ 131are 450 Care Service Employees (CSE) unlicensed. They provide most of the care in For a full list of supporting organisations please visit Most importantly, you will need to residential facilities and butand their www.10questions.org.au This leaflet hascommunity been developed endorsed by: find a home that will provide you with level of training is variable.

Professor Dimity Pond

CLIENT

Palliative Aged Care Network NSW

PROJECT Branding Concepts

CLIENT

DATE

21.02.2017

ROUND 1

Palliative Aged Care Network NSW

PROJECT Branding Concepts

SARAH MARSDEN GRAPHIC DESIGN

DATE

SARAH MARSDEN GRAPHIC DESIGN

The best way to find a home that suits you is to visit a few different homes. To find homes in your area you can use the My aged Care aged Care home Finder by calling 1800 200 422 or visit myagedcare.gov.au

www.10questions.org.au Professor Dimity Pond PhD BA MBBS FRACGP

For a full list of supporting organisations please visit www.10questions.org.au

1800 550 552 NSW@agedcarecomplaints.gov.au

About

your cultural needs in residential aged care 1800 550 552 NSW@agedcarecomplaints.gov.au

For a full list of supporting organisations please visit www.10questions.org.au If you have concerns about a residential aged care facility contact:

1800 550 552 NSW@agedcarecomplaints.gov.au

LIFESTYLE IN RESIDENTIAL AGED CARE

If you have concerns about a residential aged care facility contact:

21.02.2017

ROUND 1

About

PhD BA MBBS FRACGP

For a full list of supporting organisations please visit www.10questions.org.au

If you have concerns about a residential aged care facility contact:

care that is culturally and linguistically responsive, inclusive, sensitive and 1800 550 552 NSW@agedcarecomplaints.gov.au meets your individual needs.

ABOUT

This leaflet has been developed and endorsed by:

GP services in residential Staffing aGed care in ReSidential Questions to Ask aged CaRe ‘Endorsed by’ logo (if required)

‘Endorsed by’ logo (if required)

PALLIATIVE AGED CARE NETWORK NSW

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

• Aged care members continue to receive advocacy from the

My Aged Care 1800 200 422 myagedcare.gov.au

LOGO VARIATIONS

ENDORSED BY

PALLIATIVE AGED CARE NETWORK NSW

Outcome

To find your local ones, or for more information about aged care services contact

PALLIATIVE CARE IN RESIDENTIAL Questions to Ask AGED CARE It’s your right to ask www.10questions.org.au About

‘Endorsed by’ logo (if required)

PALLIATIVE AGED CARE NETWORK NSW

10 Questions to Ask 10 Questions to Ask FACILITIES AND

The best way to find a residential aged care facility that suits you is to visit a few.

It’S youR CONTRACTS RIght to ASk AND FEES IN RESIDENTIAL AGED CARE

It’S youR to Ask Questions RIght to ASk

PALLIATIVE AGED CARE NETWORK NSW

• A co-signed letter by a number of the Aged Care Roundtable organisations was sent to the NSW Health Minister Brad Hazzard seeking Section 104 of the NSW Public Health Act (2010) be retained.

Action

This leaflet is part of a series written by Aged care is very expensive, so it is nurses, doctors and experts with experience important that you know what you’re paying in aged care. The series aims to make your for. You can expect to pay a few different fee journey into residential aged care easier. The best way to find a residential aged care types, depending on your financial situation: facility that suits you is to visit a few. To findLook for other leaflets on questions to ask about specific care needs. These can be your local ones, or for more information about The daily fees cover living costs and personal This leaflet part services of a series written byAged Caredownloaded at: www.10questions.org.au agediscare contact: My care. The basic daily fee is payable by all nurses, doctors and experts 1800 with 200 experience 422 You may find these leaflets useful when: In addition to the questions contained in residents, with an additional means-tested in aged care. The series aims to make your myagedcare.gov.au this leaflet you should also observe the care fee payable based on Centrelink’s • Searching for a high quality residential aged journey into residential aged care easier. This leaflet is part of a series written by environment of each facility as you walk assessment of your income and assets. care facility If you require advocacy or specialist Look for other leaflets on questions to ask advice nurses, doctors and experts with experience around to decide if you want to live there. • Reviewing the quality of your current about any matter notThese covered this leaflet: about specific care needs. caninbe in aged care. The series aims to make your You will be asked to make a contribution residential aged care facility Seniors Rights Service best wayaged to find a residential care The home should not have an unpleasant downloaded at: www.10questions.org.au journey intoThe residential care easier. aged towards your accommodation costs if 1800 424 079 • Deciding between two residential aged care you istotoask visit a few. smell. This may indicate insufficient cleaning Look for other facility leafletsthat on suits questions Centrelink deems you can afford to. You may find these leaflets useful when: facilities that appear similar. or poor continence management. about specific care needs. can be You can pay in a lump sum called a To find your These local ones, or for more • Searching for eta has high quality residential agedby: This leafl been developed and endorsed at: www.10questions.org.au By law, residential aged care facilities are not downloaded Accommodation Deposit information about aged care servicesRefundable contact People should be engaged and not care facility required to have registered nurses so it’s (RAD), which is refunded when you leave the visibly bored and unoccupied, this may You may find these leaflets useful when: • Reviewing the quality of your current important to ask the right questions if you home, a Daily Accommodation Payment My Aged Care indicate insufficient staffing or lack of residential aged care facility • Searching for a high quality residential aged The best way to find a residential aged care need nursing care. 1800 200 422 (DAP), which is non-refundable, or through care facility • Deciding between two residential aged care individual activities. facility that suits you is to visit a few. a combination of the two. Many staff wear similar uniforms. Just because • Reviewing the quality facilities that appear similar. myagedcare.gov.au of your current Staff (including managers) should treat To find your local ones, or for more someone looks like a nurse does not mean This leaflet ismay part of residential aged care facility residents with respect. This will be your PALLIATIVE The best way to afind a residential agedBy care PALLIATIVE AGED CARE Extra service fees apply ifseries you law, residential aged care facilities are not AGED CARE NETWORK NSW information about aged care services contact they are. Here are the differences: • Deciding between two residential aged careNETWORK home, you should expect to be treated with byannurses, doctors and facility that suitsplace, you is to visit a few.required to have registered nurses so it’s havewritten asked for extra service NSW Thisappear leaflet has been developed and endorsed by: facilities that similar. respect. Staff should acknowledge this and which should include higher quality experts withToexperience in aged care. A Registered Nurse (RN) has undertaken My Aged Care find your local ones, or for moreimportant to ask the right questions if you ensure they include you in discussions. and additional services. a minimum three-year Bachelor of Nursing need nursing care. The series aims to make your journey By law, residential aged care facilities are not accommodation 1800 200 422 information about aged care services contact The provider may offer additional care course. They can undertake nursing required to have registered nurses so it’s Forwear a full list of supporting organisations please visitYou can book an appointment to ask into residential aged care easier. Many staff similar uniforms. Just because myagedcare.gov.au and services for a fee, but these are procedures, manage pain medication and www.10questions.org.au important to ask the right questions if you questions of the staff and management and My Aged Care someone looks like a nurse does not mean Look for other leafletsifon unregulated and only payable youquestions agree help prevent unnecessary hospital admissions. need nursing Professor care. to receive a formal tour of the home. You may If you concerns about a residential aged care facility contact: they are.have Here are the differences: 1800 200 422 Dimity Pond ask care needs. Youabout cannotspecific be forced to pay to dotoso. also like to visit to observe what by: PhD BA MBBS FRACGP This unannounced, leaflet has been developed and endorsed An Enrolled Nurse (EN) works under PALLIATIVE PALLIATIVE AGED CARE Many staff wear similar uniforms. Just becauseadditional myagedcare.gov.au fees. These can be downloaded at: A Registered Nurse (RN) hasNETWORK undertaken AGED CARE NSW 1800 550 552 day to day living in the home is like. the direction of an RN. Both are licensed NETWORK someone looks like a nurse does not mean NSW@agedcarecomplaints.gov.au a minimum Bachelor of Nursing PALLIATIVE PALLIATIVE AGED CARE NSWthree-year Professor www.10questions.org.au AGED CARE NETWORK NSW by a regulatory body. Licensing ensures they are. Here are the differences: Staffing ratios and activities may differ Dimity Pond NETWORK course. They can undertake nursing NSW PhD BA MBBS FRACGP professional standards are maintained and This leaflet has been developed and endorsed by: you require or specialist advice depending on whether it is a week day or procedures,If manage painadvocacy medication and A Registered Nurse (RN) has undertaken Moving into a residential aged care protects the public. about any matter not covered in this leaflet: weekend so try to vary the times you visit. help prevent unnecessary hospital admissions. For a full list of supportingof organisations a minimum three-year Bachelor Nursing please visit home may often be a difficult and www.10questions.org.au Assistants in Nursing (AIN)/Care Workers/ course. They can undertake nursing See if you can speak to other residents and Aged Care An Enrolled Nurse (EN)My works under emotional decision. Most aged care PALLIATIVE PALLIATIVE PALLIATIVE AGED CARE PALLIATIVE AGED CARE Care Service Employees (CSE) are procedures, manage pain medication their relatives about their personal experience CARE AGED CARE NETWORK NSW NETWORK NSW If you have concerns about a residential and aged care facilityAGED contact: the direction of an RN. Both are licensed 1800 200 422 NETWORK NETWORK services must be accredited to Professor unlicensed. They provide most of the care in NSW NSW help prevent unnecessary hospital admissions. of living there. by a regulatory body. myagedcare.gov.au Licensing ensures Dimity Pond 1800 550 552 residential facilities and community but their BA MBBS FRACGP operate but there is a big difference PhDprofessional standards are maintained and An Enrolled Nurse (EN) works under NSW@agedcarecomplaints.gov.au level of training is variable. in the way each is run, so it’s protects the public. Translating and Interpreting the direction of an RN. Both are licensed PALLIATIVE AGED CARE NETWORK NSW

Outcome

• A further 10 Questions leaflet covering LGBTI has been developed.

