The case for specifying minimum staffing levels

The case for specifying minimum staffing levels in public hospitals

“There’s a good argument for specifying minimum staffing levels in public hospital departments and services, even – or perhaps, especially - during times of financial constraint,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“Even though public hospitals are finding it tough to make ends meet after years of under-resourcing, they still have a responsibility to ensure the services they offer their communities are staffed appropriately and to safe levels. Further, the government continues to require them to do more with less and increasing poverty is adding to the demand on them.”

Mr Powell was commenting on an article in the latest issue of the ASMS magazine, The Specialist, which looks at the argument for having minimum standards within hospital departments and services. The Specialist is available online at http://www.asms.org.nz/wp-content/uploads/2015/12/10921-The-Specialist_Dec15_WEB.pdf.

In the article on page 20, Lakes DHB paediatrician Steve Bradley spoke of the necessity and value of having clearly stated minimum standards in place, both for patients and for the doctors and nurses treating them. Lakes DHB includes Rotorua and Taupo.

For instance, at his DHB, a resident doctor and a paediatrician both need to be on call to provide adequate cover and to ensure a suitably experienced clinician is available during an emergency.

“At smaller hospitals, you can find that the junior doctors who are working, while very good, have not come from paediatrics. That carries a risk. When a very sick baby or young child comes in after hours, if the doctor dealing with them isn’t experienced in paediatrics, their ability to be effective will be reduced.”

He says these issues are relevant for all DHBs.

“The fact is, if you cut a service back to the point where you have very little leeway, then there’s a safety risk. The funding model doesn’t account for this. You may actually need to staff a department or service to a higher level than predicted by the funding model.”

Ian Powell says the ASMS is taking a closer look at the issue of minimum standards and whether this needs to be spelt out clearly in the collective agreement covering members working in the country’s public hospitals.

“It’s not to say that these conversations aren’t already happening within DHBs and within services, but it makes sense to be more explicit about the level of safe staffing needed, and that’s what we’re investigating.”

ENDS

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