What we need to build a bigger, stronger workforce

In September 2022, ANMF (Vic Branch) made the case for a reduction in full-time weekly hours from 38 to 32.

The recommendation was one of several in the Branch’s submission to the Federal Government’s Senate Select Committee on Work and Care. It is also one of our key asks in a separate submission to the Victorian Department of Health’s recently convened Health Workforce Advisory Council.

This council is developing a strategy to look at workforce recovery, development and growth over the coming decade, while also identifying immediate actions we can take to better support the health workforce now.

Based on learnings from the past few years of COVID-19, among other things, the Branch’s submission details what we need to do differently to build, and rebuild, the nursing and midwifery workforce.

‘This is a critical piece of work,’ says Branch Secretary Lisa Fitzpatrick of our Health Workforce Advisory Council submission. ‘It highlights the issues that are causing pain and angst for our members across the state, as well as what we need to happen. And it informs our state election asks.’

Short, medium and long-term

The submission is divided into short-term, medium- and long-term initiatives, each of which falls into one of three categories:

• workforce training, development and capability
• workforce supply and growth
• workforce wellbeing and engagement.

There are dozens of short-term initiatives we would like to see implemented within the next 12 months, many medium-term initiatives to be addressed over the next three years, and one long-term initiative involving superannuation reform. The submission goes into detail on why each of these initiatives is required, and what needs to be done in order to achieve them. Just some of the short-term initiatives include:

• Reducing hospital admissions from aged care by increasing and embedding Residential in Reach in public health services.
• Reintroducing the Bachelor of Midwifery, as well as bolstering career progression for midwives by ensuring a career and leadership structure for midwives that replicates the nursing structure. Also introducing senior midwife positions above the unit manager.
• Ensuring nurses, midwives and carers can access safe and affordable onsite or co-located car parking.
• Enabling flexibility in the workplace, through initiatives including:
  • updating inflexible rostering structures to allow staff to better manage their other needs and responsibilities (such as childcare)
  • reviewing shift patterns with consideration to fatigue research and principles
  • giving workers the option to be employed on set shifts instead of a rotating roster
  • and ensuring genuine access to flexible work arrangements that are recalibrated to a modern workforce.
• Developing a system for real-time capacity and demand workforce data across the public sector that would increase transparency and inform workforce requirements across health services, to enable appropriate, prompt responses to shortages.
• Using that real-time data, among other mechanisms, to ensure maintenance of minimum staffing requirements on a shift-by-shift basis and to assess staffing to ensure employers are monitored.
• Fully funding a statewide plan to embed nurse practitioners in all aspects of the public health sector, and establishing a Department of Health/ANMF/nurse practitioner workforce strategy development group with the aim of increasing employed nurse practitioner numbers and expanding nurse practitioner-led models of care.

Among the medium-term initiatives the Branch would like to see implemented are:

• Increased and appropriate access to childcare, through the construction of childcare providers onsite at health services, and ensuring childcare – and before- and after-school care at primary schools – is funded to open increased hours and with an increased number of places. We would also like to see greater rebates on the cost of childcare.
• Increased qualification allowances to retain those nurse and midwives with specialist skills, knowledge and experience in clinical positions.
• Removing arbitrary minimum hours to retain those nurses and midwives transitioning to retirement or other life stages.

Key asks

All of the short-term, medium- and long-term initiatives, including those mentioned above, underpin six key asks that ANMF (Vic Branch) will put to the government and opposition ahead of the November state election. Those key asks are:

1. Develop and build an integrated health service. This includes:
   1. Public sector state-wide employment
   2. Centralised policies, with best-practice guidance, education, onboarding and training overseen and delivered by Safer Care Victoria.
   3. Development of a centralised education portal that covers agreed mandatory training for public sector nurses and midwives. This will assist in movement of nurses and midwives across health services as required, ensure consistency in mandatory training between services, and decrease onerous and lengthy onboarding requirements.
2. State government to increase capacity in public aged care and specialised disability accommodation, including the increased presence of registered and enrolled nurses and nurse practitioners (which will also address hospital capacity).
3. Extending the existing state-run respiratory clinics to include nurse practitioner-led primary health care clinics/hubs. These clinics/hubs will be designed to manage complex comorbidities, chronic health matters, family matters, sexual health, mental health, AOD and more.
4. 32-hour full-time equivalent work week for nurses and midwives employed in clinical positions (meaning employees would receive full time pay and conditions for 32 hours a week instead of 38).
5. Expanding undergraduate nursing and midwifery degree employment models (RUSONs/RUSOMs) and investigating increasing recognition of RUSON/RUSOM experience to meet clinical placement registration requirements. RUSON/RUSOM positions to be funded and committed to as positions in addition to minimum ratios.
6. Implementation of grants or bursaries for undergraduate/pre-registration nursing and midwifery to compensate for unpaid placements.