This leaflet is part of a series written by nurses, doctors and experts with experience in aged care. The series aims to make your journey into residential aged care easier. Look for other leaflets on questions to ask about specific care needs. These can be downloaded at: www.10questions.org.au

aged care campaign for safe staffing and skills mix in residential aged care facilities.

www.10questions.org.au

• A rollout of leaflets across NSW is being scheduled.

Keep Our Hospitals Public Anti-Privatisation Campaign

• The Association co-presented the 10 Questions project with Partners in Culturally Appropriate Care (PICAC) at the 4th International Conference on Ageing in a Foreign Land in Adelaide. • An abstract has been submitted to co-present the 10 Questions project with the Royal Australian College of General Practitioners NSW faculty at the 2017 Australian Association of Gerontology Conference in Perth in November 2017. • The 10 Questions leaflet has attracted media attention and exposure across a range of outlets and publications, furthering the work of the federal aged care campaign.

Following the 15 September 2016 announcement by the NSW Government to privatise the five major regional public hospitals of Maitland, Wyong, Goulburn, Shellharbour and Bowral, local Association member activists together with HSU, ASMOF, the Association and Unions NSW, commenced a robust campaign to oppose the privatisation decision. Labor MPs joined in the fight and petitions from the Labor Party and the combined unions, distributed widely in the community, collected over 30,000 signatures that were tabled in Parliament on 10 November 2016. Key Direction 3: Strategy 3.4, Strategy 3.5 Key Direction 2: Strategy 2.4 Key Direction 1: Strategy 1.1, Strategy 1.2, Strategy 1.3, Strategy 1.4, Strategy 1.5

Action Wyong Hospital – Central Coast Local Health District (LHD)

Leaders have guided the campaign from the ground with the overarching combined unions driving the campaign state-wide. A candlelight vigil organised by David Harris MP in April 2017 was well attended and Association activists approached the local MPs to support ratios in public hospitals – a key factor to maintaining quality patient care, and a compelling argument to keep hospitals public. A well-attended community Forum held on 15 June 2017 showed strong support for the antiprivatisation campaign and new member leaders were identified for development, giving the local branch more depth. In July, the State Government announced it was not proceeding with the privatisation of Wyong Hospital – a huge win for the community, staff and their unions.

46 Key Direction 3

Maitland Hospital – Hunter New England LHD

Member activists, supported by the HSU, conducted a media stunt outside the hospital on 19 October 2016, calling on the community to join them in defending public health services in the Hunter; this action received widespread media coverage throughout the Hunter. On 16 May 2017, a public meeting was held at East Maitland

Bowral and District Hospital – South Western Sydney LHD

On 21 October 2016, the SWLHD Chief Executive notified staff that Ramsay Health Care was successful in the expression of interest process and would be submitting a proposal for the Bowral and District Hospital.

Bowling Club to discuss Maitland Hospital’s future. Over 200 community members attended, including Association members from Maitland, Cessnock and John Hunter Hospitals; Michael Di Rienzo, Chief Executive of HNELHD; Jenny Aitchison, Member for Maitland, and Dr Ben Spies-Butcher, senior lecturer in economy and society, Macquarie University.

Following the initial privatisation announcement, a number of branch meetings and community activities were held, including a community rally and two community forums. It is clear that there has been a lack of transparency and genuine consultation by both the Ministry of

A Q&A panel followed, where community members heard about the impacts of privatisation from the Association’s Judith Kiejda, HSU’s Gerard Hayes, and ASMOF’s Andrew Holland.

Health and the LHD Executive on what privatisation would mean for the Bowral and District Hospital. The hard work and joint efforts of lobbying from health workers, their unions and the community paid off in July, when Bowral Hospital was identified as the third hospital to remain in public hands.

Shellharbour and Port Kembla Hospital – Illawarra Shoalhaven LHD

A staff forum held by the ISLHD Chief Executive and Health Infrastructure Director identified staff affected by the proposed privatisation, which included staff members from the Mental Health wards at Shellharbour Hospital, Port Kembla Hospital and Kiama Ward at Shellharbour Private Hospital. A local core campaign team comprising organisers from the Association, HSU and ASMOF meet regularly to implement strategies of activating members

Goulburn Base Hospital – Southern NSW Local Health District

Local branches joined in action with the local community union group, Goulburn District Unions, and saturated the community with information on what privatisation would mean for them.

and engaging the local community. South Coast Labour Council was contacted to assist in community awareness of the campaign. Local health workers from Shellharbour and Port Kembla Hospitals organised a community forum held on 5 June 2017, hosted by WIN News. Over 300 community members attended and participated in a very passionate discussion about expressions of concern regarding this privatisation proposal. Attendees included: Gareth Ward, Member for Kiama; Anna Watson, Member for

The local branches also engaged in door-knocking, assisted in arranging a local rally against privatisation and a well-attended Politics in the Pub event, to which the local Member was invited. Additionally, the community was galvanised by the concurrent announcement that the community’s

Shellharbour; Walt Secord, Shadow Minister for Health, along with Association officers and branch officials, HSU and ASMOF members and Arthur Rorris, Secretary South Coast Labour Council – all of whom participated in a Q&A panel. Further correspondence will be sent by community members to the Minister for Health. The Shadow Minister for Health did state that if the ALP was in government, it would not privatise public hospitals but did not commit to reversing any privatisation decision made by the current government.

well-loved Bourke Street Health Service would close and be moved into the Goulburn Base Hospital, before any rebuild of the hospital. Goulburn Base Hospital received no tenders for privatisation of the facility, a victory claimed by members and the community in discouraging prospective tenders.

48 Key Direction 3

Education & Scholarships 2017 Education Program Key Direction 3: Strategy 3.3

Action

Outcome

• The number of Association members has increased throughout the campaign. • Many new member leaders have emerged from involvement in the campaign with several undertaking education at the Association. • Rallies against privatisation have received widespread media coverage. • Politicians, including local and federal members from the Greens and Labour Party have publicly announced their opposition to privatisation. • Overwhelming community support opposing privatisation has been evident from the attendance at forums, including a Politics in the Pub, which was the catalyst for the creation of Public Health First, a community action group. Anti-privatisation campaign public opinion research In April this year, health unions including the Association, HSU and ASMOF, as well as Unions NSW, commissioned research into the public opinion of privatisation in order to better position ourselves with a long-term public campaign in the lead up to the 2019 NSW State Election.

The key objectives of the research

were to find the most persuasive arguments to: • Build community support for public health. • Create a political opportunity for supporters of public health. • Create roadblocks to privatisation of public health. Key Direction 3: Strategy 3.5

Action

The research methodology included comprehensive desk research that identified current values and frames around the issue of privatisation; field research with focus groups in regions affected by privatisation, and surveys and dial testing of messages with members and the community more broadly. Outcome

• Key analysis of public opinion showed that the balance of public opinion is overwhelmingly opposed to privatisation, which puts health unions in a winning position to prosecute this argument. • Unions are well placed to give people a clear, positive choice against privatisation. • Creative work is currently being undertaken to re-launch the privatisation campaign with a clearer, stronger message aimed at shifting public opinion.

In the period July 2016 – May 2017, 47 seminars were conducted with 32 held in the metropolitan area and 15 in regional areas, representing a 34% increase in the number of seminars offered to members during the same period last year. Outcome

• Five new seminars were on offer to members: Financial Wellness, Medication Safety, Transition to Practice, Getting people onside, and Managing difficult and aggressive clients. • A total of 1,492 members attended the 47 seminars, representing an increase of 56% for the period. • Online seminar registration via the Association website continues to be very successful. • A number of facilities have requested seminars to be held on site, particularly the Legal and Professional Issues and the Importance of Documentation seminars. The main reason for requesting the onsite delivery mode is the difficulty for staff to access education and training with study leave. Facilities can arrange rosters to incorporate an onsite session for staff.

