Second phase of ratio improvements from March

The second phase of improvements under the Safe Patient Care Amendment Act is to be introduced from 1 March 2020.

The public sector health services ratio improvements and new ratios to be introduced are:

Ratio improvements

1. Palliative care units: 4:4:6 + in-charge on each shift (currently 4:5:8 with no in-charge on night duty. Part 2 S.23 of the Act)
2. Birthing suites (AM shifts) + in-charge if six suites or more (currently no in-charge Part 2 S.31 of the Act)
3. Special care nurseries (AM and PM shifts) + in-charge if eight cots or more (currently no in-charge Part 2 S.27 of the Act)

New ratios

1. Oncology wards: 4:4:8 + in-charge on all shifts
2. Acute stroke units: 1:3 + in-charge on all shifts (where they meet the definition under the Act)
3. Specialist haematology wards: 3:3:5 + in-charge on all shifts (where they meet the definition under the Act)

50 per cent rule removal

1. Night shifts in all palliative care inpatient units and geriatric evaluation management beds
2. Morning shifts in the following wards of level 3 and level 4 hospitals:a. general medical or surgical wards
   b. coronary care units
   c. high dependency units
   d. operating theatres
   e. post-anaesthetic recovery rooms
   f. level 4 acute wards
3. Morning shifts in level 2 emergency departments, and emergency departments with more than 7000 presentations per annum. Health services must start rostering to the new ratios from 1 March 2020, unlike last year when employers were given a six-month grace period to introduce the first phase of ratio improvements. The Safe Patient Care Amendment Act was passed on 21 February 2019. In the first phase of improvements, introduced from 1 March 2019, the 50 per cent rule was abolished as follows:

• all shifts in level 1 emergency departments.
• all shifts in the following level 1 and 2 hospital wards/ units: medical and surgical, coronary care, high dependency, operating theatres, post anaesthetic recovery room.
• all night shifts in the following level 3 and level 4 hospital wards/ units: medical and surgical, all aged high care residential wards, coronary care, high dependency, operating theatres and post-anaesthetic recovery rooms.
• night shift in level 2 and 3 emergency departments (and those with more than 7000 presentations per annum)
• night shift in all aged high care residential wards in all hospitals.

All Victorian public sector hospital CEOs have been reminded of the March 2020 improvements and the need to recruit to the positions.

As a result of the improvements under the Act, more than 600 additional nurses and midwives will be employed between 2019 and 2022.

As part of its 2018 state election commitment, the Andrews Government promised a further round of ratio improvements that will lead to an additional 542 nurses and midwives in the Victorian public health system. Preliminary work and consultation have begun on a second amendment bill.