New Nurse and Midwife Staffing Requirements in Victoria

This article applies public hospitals and health services in Victoria, as well as operators of Maternal and Child Health Centres and state-wide telephone advice services who provide maternal and child health advice.

Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2020 (Vic)

Please be advised that the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2020 (Vic) (the Bill) passed its third reading in the Victorian Parliament on 10 November 2020 and received Royal Assent on 17 November 2020. The commencement information of the Bill is as follows:

  • Part 1 and sections 8, 9, 10, 11 and 14 of the Bill came into operation on 18 November 2020.
  • Section 6 of the Bill comes into operation on 1 March 2021.
  • Sections 4, 5, 7, 12, 13 and 15 of the Bill come into operation on 1 July 2022.
  • If a provision of the Bill (other than Part 1 and sections 4 to 15) do not come into operation before 17 November 2021, it comes into operation on that day.

Overview

The Bill amends the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015 (Vic) (the SPC Act) to change the rounding method used when determining staffing requirements and certain nurse to patient and midwife to patient ratios on specified shifts in certain wards. These amendments form part of a second phase of improvements to ratios that were first introduced to the SPC Act in March 2019.

The Bill also amends the Child Wellbeing and Safety Act 2005 (Vic) (CWS Act) to require providers of certain maternal and child health services to employ or engage nurses for those services only if the nurses have prescribed maternal and child health nursing qualifications.

The key changes introduced by the Bill are discussed below.

Rounding method for staffing requirements

Hospitals may remember that prior to 1 March 2019, section 12 of the SPC Act provided for circumstances where a ratio was applied under the SPC Act that did not produce a whole number. The effect of that previous section 12 was to exempt an operator of a hospital from the requirement to roster an additional nurse if the ratio warranted the rostering of less than 50% of an additional nurse. On 1 March 2019, section 12 of the SPC was amended to impose an obligation (the new rounding method) on an operator of a hospital in relation to certain wards (wards of high-demand and complexity, i.e. general medical or surgical wards, coronary care units, operating theatres, post-anaesthetic recovery rooms and emergency departments) to roster an additional nurse where the application of a ratio to a ward resulted in a number that was not a whole number.

Hospitals should note that section 6 of the Bill amends section 12 of the SPC Act to stipulate the date on which the new rounding method applies when determining staffing requirements in:

  • an acute stroke ward;
  • a haematology ward;
  • an oncology ward;
  • the morning shift and the afternoon shift in an aged high care residential ward in all hospitals; and
  • the night shift in a rehabilitation bed in all hospitals.

These amendments provide for the complete phasing in of the application of the new rounding method for all ratios applying under the SPC Act. This means that in relation to a particular ward on a specified shift, where the actual or expected number of patients in a ward or the number of beds is not divisible into a whole number when the relevant ratio is applied, the operator of the hospital must ensure that the ward or number of beds is staffed with one additional nurse or midwife (as the case requires) in order to comply with the relevant ratio.  It is important to note that the Bill’s amendments to section 12 of the SPC Act operate in a highly particularised fashion, applying differentially depending on the type of shift (i.e. morning, afternoon or night). For example, the new rounding method will apply to an acute stroke ward, a haematology ward and an oncology ward on the morning shift in all hospitals on and from 1 March 2021. Moreover, the new rounding method will apply on and from 1 July 2022 on the afternoon shift in an aged high care residential ward in all hospitals and on the night shift in a rehabilitation bed in all hospitals.

As the amendments to section 12 brought about by the Bill are highly prescriptive (meaning that a summary of it cannot cover all of the finer particulars relevant to each ward and hospital type), we recommend that organisations review the Bill to the extent that it applies to their own health service.

Amended nurse to patient and midwife to patient ratios

Level 1 hospitals should note that section 8 of the Bill will amend section 15 of the SPC Act to amend the ratio applying to general medical or surgical wards in level 1 hospitals by introducing a requirement to staff one nurse in charge on the night shift on and from 1 July 2021.

Level 2 hospitals should be aware that section 9 of the Bill will amend section 16 of the SPC Act to amend the ratio applying to general medical or surgical wards in level 2 hospitals by introducing a requirement to staff one nurse in charge on the night shift on and from 1 July 2022.

Organisations that operate a level 3 hospital should be aware that section 10 of the Bill will amend the ratio applying to general medical or surgical wards in level 3 hospitals by introducing a requirement to staff one nurse in charge on the night shift on and from 1 July 2023.

In addition, section 12 of the Bill will amend section 27 of the SPC Act to alter the ratio applying to special care nurseries by introducing a requirement to staff one nurse in charge or midwife in charge on the night shift for special care nurseries which have 8 or more occupied cots.

The Bill amends section 31(1)(b) from the SPC Act to alter the ratio applying to birthing suites by introducing a requirement for hospitals with 6 or more nominated birthing suites to staff one midwife in charge on the afternoon shift (on and from 1 July 2023) and on the night shift. The Bill will also substitute section 31A(1)(b) of SPC Act to amend the ratio applying to postnatal wards by introducing a requirement to staff one midwife in charge or nurse in charge on the night shift (on and from 1 July 2022).

Qualifications required for maternal and child health nurses

Section 16 of the Bill also inserts two new sections (sections 46ZAA and  46ZAB) into the CWS Act that impose new requirements on operators of Maternal and Child Health Centre and person who operate a state-wide telephone advice service that provides maternal and child health advice. These 2 sections prohibit the operator of a Maternal and Child Health Centre and also a person who operates a state-wide telephone advice service that provides maternal and child health advice, from employing or engaging a nurse to provide a prescribed maternal and child health nursing service, unless that nurse has a prescribed specialist maternal and child health nursing qualification, or a qualification, that is substantially equivalent, to a prescribed specialist maternal and child health nursing qualification. It is important to note that section 16 of the Bill will also introduce section 46ZAC to the CWS Act which provides that these two sections are not intended to alter, vary, authorise or require the alteration or variation of an employment contract or any workplace instrument within the meaning of the Fair Work Act 2009 (Cth).

Please click here to access the full Bill.


Contact

For further information please contact the Law Compliance team:

Phone: 1300 862 667

Email: info@lawcompliance.com.au

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