Aged Care Nurses Forum Action

Aged Care Nurses Forums were held in Sydney in October 2016, Ballina in February and Tweed Heads in May 2017. Outcome

• The Tweed Heads forum was supported by the Senior Rights Service, Northern Rivers Community Legal Centre and Alzheimers Australia. • The metropolitan forum was supported by Partners in Culturally Appropriate Care (PICAC) NSW/ACT and the NSW office of the Aged Care Complaints Commission. • Because of the success of the regional forum, further regional forums will be scheduled to reflect the geographic spread of aged care membership.

Bob Fenwick Mentoring Grants Program

Mental Health and Drug & Alcohol Nurses Forum

Action

The Association has again managed the Bob Fenwick Mentoring Grants Program for 2016 in partnership with the NSW Ministry of Health Mental Health Branch. Outcome

The annual Association Mental Health and Drug & Alcohol Nurses Forum 2016, with the theme Cultural Barriers: Accessing Mental Health and Drug and Alcohol services, was held in September 2016 with 100 attendees.

• The program saw 20 Mentees participating in 2016.

Outcome

• The Bob Fenwick Mentoring Grants Program Ceremony was held on 13 October 2016. Mr John Feneley, NSW Mental Health Commissioner, provided the opening address and gave positive encouragement for the program; the Award Certificates were presented by Mrs Jan Fenwick and Association General Secretary, Brett Holmes. • The 6th round of the program in 2017 is now underway, with 20 mentees having been selected to participate.

• Eight presentations were provided, with the primary focus being on refugee mental health and Aboriginal mental health and drug and alcohol services. Scholarships Action

The Association administers a number of scholarships, providing education and training opportunities for members. These include The Edith Cavell Trust, Lions Nurses Scholarship and the Old People’s Welfare Council (OPWC). The OPWC has advised it will provide further funds for aged care scholarships in 2018.

50 Key Direction 3

Outcome

• The Edith Cavell Trust provided 35 scholarships to registered and enrolled nurses, midwives, and students of these disciplines to assist them with their studies in the 2017 academic year.

• The ISLHD agreed that the deletion of DDoN positions was in breach of the award and revised its initial proposal, resulting in the retention of DDoNs at all sites within the ISLHD.

• The Lions Nurses Scholarship Foundation provided 18 scholarships to registered and enrolled nurses and midwives, to assist them with their studies in the 2017 academic year.

• An after-hours NM/DDoN position was created at Milton Uladulla Hospital.

• The OPWC provided five scholarships to aged care nurses to assist them with their studies in the 2017 academic year.

Illawarra Shoalhaven Local Health District Leadership Structure Realignment

On 16 May 2017, the Association received documentation setting out a restructure of senior management positions across all sites to follow the implementation of the Chief Executive’s Leadership and Governance framework. The initial proposal to delete all DDon positions in the C hospitals (smaller sites), and a proposal for the site DoNM position to have no operational reporting lines was of concern to branch representatives. Key Direction 3: Strategy 3.1

Action

Branches passed resolutions opposing this structure on the grounds that DoNMs must have professional and operational responsibility. DDoNs are a senior nursing position and provide support to both DoNMs and NUMs, and their deletion and/ or dual grading undervalues their role and destabilises the nursing structure.

• DoNM positions have been strengthened to ensure they are briefed on operational matters. • In September 2016, the Nurse Manager Branch endorsed a resolution supporting the management restructure that was agreed by the Association.

Key Direction 3 Progress Report Key Direction Leadership Team 3 Key Direction 3: Strategy 3.1, Strategy 3.2, Strategy 3.3, Strategy 3.4, Strategy 3.5

the need to ensure transfer of information to all levels of workers providing direct patient care. It also called for safer handover systems in community based services and residential aged care facilities. • The paper was widely distributed to ensure that members are represented on issues affecting their workplace and to promote safe quality health care.

NSW Government Changes to the Industrial Court of NSW

The NSW Government implemented changes to the Industrial Relations Commission of NSW (IRC). This meant those matters dealt with by the IRC sitting as an Industrial Court were stripped out and would alternatively fall within the jurisdiction of the Supreme Court of NSW.

Action

The Association continues to produce issues papers on subjects that are relevant to the profession.

Key Direction 3: Strategy 3.1 Key Direction 2: Strategy 2.4

Action

Outcome

• A paper was published in December 2016 reporting on the Do not disturb outcome of consultation with members on nursing handover. Titled Do not Disturb – Findings from the NSWNMA staff handover survey; the paper highlighted the need for safe staffing and skills mix to enable safe transfer of information between spans of duty. It called for caution in the use of a third person handover; recognised NSW Nurses and Midwives’ Association

PROFESSIONAL ISSUES | 3

Findings from the NSWNMA nursing handover survey

The NSW Government, after years of stripping away the powers from the Industrial Court, sought the transfer of Industrial Court functions to the Supreme Court of NSW. Unions NSW and affiliates, including the Association, made representations about the undesirability of the changes. One area of concern was that the costs and the formality of undertaking cases before the Supreme Court would be prohibitive in relation to anything but the most extreme matters. Another change was that the Supreme Court would now sit in judgement of any claim involving dispute orders issued by the IRC that had not been complied with.

Outcome

• One of the first by-products of these changes was the Supreme Court considering the case of the Public Service Association (PSA), which undertook a 24-hour stoppage on 14 February 2017 across all FACS sites in defiance of IRC orders to cease and refrain from such action.

• The PIC provides invaluable advice to the 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 due for discussion and endorsement at Annual Conference.

• The PSA was fined $84,000 by the Supreme Court which was strikingly in excess of fines that were generally applied by the Industrial Court. • In arriving at this penalty, the Supreme Court noted that the PSA had aggravated its offence by continuing to proceed with the action even after the Supreme Court had found – in a preliminary decision – the PSA was in breach of the orders made by the IRC. • It is likely that this decision will only ‘encourage’ the NSW Government to seek similar penalties against unions in other like situations.

Association Professional Issues Committee and Reference Groups Key Direction 3: Strategy 3.5

Professional Issues Committee Action

The Professional Issues Committee (PIC) meets bi-monthly and consists of Association Professional Officers, members and Councillors from all areas of the health sector.

• The PIC has also provided comment on the ANMF policies due for review in the period; the number of policies requiring review continues to increase. • PIC discusses numerous professional issues including national registration, aged care, midwifery and educational topics. Reference Groups Climate Change Action

In line with the increasing importance of climate change the Association established a Climate Change Action Reference Group (CCARG) to enable interested and active ‘green’ member activists involved in environmental issues and Global Green and Healthy Hospital (GGHH) issues. Outcome

• The CCARG commenced in September 2016 with a membership of 20 people. As well as working on a range of environmental issues such as hospital involvement in World Environment Day, the CCARG has also had success in providing support to the Climate and Health Alliance (CAHA). • The Association has been active in the first stage of CAHA’s National Strategy for Climate, Health and Wellbeing by communicating with CEOs from key health organisations, obtaining members’ support in

reading CAHA’s discussion paper and responding to its survey, as well as taking part in an online discussion on plans and progress for the CAHA Strategy. • After a roundtable session with CEOs of key health organisations and selected MPs in the national parliament, CAHA’s second phase of its Strategy commenced with a draft framework for the National Strategy for Climate, Health and Wellbeing. The Association has provided feedback on this document and intends to visit MPs in the NSW Parliament to introduce them to CAHA’s Strategy plans. • The launch of the National Strategy Framework for Climate, Health and Wellbeing in Australia took place at Parliament House in Canberra on 22 June 2017. • Currently, the Association has nominated a member and a ‘green’ activist to attend the threeday residential community activist training held in June 2017. • The other responsibility of the CCARG is the Global Green and Healthy Hospital’s (GGHH) Network. The Association is a member and by encouraging individual interested members to join GGHH Connect, it hopes to encourage NSW hospital membership. The Association is currently working towards its next Environmental Health Seminar being held on 15 September 2017 at Prince of Wales Private Hospital, a facility that is also a GGHH member.

52 Key Direction 3

Drug and Alcohol

Midwifery

Action

Outcome

• The Association’s Drug and Alcohol Reference Group provides input to the Association on relevant drug and alcoholrelated matters, as required.

• The Midwifery Reference Group met regularly during the year and provided a forum for members to discuss and debate professional issues relevant to midwives and midwifery.

The Vision Statement series continued, consulting nurses and midwives about the question of an apology to Aboriginal and Torres Strait Islander Peoples for past wrongs and the role of immigration in the health service.

