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Ratio improvements ‘grace period’ 31 August deadline

Ratio improvements ‘grace period’ 31 August deadline

Health Minister Jenny Mikakos at the ratio amendment bill announcement in December 2019. Photo Chris Hopkins

The last day of the ‘grace period’ for the implementation of the first improvements under the Safe Patient Care Act’s 2019 amendments is 31 August 2019.

Section 41(5) provides that the legislation’s dispute resolution process does not apply to alleged breaches of the 1 March 2019 amendments and improvements, until 31 August 2019.

This was to ensure that hospital operators had enough time to recruit additional nurses and midwives to meet the new staffing requirements.

The staffing requirements that become enforceable on 1 September 2019 include:

  • Casey Hospital, Monash Children’s Hospital and Sunshine Hospital all being categorised as Level 1 for the application of medical/surgical ward ratios
  • ratio calculation for mixed wards
  • removal of the ability of a hospital to vary ratios by way of a redistribution of nursing or midwifery hours, a below ratios distribution or a trial of an alternative established staffing model
  • a new mechanism that requires a hospital to determine and publish a notice of the nominated birthing suites for the six-month period of 1 September to the final day of February – by the end of August. The declaration must reflect actual utilisation, including use of a birthing suite for midwifery outpatient assessment
  • the removal of the ‘Night Duty Formula’ in Level 1 emergency departments (those named in Part 1 of Schedule 3), that allowed less staffing on night shift
  • the abolition of the old 50 per cent rule (and therefore rounding up becomes an obligation where the ratio does not divide equally into the number of occupied beds) on:
  1. all shifts in level 1 and level 2 hospital medical and surgical wards; coronary care units, high dependency units; and post-anaesthetic recovery rooms
  2. all shifts in the level 1 emergency departments
  3. night shift in the level 2 emergency departments (including those not named as level 2, but with annual presentations of more than 7000)
  4. night shift in level 3 hospital medical or surgical wards; coronary care units; high dependency units; and post-anaesthetic recovery rooms
  5. night shift in level 4 hospital acute wards; coronary care units; high dependency units and post-anaesthetic recovery rooms;
  6. night shift in all aged high care residential wards.

Call out for Job Reps

Critical to our success in implementing and monitoring these improvements will be having at least one, and preferably two, Job Reps in every ward or unit.

If your ward doesn’t have two Job Reps, it’s time to get together an nominate a fellow member to be your ANMF Job Rep. Reps will give ANMF a voice on the ground to help address any teething problems with the implementation of these improvements, and those scheduled for 1 March 2020.

For more information, or to nominate as a Job Rep, visit or contact your ANMF Organiser via

How can I find out what level my hospital or emergency department is?

You’ll find level 1, 2 and 3 hospitals named in Schedule 1 of the amended Safe Patient Care Act. If your hospital is not named, it’s a level 4. Emergency department categories are in Schedule 3.