As of 31 August 2024, the new Health Services (Health Service Establishments) Regulations 2024 are in force. Unfortunately, despite ANMF submissions and advocacy, none of the new or amended clauses are related to workforce matters.
The Regulations set the minimum requirements in private hospitals and day procedure centres for everything from staffing levels and skill mix to nursing and midwifery career structure, clinical governance requirements, reporting and quality and safety.
The new regulations replace the Health Services (Health Service Establishments) Regulations 2013, which expired on 1 September 2024. As part of the stakeholder consultation for the new regulations, ANMF (Vic Branch) made a comprehensive submission that drew on the expertise and insights of our members employed within private hospitals and day procedure centres, as well as follow-up submissions.
Among our recommendations for amendments to the existing Regulations were:
- Establish minimum nurse-to-patient and midwife-to-patient ratios that are identical or align closely with the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015.
- Provide high-quality transition to practice programs that align with the Nursing and Midwifery Transition to Practice Program Guidelines 2018.
- Where the private hospital offers maternity and newborn services, aligning with the nursing requirements to appoint:
- a Director of Midwifery [DOM], who is a midwife, where the Director of Nursing does not hold registration with the Nursing and Midwifery Board of Australia as a midwife.
- a Deputy Director of Midwifery to deputise for the DOM.
- A Midwifery Unit Manager per ward/unit providing maternity and newborn services
- Insert a requirement for private hospitals and day procedure centres to appoint:
- a Deputy Director of Nursing to deputise for the DON
- a Deputy Director of Midwifery to deputise for the DOM
- an after-hours coordinator, who is a registered nurse, to be responsible for the site in the off-duty periods of the DON.
What has changed?
Among the 90 new or amended clauses in the Regulations 2024 are changes to clinical governance, the reporting of sentinel events, admissions assessments and fees. ANMF is generally supportive of these changes.
But in regard to workforce, not one of our recommendations has been included. This is despite the Department of Health’s initial consultation paper indicating that ratios were on the table.
Other urgent matters not addressed by the new Regulations include regulating emerging areas of clinical practice (including cosmetic surgery and mobile anaesthesia) and initiatives to better prevent and manage staff fatigue.
The department continues to maintain that these elements will be considered in the promised Phase 2 reforms, ‘to allow for broader consultation and appropriate impact assessment’, but still have not committed to any actual dates for this to occur.
The government has had an opportunity to remake and improve the Regulations to ensure that they remain fit for purpose and meet the objectives of safe, quality patient care. They have failed to take full advantage of this opportunity.
The Branch continues to seek a commitment from the government to confirm a date for the Phase 2 reforms.