• Members have been consulted and provided input into the ‘ICE’ tutorial developed by the ANMF with access to the tutorial available for ANMF and branch members, along with the Association’s Policy on Alcohol and Other Drugs Issues in the Workplace. Mental Health Outcome

• The Reference Group met regularly with members’ input sought on a number of issues over the last 12 months. Discussions included the privatisation of mental health and the impact of NGO-managed projects that are encroaching on public community mental health nursing services. Other topics included AiNs in Mental Health PICU’s. • Comments were sought on submissions, including Essential Elements for Recognising and Responding to Deterioration in a Persons Mental State and the Fifth National Mental Health Plan for Consultation. • Input was also sought from the group on correspondence to the then Minister for Mental Health, the Hon Pru Goward, asking for development of education opportunities for nurses new to Mental Health, to help improve their understanding of mental health nursing.

• The use of non-midwives in maternity settings, scope of practice, Birthrate Plus and models of care were issues that generated significant discussion this year.

Nurse Uncut blog Expansion of social media presence

Outcome

• The Circulation Audit Bureau (CAB) audit tool showed an increase from an audience average of 16,000 per month to the highpoint of 27,800 in January 2017. • Another display advertising space was added to the home page in March 2017. • Recruiters and nursing and midwifery academics continue to seek a platform for their content on the blog.

Reconciliation Action Plan (RAP)

With its mid-2016 revamp, Nurse Uncut began to carry digital advertising, both as display advertisements and as nursing job and research posts, which are also posted on the Nurse Uncut Facebook page and in the e-newsletter. The blog continues to carry pieces written by members about the issues which directly affect them, such as the right to marriage equality, the stresses of aged care nursing and the difficulties of being a new graduate. Key Direction 3: Strategy 3.1, Strategy 3.2 Key Direction 4: Strategy 4.3

The Association has formed an internal Reconciliation Action Plan (RAP) working group that has commenced preparations for the first phase of its reconciliation action plan, which is based on the Reflect template. Work has commenced reflecting on the internal Association workplace relationships with Aboriginal and Torres Strait Islander peoples and any improvements that can be made. Key Direction 3: Strategy 3.4

Action

Staff events were held to mark Reconciliation Week and NAIDOC Week and potential speakers are being considered with identification of cultural safety training opportunities for staff being investigated. There will be a liftout section in The Lamp each year focussing on Indigenous issues. Outcome

• This is an ongoing project which will evolve as milestones are reached under the endorsement and guidance of Reconciliation Australia.

South Eastern Sydney Local Health District Child and Family Health Service – Restructure

The Child and Family Health services across St George and Sutherland Hospitals were proposed to be amalgamated, resulting in the deletion of a NUM2 position and the creation of a NM3. Key Direction 3: Strategy 3.2

Action

Consultation at both sites revealed members were highly supportive of a new Nurse Manager (NM) position for Child and Family Nursing, but believed this should not be at the expense of losing a NUM position. Consultation also revealed was a large service with over 70 nurses, many of whom work part-time across a number of stand-alone child and family centres. The loss of a NUM was likely to create a significant workload issue for the remaining NUM and the new NM position and

would result in a reduction in clinical support, leadership and expertise within this service. It was also identified that SESLHD was the only Child and Family Health service without a dedicated CNC position. Consultation continued with the employer via several USCCs. Outcome

• Following consideration of the feedback from members, the proposal was amended accordingly and it was proposed that the NM3 position would be created; 1.8 FTE of the NUM2 would be maintained, and a small service of five FTE would be amalgamated with the Child and Family Health Service, resulting in the deletion of a NUM1 of this service. • Additionally, a dedicated CNC2 position was introduced to the Service. • Members supported all proposed changes and agreed this was a more manageable structure. Dialysis Unit – proposed deletion of NUM 1 position

In 2015, St George and Sutherland Hospitals separated many shared services, resulting in the commencement of a voluntary redundancy program and the proposed deletion of some positions, one of which was the NUM1 of the St George Dialysis Unit. Key Direction 3: Strategy 3.2

Action

Association members held multiple branch meetings, passed resolutions condemning the proposal, engaged work-to-rule strategies and outlined all likely issues that would be created if this position was to be deleted.

Despite the Association’s opposition, the proposal was implemented. Association industrial officers lodged the matter with the IRC for conciliation. The IRC Commissioner met with representatives and activists and acknowledged that the employer had implemented change when the status quo should have been maintained, but he requested the parties commence a trial of the new structure and that members collect evidence for submission at a further conciliation meeting. Outcome

• The parties attended a further IRC conciliation meeting with members presenting strong evidence that the deletion of the NUM1 position would negatively impact patients and workers. • Despite this evidence, the Commissioner did not have the power to force the employer to reinstate this position, nor would he give recommendations to the Association to seek further discussions with the Ministry of Health. Prince of Wales Hospital

Excessive overtime resulted following the implementation of a 24/7 Endovascular Clot Retrieval (ECR) Service executed under pressure from the Ministry of Health in response to unfavourable media attention. The staffing model was designed for a 08:00 till 20:00 service, however members were becoming fatigued and working excessive overtime due to the number of on-calls required to cover the ECR service. Key Direction 3: Strategy 3.5 Key Direction 1: Strategy 1.3, Strategy 1.4

54 Key Direction 3

Action

The numerous resolutions on member and branch concerns passed by the branch received unsatisfactory responses from Executive management. This on-call service is outlined in the Clinical Business Rule for the Interventional Radiology Service. Outcome

• The Medical Imaging Department members returned to the previously agreed 08:0020:00 seven days a week on-call. • The branch ensured that the ECR service is now being conducted at another site. • Executive management agreed to the branch recommendation of alternating on-call responsibilities and allocating the shared responsibility of the on-call allocations, reducing the requirement by 50%. • The Medical Imaging Department members agreed to accept local patients who presented to the ED and any other inpatients who need this specialist service instead of having to move them to another hospital on the days that they did not cover the on-call. • Members have extended this specialist service to other hospitals which will make the service available to more patients in hospitals that are closer to their communities.

Sydney Alliance The Sydney Alliance brings together a diverse community of organisations, unions and faith groups to advance the common good and achieve a fair, just and sustainable city. The Alliance provides opportunities for people to have a say in decisions that affect them, their families and everyone working and living in Sydney. The Sydney Alliance is a non-party political organisation and the Association was one of its founding organisations. Key Direction 3: Strategy 3.4, Strategy 3.5

Action

Two main campaigns for the city-wide actions are penalty rates (Save our Weekend) and Housing Affordability. Association members are impacted by both of these issues. A number of working parties were formed to consider how to address housing affordability in NSW. While this is most problematic in Sydney, a recent survey indicated that members as far away as Dubbo were impacted. The Association has worked with faith groups and community groups to explain the range of its coverage from different wage differentials and health sectors. This complex issue needs to have complex solutions that meet the needs of the Association’s diverse membership.

Outcome

• As well as contributing to submissions, the Association was represented at public forums on 4 May and 12 July 2017, attended by the NSW Housing Minister, Anthony Roberts, and members of the Greater Sydney Commission. Minister Roberts’ mother is an ophthalmic nurse and he has publicly voiced his concerns with nurses traveling long distances after shift work.

Submissions and Inquiries The Association has made submissions to numerous public inquiries and consultations throughout the year to ensure members are fully represented. Key Direction 3: Strategy 3.5

Environmental Health Action

Submissions have been made on behalf of the Association on relevant environmental health issues to ensure members and their communities are fully supported. The Association is interested in the cessation of coal use in the production of electricity due to the concern about the health of nurses, midwives and the community.

Outcome

• Submissions over the past year include: Inquiry into the Retirement of Coal-Fired Power Stations; The Independent Review into the Future Security of the National Electricity Market, and The Banning of CSG in NSW and Opposition to the New Santos Proposal – The Narrabri Coal Seam Gas Project. Housing Affordability Action

The Association provided a submission in response to the Sydney Olympic Park review of Master Plan 2030. Outcome

• The submission requested that the Master Plan 2030 for Sydney Olympic Park reconsider the current target of three percent of affordable housing at Sydney Olympic Park and that the target is increased. • The submission also requested that key workers are included in eligibility criteria for affordable housing in the Plan. Inquiry into Competition, Choice and Contestability in Human Services Action

A response was made to the Productivity Commission Inquiry into Competition, Choice and Contestability in Human Services. Outcome

• The Association’s submission made the point that while goals such as innovation, cost effectiveness, choice and consumer responsiveness are worthy and relevant, the primary performance measures in the healthcare sector must be quality, safety, equity of access and affordability.

• The orthodoxy that privately delivered services will always be more efficient than publicly provided services was rejected, and the point made that this is particularly so in the healthcare sector, where it is well understood that market mechanisms do not drive quality and efficiency. • The Productivity Commission responded with a follow-up public consultation focussing on areas identified in the previous consultation as appropriate for greater competition, choice and contestability. The Association worked with the ANMF to provide a national response reiterating its commitment to publicly-funded universal health insurance, i.e. Medicare as the most efficient and effective mechanism to distribute resources in a manner that generally ensures timely and equitable access to affordable healthcare on the basis of clinical need, rather than capacity to pay. • It was also emphasised that the healthcare sector cannot be viewed as a traditional marketplace. The competitive levers, which are applied in normal markets, do not always translate to health ‘markets’. The introduction of some competitive measures can be useful, e.g. removing the anti-competitive behaviour and restrictive practices, which prohibit access to the MBS for a range of health professionals. Other measures, however, could lead to much greater inefficiencies without any improvements in quality of care.

Mental Health

Fifth Mental Health Plan Consultation Action

The Australian Government’s Department of Health Fifth Mental Health Plan Consultation Survey submission was made in December. Outcome

The Association included a number of suggestions: • Accountability by federal and state governments, with defined targets to be met. • Retention and support of the current mental health specialty workforce. • Mental Health Nurse Incentive Program provided with ongoing funding. • Improved budget funding for mental health. • The Stepped Care Model needs appropriate workforce support to be in place for this model to have success. Living Well in Later Life Project Action

The Association provided a submission to the NSW Mental Health Commission’s, ‘Living Well in Later Life’ project in regard to the draft Living Well in Later Life – the Case for Change and the accompanying Consensus Statement. Outcome

• The Association agreed with the overall theme to improve mental health of older clients by making the public and the health workforce more responsive to the mental health needs of this population. Those experiencing mental health problems in the elderly population will increase proportionately and this needs to be urgently addressed.

56 Key Direction 3

• The NSW Mental Health Commission was called upon to reconsider its stance on supporting the privatisation model of the mental health system, currently being adopted by the government. The Association does not want to see a workforce that is not skilled nor has the resources to provide a health service that puts quality of care and patient safety first in all health sectors, including aged care. • The Commission was asked to put its support behind a publicly-managed model that is appropriately staffed by professionals who have the competencies, knowledge and commitment to provide a responsible public mental health service that delivers best care.

Outcome

• The draft Consensus Statement outlined the elements of best practice and provided a fair and comprehensive framework for mental health services to use as a guide when developing and tailoring their local services for recognising and responding to deterioration in a person’s mental state.

• The Association’s comments focused on promoting the need for nurses to have clear guidance for arguing for adequate devices and hardware when implementing digital systems in their workplace. This edition of the standards is not designed to be over-prescriptive on such matters but future editions will seek to incorporate more detailed advice.

Work Health and Safety Member Representation

Work Health and Safety (WHS) and the protection of workers from risks is essential for nurses and midwives, and contributes to the continuity and quality of healthcare services and outcomes provided to the community.

Up by 54%

Up by 19%

Up by 24%

Up by 32%

Manual handling

The Association made a submission to the National Consensus Statement Essential Elements for Recognising and Responding to Deterioration in a Person’s Mental State and comments provided to the Australian Commission on Safety and Quality in Health Care last September.

Outcome

Bullying & harassment

Action

Comments were submitted in relation to the Standards Australia Digital Hospitals Handbook Peer Review.

• Issues raised by members increased by 19% in total over the last 12 months (360). Notably there has been a further 24% increase in issues related to violence, aggression and security (135), 32% increase in bullying and harassment issues (34) and a 54% increase in manual handling issues (27) within that period.

Violence, aggression & security

National Consensus Statement

Action

Outcome

Total issues

• A secondary submission was made focusing on aged care issues and incorporating member comments and feedback gained through consultations.

Standards Australia Digital Hospitals Handbook Peer Review

Key Direction 3: Strategy 3.4

Action

Member concerns relating to WHS issues were addressed through undertaking workplace inspections, communicating directly with management, collaboration with internal and external stakeholders and working directly with members to support and manage issues. This year has seen increased collaboration with external strategic stakeholders including the ACTU, Unions NSW, SafeWork Australia, SafeWork NSW, NSW Health, HETI, Comcare, Standards Australia and ISO Standards.

Violence, aggression and security Bullying and harassment Workload/fatigue/shiftwork Work environment Manual handling Infection control Hazardous chemicals Others

• 38% of all issues followed up with members are related to violence, aggression and security. • Other issues included bullying and harassment – 9%; workload/ fatigue/shiftwork – 21%; manual handling – 8%; work environment – 10%; hazardous chemicals – 3%, and infection control – 5%.

• The Violence Reporting App continues to be utilised by members with over 200 entries received from over 50 different facilities across NSW. Continued use of the App is recommended, noting that utilising this tool does not replace local agreed arrangements for reporting of violence in the workplace. The App has been recognised by the ACTU and other applications are now being made available for use in other industries for reporting associated risks in the respective industry. Australian Standards Action

Representing the interests of the ANMF, the Association has been contributing to a range of Australian Standards and associated ISO Standards and also represented the ACTU on the review of Model Codes of Practice. Outcome

• Representation of the interests of nurses and midwives is being given towards Standards related to Security in Healthcare Facilities; Management of Sharps and Waste in Healthcare Facilities; Credentialing of Contractors to Healthcare Facilities; and, ISO Standards for Sharps Containers in consultation with others of the associated expert panels. Domestic Violence Working Party Action

A Domestic Violence Working Party has been formed. Outcome

• The working party will be developing objectives and goals in regard to future work on this issue.

Workplace consultative arrangements Action

In order to build the capacity of members to improve WHS in their workplaces, the Association has been working to improve WHS consultative arrangements for nurses and midwives. Outcome

• An information kit has been developed to assist members to implement WHS consultative arrangements, including the establishment of Health and Safety Representatives (HSRs) and WHS committees in their workplaces. • Negotiations with facilities on establishing work groups and the election of HSRs. • Application has been made to SafeWork NSW for the Association to deliver HSR training on behalf of members. Workplace violence Action

Workplace violence continues to be an issue of concern to nurses and midwives. Mental Health, Drug and Alcohol, Aged Care and EDs continue to be the highest risk areas. Outcome

• Workplace visits have been conducted at numerous sites across NSW. • Collaboration with SafeWork NSW has seen violence placed as a key issue for SafeWork NSW with the healthcare industry seen as a target industry for WHS risks, both in hazardous manual tasks and violence in the workplace. • Further collaboration has been established with Standards Australia, including representation on the Review Committee for the

revision of AS4485 Security for Healthcare Facilities. • The Association was also part of a focus group to revise the HETI Violence Prevention Management training techniques. • Introduction of duress systems in multiple aged care facilities. • Significant work has been undertaken at the Forensic Hospital around workplace violence, in conjunction with SafeWork NSW.

58 Key Direction 4

Key Direction

Promote the Association as a significant and professional advocate for the health system and our members 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 Associationâ&#x20AC;&#x2122;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

The Association 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.

Nurses at Work – Book launch A history of industrial and occupational health nurses in New South Wales

Nurses at Work is an important record which captures the valuable historical role of occupational health and safety nurses, social dimensions of the work they undertook, the evolution of addressing occupational illness and injury in the workplace, and advancement of the OHS nursing specialty over time. Key Direction 4: Strategy 4.1, Strategy 4.3

Action

In 2011, the Association Council was approached by Nancy Bundle AM, former NSWNA President (during 1978), to assist in compiling and publishing the book Nurses at Work: A history of industrial and occupational health nurses in New South Wales. Ms Bundle worked on the project with retired academic, Honorary Associate Professor Dr Jim Kitay, from the School of Business at The University of Sydney. The resources of the Association’s Library were also used for extensive archival

research to assist the project. In December 2016, nearing the completion of the manuscript, the Association became involved and worked with the authors over a five month period to produce a final manuscript; coordinate the editing, design, indexing and publishing process, and plan an official launch of the book. Outcome

• On 17 May 2017, an official book launch was held at the Association’s Waterloo office, coinciding with activities held during May to celebrate International Nurses Day. Around 100 guests attended the launch and a large number of copies of the book were sold on the day. • The Association will continue to promote Nurses at Work through coverage in The Lamp, Nurse Uncut as well as a book review in the ANMJ.

60 Key Direction 4

ANMF CPE (CPD) website

Facebook Training

Education website with more functionality

Educating staff and members with social media skills for organising

The ANMF earlier this year relaunched its CPD website, which now boasts many more learning opportunities for members. Besides more online modules, as well as live stream of overseas conferences, members now also have the ability to capture and track their CPD records, assemble lesson plans and receive immediate notice of available courses. Key Direction 4: Strategy 4.3

Action

Nurse Uncut has collaborated with the ANMF to promote its online Continuing Professional Education (CPE) site, which offers heavily discounted courses to members. A series of blog posts about the pillars of registration were published in the lead-up to the AHPRA registration deadline of 31 May 2017, linking to the CPE site, as well as a new display advertisement for the site on the home page. A special free coupon offer was sent by SMS to members who had already used the CPE site, promoting this as a benefit of membership. Outcome

• The link between Association membership and access to the ANMF CPE site was foregrounded for members; the Professional Indemnity blog post in particular was widely read. The infrastructure for future collaboration has now been established.

During May and June 2017, Association organisers attended internal workshops conducted by the Campaigns and Communications team, aimed at enabling them with the skills needed to use Facebook as an organising tool during campaigns. Key Direction 4: Strategy 4.3 Key Direction 2: Strategy 2.6

Action

Given the growth of Association branches and their presence on Facebook, it was determined that staff develop the skills necessary to create and manage Facebook pages. There has been recent success in using Facebook during bargaining campaigns, such as with Bupa and Estia. Outcome

• Facebook pages or groups are now encouraged to be included in campaign organisation planning to benefit members and the community. • Organisers who received training now have the ability to pass on those skills to members who may be interested in maintaining Association branch pages. • By building branch pages, members and the community can be kept informed of unionled campaigns and events.

Key Partnerships Key Direction 4: Strategy 4.1

Health care procedures in schools Action

The Association has continued to provide professional advice to the PSA in the ongoing dispute with the NSW Department of Education (DoE) on role boundaries in the provision of support at school for students requiring healthcare procedures. Outcome

• The PSA has been in dispute with the DoE in the IRC since February 2016. The Association has provided advice throughout the proceedings to the PSA with regard to the clinical aspects of the healthcare procedures being undertaken. • Under the Joint Statement 2005 Special Consideration Committee, the Association, along with the PSA and the DoE, was asked to review students needing healthcare procedures in schools for the year 2017. Further information was required from the DoE to make a professional judgement on the safety of these procedures, as the DoE did not provide this information. As a founding member of the tripartite agreement, the Association needed to ensure the best healthcare possible was being provided to these students. Consequently, the decision was made not to attend this committee until the matter was resolved. • The Association last attended the IRC hearing on 13 March 2017

with all parties present. The DoE provided a draft policy document that was intended to replace the Joint Statement for comment from all parties. • It appears that the Special Consideration Committee will not continue. The Association will remain as a health procedure consultation body for future discussions on healthcare procedures in schools. Nationally Coordinated Codeine Implementation Working Group Action

An invitation was received from the Department of Health Therapeutic Goods Administration (TGA) communication strategy to join the Nationally Coordinated Codeine Implementation Working Group in May 2017. Outcomes

• The aim is to inform and educate all affected stakeholders of the upcoming changes to the availability of low dose codeinecontaining medicines from 1 February 2018. • Representatives from state and territory health departments and peak professional bodies representing consumers, pharmacists, medical and nursing professionals were in attendance. • The key purpose is to facilitate a coordinated and consistent approach to the drafting and delivery of key messages and education material to all affected stakeholders. • The Association will provide a voice for members and continue to do so leading into the change on 1 February 2018 and thereafter.

NSW Health Palliative Care Roundtable

Quality Aged Care Action Group

Action

An invitation was received from the Minister of Health, Brad Hazzard, and Parliamentary Secretary, Leslie Williams, to attend the NSW Health Palliative Care Roundtable on the future for palliative care which was held at Parliament House, with further roundtables held across the state.

The Association continues to provide secretariat support to the Quality Aged Care Action Group QACAG Inc (QACAG). Quality Aged Care The group has met Action Group Incorporated bi-monthly over the past year. Submissions aligned to the Association’s Strategic Plan have been made on behalf of QACAG Inc throughout the year.

Outcomes

• Discussion was held on palliative care being the core business for all health professionals. • Discussion was also held on the need for better resource allocation across sectors to enable a palliative care team approach and increasing the specialist workforce. • Effective communication between hospitals, GPs and the community was needed. • Discussions will continue across the state around solutions to address these issues. • Association members have been involved and attended with Association officers at the first roundtable held in April. • The Association and members will continue to consult throughout remaining roundtables.

Outcome

QACAG manned a stall at the NSW Seniors Expo 2017 in March. This was used to promote the federal aged care campaign and the 10 Questions to Ask leaflets developed by the NSW Aged Care Roundtable. Submissions made: April 2017 – Single Quality Assessment Framework; December 2016 – Draft Service Delivery Model for a New Carer Support Service, and August 2016 – Australian Law Reform Commission Elder Abuse Inquiry.

62 Key Direction 4

Roundtable on Renter Security Action

The Association accepted an invitation to attend a Roundtable on Renter Security. The Roundtable was organised by the Tenants Union and hosted by Homelessness NSW. Outcomes

• The discussion focused on the current ‘no grounds’ evictions provisions that exist within the current tenancy legislation. • There was discussion that the ‘no grounds’ evictions impact on rental security and result in renters not asserting their rights due to fear of being evicted.

International Midwives Day / International Nurses Day Celebrations – 5 to 12 May 2017

The Association promoted nurses and midwives delivering Safety at Work as part of this year’s International Midwives Day and International Nurses Day activities; for example, seeking improved nurse-to-patient ratios, improving skill mix, tackling workloads and addressing violence in the workplace.

Action

In October 2016, the Association was invited to attend the Women’s Electoral Lobby (WEL) expert roundtable on abortion law decriminalisation. Outcomes

• The discussion focused on the current legal position and access and provision of abortion services in NSW. • WEL will hold a second roundtable later this year and the Association has been invited to attend.

Mardi Gras 2017 Parade entry with Equality as the theme

For the first time, the Association had a parade entry at this year’s Sydney Gay and Lesbian Mardi Gras. Key Direction 4: Strategy 4.3

Action Key Direction 4: Strategy 4.3

Action

Women’s Electoral Lobby

• On International Nurses’ Day, members took part in breakfast barbeques, morning and afternoon tea parties, award ceremonies, staff lunches and even bed making competitions.

As in previous years, the Association produced promotional posters and encouraged all facilities across all sectors to engage in local activities and recognise their contributions to the professions of nursing and midwifery. Outcome

• On International Midwives’ Day, celebrations included morning and afternoon tea parties, ‘walk with midwives’ marches, midwifery conferences, as well as making birth kits for women in developing countries.

The entry allowed 30 Association members the opportunity to march to celebrate and continue to fight for equality. Outcome

• The parade provided the Association a creative and innovative opportunity to represent and advocate for the professions of nursing and midwifery and to demonstrate the Association’s support for diversity and Lesbian, Gay, Bisexual, Trans, Queer and Intersex (LGBTQI) rights. • It helped motivate and empower members and staff who support or identify as LGBTQI to participate in the parade and celebrate equality.

Outcome

• A survey was sent to all members to determine the level of support. The response was overwhelmingly positive, with many telling their stories of why it was important for the Association to be involved in this campaign. • Following on from the survey, the Association created a Facebook page Nurses & Midwives for Equality, offering a platform for nurses and midwives to share their opinions and to provide updates on the campaign. • The Association’s presence created a larger and broader union presence in the parade.

Marriage Equality Campaign support

The Association holds strong values around social justice and human rights and believes in a fair, just and equitable society for all people. The Association acknowledged the compelling research that identifies the health risks to those who are discriminated against

on the basis of gender, sexual orientation or gender identity, including social isolation, poor self-esteem, and the risk to mental health and well-being. Same-sex attracted, intersex and gender-diverse people do not exist on the fringe of society or in isolation; they are members, family, friends, workmates and neighbours. Key Direction 4: Strategy 4.1 Key Direction 2: Strategy 2.4, Strategy 2.6

Action

At the 71st Association Annual Conference in 2016, a resolution was passed to support the participation in the Australians for Equality National Campaign for Marriage Equality.

• Representatives from the Association attend monthly meetings to receive updates from the equality campaign team and offer support.

Association website Improved functionality

In 2016, a communications review of the Association’s ability to communicate effectively with members and stakeholders found that the Association website, while content rich and heavily visited, needed to be more mobile-friendly and easier to navigate. Key Direction 4: Strategy 4.3, Strategy 4.4

Action

Web developers were engaged in late 2016 to redesign the Association website. Content has been streamlined into a simpler menu, with a new Professional Issues section. A simpler design will make the site more userfriendly and provide foreground information for members. Outcome

• The new site will be launched following the 2017 Annual Conference.

64 Key Direction 2

Key Direction

Ensure our people and resources are aligned with our Vision 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 Association 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 Association

The Association is committed to valuing and developing our staff and managing our resources to enable it to achieve its Vison and Key Directions. Resources are managed in the best interests of Association members who have placed their trust in good governance of their union.

Association Organisational Structure New team structures

As the Association grew, the flat team structures and reporting lines that had previously existed in: • Member Industrial Services Team (MIST) • Member Organising Team (MO) • Strategic Industrial Bargaining Team (SIBT), and • Professional Services were reviewed and a need for change was identified. Team sizes had become too large for a Manager to effectively undertake the day-to-day management of their team, impacting on the way services are provided to members and the support provided by the Association to its own staff. Key Direction 5: Strategy 5.3

Action

Following extensive consultation at team and organisational level, team based structures were introduced in MIST, MO, SIBT and Professional Services. Outcome

• MIST – four Lead positions were advertised and appointed in early November 2016. One Lead has responsibility for the Information Team while the remaining three Leads have responsibility for multidisciplinary teams based on geographical area. The Leads continue to report directly to the Manager, MIST. • MO – four Lead Organiser positions were advertised and appointed by February 2017.

One Lead Organiser has responsibility for the newlyestablished Development Organising and Education pod while the remaining three Lead Organisers have responsibility for a team of Organisers based on public, private or aged care employer groups. The Lead Organisers continue to report directly to the Manager, MO. • SIBT – two Campaign Lead positions were advertised and appointed early March 2017. The Campaign Leads have responsibility for multidisciplinary teams based on campaigns. The Campaign Leads continue to report directly to Manager, SIBT. • Professional Services – one Senior Professional Officer position was advertised and appointed in mid-March 2017. The Senior Professional Officer has responsibility for the Professional Officers within the team. The Senior Professional Officer and Legal Officers continue to report to the Manager, Professional Services. Staff Engagement Survey

The ability for the Association to successfully grow and improve requires it to effectively work together and maximise the talents of staff. On 1 February 2017, an organisation-wide staff engagement survey was launched. The survey was conducted in order to acquire a better understanding of what the union is doing well, what could be done better and what changes need to occur to ensure the successful implementation of the Association’s Strategic Plan. Key Direction 5: Strategy 5.5

66 Key Report Direction to 2017 2 Annual Conference

Employee Scholarship

Action

The survey was managed by an external provider, Insync Surveys, with all responses strictly anonymous.

The Association is committed to excellence in the professional development of its employees. The annual Employee Scholarship provides an opportunity for employees to further their academic studies and in turn support union principles and the Strategic Plan.

The survey was broken up into two sections with the first focusing on staff engagement. This section will be repeated annually to measure the effectiveness of initiatives that arise from the survey results. The second section was specific to the Strategic Plan and was designed to help manage the change required for its implementation.

Key Direction 5: Strategy 5.4

Action

Following the closing date of 17 February 2017, the data was analysed and responses shared with staff. Outcome

• An exceptionally high response rate of 88% with staff providing valuable insights via the comments in the open-ended questions. • Strong connection to the values of the Association and the union movement. • Support and confidence in the new team structures.

• Communications between teams and the reference to silos was an ongoing concern and is an area of focus for upcoming initiatives.

• Support and excitement regarding the upcoming release of CORE, the Association’s new membership program.

• Some overlap and inefficiencies in processes were raised and these are currently being investigated at a team level, before considering the responses from a whole-of-organisation context.

• The majority of staff are familiar with the Association’s Strategic Plan and believe the 2020 goal of 75,000 members is achievable.

• Staff generally feel that the Association is a great place to work with excellent conditions and entitlements.

In addition to optional and mandatory training courses that are provided, the Association 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. Outcome

• The Scholarship Committee (made up of Council and external representatives) awarded three scholarships to Association employees for the calendar year 2016 to assist with tertiary studies relevant to their positions within the Association.

Conclusion It has been a particularly tough year for workers’ rights since the 2016 Annual Conference. We have seen cuts to weekend penalty rates; privatisation so rampant even more public hospitals and services have become targets; a re-hash of the ‘zombie’ policy to lift the pension age to 70; blatant disregard for our aged care workforce; and stagnant wage growth amid a ruthless level of tax evasion and wage theft. Despite this attack, we have been successful in quashing plans from private healthcare operators, Sonic Healthcare and Estia Health, to reduce Sunday penalty rates, and have put the brakes on three of the five hospital privatisations. Community support is building strongly behind the drive to keep the other two public hospitals in public hands. This is an incredible victory for the Association and our members, along with HSU, ASMOF

and Unions NSW. I congratulate all those who have worked so hard to fight against these privatisations. As a union that continues to grow year-on-year, our voice is getting louder. Now is an important time to stand united on the issues workers face if we are to secure a fair and equitable future for all. Inequality is at a near 75-year high as the gap between the rich and poor widens. This is a serious issue that affects all Australians - posing dangers to health, social stability and sustainable growth. The Association must not be complacent or stand aside while the government continues to take power away from working people. We may presume essential services are safe, as we are not always the first target, but it is clear from government actions over the last 12 months that we are all at risk of losing the rights we have worked so hard to obtain. This is why we must continue to fight for issues close to home, such as better staffing and skill mix in

aged care, nurse-to-patient ratios and keeping public hospitals public, but also the wider issues, such as tax and economic justice, affordable housing, wage growth, workers’ capital and further cuts to penalty rates. We need more government accountability, particularly around the state of our disability and mental health services. There are risks and opportunities arising from the announcement of a review into mental health services, but a review into disability services was pushed aside amidst the NDIS roll-out that will completely remove the safety-net of government-run group homes for those who need support the most. NSW has a budget surplus of $4.5 billion thanks to this government’s privatisation blitz of our assets and public services, yet in the latest budget we saw almost no relief for the real crises we face. This is just the tip of the iceberg. We still have a long way to go but we should be proud that we are making progress.

68 Report to 2017 Annual Conference

Acknowledgements

I wish to acknowledge and thank Judith Kiejda for her ongoing joint leadership of this union. Judith is providing leadership in our union as well as being the President of Unions NSW, a Junior Vice President of the ACTU and Health Coordinator for Oceania in Public Services International (PSI). All are marks of the respect for Judith’s capacity and passion for not only our union but the union movement at state, national and international levels. Our executive office team of Maggie Potts, Alyce Gillespie, Miriam Galea, Kerry Halliday and Chantel Miller continue to make very essential contributions to the running of the union. Judith and I cannot do our job without their dedicated assistance. 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. Our Councillors have shown great leadership and foresight to support the change and take the hard decisions needed for this union to be continuously focused on our delivery of services and support for our members. The Senior Leaders Group have made significant progress on guiding us towards our strategic goals with their leadership as Co-Chairs of our Key Direction Leadership Teams 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. The staff of the Association and now also the ANMF NSW Branch are continuously impressing Judith and I with their energy and enthusiasm for their work organising and supporting our members and the Union in a very dynamic environment where we are pursuing

our Strategic Plan goals but also responding to the challenges faced by our membership. I am grateful for their support for the changes we have made to the structure of the two unions in order to deliver seamless services to our members, despite the legislative hurdles that have been placed in our path. I thank each and every one of them for their contribution and I hope delegates here will join with me in recognising their efforts. Finally, I want to thank all of our Branch Officials for their efforts throughout the last twelve months. Our unions the NSWNMA and ANMF NSW Branch would not be anywhere as effective without your volunteer efforts to make the working and personal lives of our members and their communities better. 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. Brett Holmes

General Secretary

New South Wales Nurses And Midwives’ Association

Summary Of Financial Information For The Year Ended 31 December 2016 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 OR OTHER COMPREHENSIVE INCOME FOR THE YEAR ENDED 31 DECEMBER 2016 Membership revenue

2016 ($)

2015 ($)

34,004,364

32,447,655

NursePower fund subscriptions

3,778,262

3,605,315

Reversal of Impairment Provision – Land & Buildings

2,083,769

1,831,210

1,497,561

Other income Total income Less total expenditure Result for the year Net fair value movements for available-for-sale financial assets

41,697,605

37,550,531

(37,583,222)

(34,812,453)

4,114,383

2,738,078

115,878

(91,663)

Remeasurement of retirement benefit obligations

249,884

948,099

Total comprehensive income attributable to members

4,480,145

3,594,514

SUMMARY BALANCE SHEET AS AT 31 DECEMBER 2016 Total equity

41,808,948

37,328,803

Current assets

22,252,998

20,470,549

Non-current assets

31,407,006

29,307,691

53,660,004

49,778,240

11,123,840

10,855,844

Represented by:

Total assets Current liabilities Non-current liabilities Total liabilities Net assets

Information to be Provided to Members or Registrar

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

727,216

1,593,593

11,851,056

12,449,437

41,808,948

37,328,803

Report of the Independent Auditor on the Summary Financial Statements to the members of the New South Wales Nurses and Midwives’ Association Opinion

The summary financial statements, which comprise the summary balance sheet as at 31 December 2016 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 2016. In our opinion, the accompanying summary financial statements are a fair summary of the audited financial report.

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 4 April 2017. 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 & Co

Chartered Accountants

Stephen Milgate Partner 4 April 2017, Wollongong Liability limited by a Scheme approved under Professional Standards Legislation 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.

70 Report to 2017 Annual Conference

annexure New Agreements finalised by the Association Over the past year the Association has finalised new Agreements with 28 employers, covering more than 3,000 members across 198 sites. Name of Employer

No. of Sites

Sector

ADSSI Limited

Aged Care

Advantaged Care Pty Ltd

Aged Care

Aged Care Quality Agency

Aged Care

Aged Care Services Australia Group Pty Ltd

Aged Care

AGL Limited

Other

Australian Health Practitioner Regulation Agency (AHPRA)

Public Service

Cranbrook Care Group

Aged Care

Estia Health

Aged Care

Family Planning Association

Private Sector Specialist Services

HammondCare Group

Aged Care

Hardi Nursing Home Management Pty Ltd

Aged Care

Healthe Care Australia Pty Ltd (Bega Valley Private)

Private Sector Day Procedure Centres

Healthe Care Australia Pty Ltd (Hunter & Mayo Home Nursing Services)

Other

Healthe Care Australia Pty Ltd (Wollongong Day Surgery)

Private Sector Day Procedure Centres

Little Company of Mary Healthcare Limited

Aged Care

Mark Moran Group

Aged Care

McKenzie Aged Care Group

Aged Care

Mission Australia

Aged Care

NSW Department of Family and Community Services (ADHC)

Public Service

NSW Police Force (Police Nurses)

Public Service

Opal Specialist Aged Care

Aged Care

Regis Aged Care Pty Ltd

Aged Care

Royal Rehabilitation Centre Sydney

Affiliated Health Organisation

Southern Cross Care (NSW) Inc

Aged Care

St John of God Health Services

Private Hospitals

St Vincent de Paul Society of Aged and Special Care Services

Aged Care

The Cram Foundation

Private Sector Specialist Services

Trustee of the Roman Catholic Church for the Diocese of Sydney

Aged Care

INDEX

Content 2 Report to 2017 Annual Conference 4

Association Council and Executive 4 Edith Cavell Trust 5 Professional Issues Committee 5 Australian Nursing & Midwifery Federation (ANMF) 5 Conclusion 6

A Year in Review

Membership Growth 8 Finance 8 Aged Care 8 Ratios 9 Penalty rates 10 Anti-privatisation 11 Northern Beaches 11 Review of Seclusion, Restraint and Observations in Mental Health 12 Social Issues 12 Marriage equality 12 Affordable Housing 12 Climate change 12 Progress on the Strategic Plan 13

Report to 2017 Annual Conference 14

Organising 14 Re-designed member training 14 Enhanced structures 15 The Security Roundtable 15 Global Nurses United 16 Public Services International (PSI) 16 Australian Council of Trade Unions (ACTU) 17 Unions NSW 17 The Lamp 17 Conclusion 17

Key Direction 1: Grow our capacity to influence

BUPA Aged Care Services 19 Dispute – part-time employees and their contracted hours and shifts 19 Estia Health 20 Enterprise Agreement Bargaining 20 Reduction of hours and removal of RDOs 20 Family and Community Services 21 Disability Services – rollout of the NDIS 21 Riverside Centre, Orange – New Model of Care 22 Healthscope Private Hospitals 22 Member Growth and Development 22 Hunter New England Local Health District 23 Gunnedah District Hospital – Peer Group C Ratios Campaign 23 Hunter-wide Christmas toy drive 24 Illawarra Shoalhaven Local Health District 24 Shoalhaven District Hospital 24 Justice Health & Forensic Mental Health Network 25 Forensic Hospital 25 Member Recruitment 25 Associate member recruitment 25 New graduate and transitional year recruitment 25 Murrumbidgee Local Health District 26 Wagga Wagga Rural Referral Hospital 26 Northern NSW Aged Care 26 Branch Official and Activist Training 26 NSW Health 26 Inaccurate ADO Accruals 26 Ramsay Health Care 27 Member Growth and Development 27

South Eastern Sydney Local Health District 28 Adult Community Mental Health (Northern Sector) 28 Prince of Wales Hospital 28 Southern NSW Local Health District 28 Chisholm Ross Centre – Introduction of AiNs on night duty 28 Eurobodalla Operating Theatres – Moruya and Batemans Bay Hospitals 29 South East Regional Hospital 29 Western NSW Local Health District 29 Bathurst Health Service 29 Nyngan Health Service – Anti-violence Campaign 29 Orange Health Service 30 Western NSW Mental Health 30 Western Sydney Local Health District 31 Westmead Hospital – Ratios campaign 31 Westmead Hospital – car parking 31

Key Direction 2: Be innovative in our advocacyand bargaining

Public Health System 33 2017 Public Health System Award claim 33 Christadelphian Homes 34 Enterprise Agreement Bargaining 34 Member Representation 35 Emerging legal and professional issues 35 Legal representation before statutory bodies 35 Legal Tribunals 36 Ministry of Health & Northern Sydney Local Health District 36 Northern Beaches Hospital redevelopment 36 Nepean Blue Mountains Local Health District 36 Mental Health – Introduction of change 36 NSW Government 37 By-elections: North Shore, Manly, Gosford 37 NSW Health 38 Multiple disputes re In-Charge of Shift Allowance 38 NSW Ministry of Health 38 Working with Children Check 38 NSW Parliament 38 Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 38 NSW Legislative Council’s Standing Committee on Law and Justice First review of the workers compensation scheme 38 Opal Specialist Aged Care 39 Enterprise Agreement Bargaining 39 Metropolitan sites 40 Save Our Weekend campaign 41 Penalty rates 41

Key Direction 3: Promote a world class, well-funded, integrated health system 42

National Aged Care Staffing and Skill Mix Project 43 ANMF report 43 Aged Care Campaigns 44 RNs 24/7 in Aged Care 44 10 Questions to Ask project 44 Keep Our Hospitals Public 45 Anti-Privatisation Campaign 45 Anti-privatisation campaign public opinion research 48 Education & Scholarships 48 2017 Education Program 48 Aged Care Nurses Forum 49 Bob Fenwick Mentoring Grants Program 49 Mental Health and Drug & Alcohol Nurses Forum 49 Scholarships 49 Illawarra Shoalhaven Local Health District 50 Leadership Structure Realignment 50

Key Direction 3 50 Progress Report Key Direction Leadership Team 3 50 NSW Government 50 Changes to the Industrial Court of NSW 50 Association Professional Issues Committee and Reference Groups 51 Professional Issues Committee 51 Reference Groups 51 Nurse Uncut blog 52 Expansion of social media presence 52 Reconciliation Action Plan (RAP) 52 South Eastern Sydney Local Health District 53 Child and Family Health Service –Restructure 53 Dialysis Unit – Proposed deletion of NUM 1 position 53 Prince of Wales Hospital 53 Sydney Alliance 54 Submissions and Inquiries 54 Environmental Health 54 Housing Affordability 55 Inquiry into Competition, Choice and Contestability in Human Services 55 Mental Health 55 Standards Australia Digital Hospitals Handbook Peer Review 56 Work Health and Safety 56 Member Representation 56 Australian Standards 57 Domestic Violence Working Party 57 Workplace consultative arrangements 57 Workplace violence 57

Key Direction 4: Promote the Association as a significant and professional advocate for the health system and our members 58 Nurses at Work – Book launch A history of industrial and occupational health nurses in New South Wales ANMF CPE (CPD) website Education website with more functionality Facebook Training Educating staff and members with social media skills for organising Key Partnerships Health care procedures in schools Nationally Coordinated Codeine Implementation Working Group NSW Health Palliative Care Roundtable Quality Aged Care Action Group Roundtable on Renter Security Women’s Electoral Lobby International Midwives Day / International Nurses Day Celebrations – 5 to 12 May 2017 Mardi Gras 2017 Parade entry with Equality as the theme Marriage Equality Campaign support Association website Improved functionality

59 59 60 60 60 60 60 60 61 61 61 62 62 62 62 62 62 63 63 63 63

Key Direction 5: Ensure our people and resources are aligned with our Vision 64 Association Organisational Structure New team structures Staff Engagement Survey Employee Scholarship

65 65 65 66

Conclusion 67

Acknowledgements 68

Summary of Financial Information for the Year Ended 31 December 2016 69 Annexure 70

More information NSW Nurses and Midwivesâ&#x20AC;&#x2122; Association M 50 Oâ&#x20AC;&#x2122;Dea Avenue, Waterloo NSW 2017 P 8595 1234 (metro) 1300 367 962 (non-metro) F 9662 1414 E gensec@nswnma.asn.au

www.nswnma.asn.au

Authorised by B.Holmes, General Secretary, NSWNMA