The implementation of Safe Staffing Levels (SSL) has commenced in NSW public hospitals. This initiative involves the introduction of minimum staffing levels, which will result in more nurses and midwives in NSW Health.
View the below SSL resources for more information:
In May 2023, the Safe Staffing Levels Taskforce was established with key leaders from the NSW Nurses and Midwives’ Association (NSWNMA), NSW Health, and local health districts. The Taskforce continues to work collaboratively to ensure the implementation of the Government’s commitment of 2,480 full-time equivalent (FTE) staff towards the rollout of SSL over the coming years.
NSW Health is implementing significant enhancements to the nursing and midwifery workforce with the introduction of ratios and additional supplementary roles.
The changes allow flexibility in the allocation of staffing according to clinical acuity and models of care in operation. Nursing and midwifery managers will continue to be empowered to make decisions regarding staffing based on local clinical considerations.
Implementation of the agreed Safe Staffing Level areas will be scheduled in phases. Implementation of SSL has commenced in Level 3 to 6 Emergency Departments (ED). SSL will progressively be implemented across other departments.
The Taskforce continues to meet regularly to determine the ongoing implementation of Safe Staffing Levels across NSW Health.
Note: Relevant areas/sites for rollout will be identified by the SSL Taskforce, subject to the 2,480 funding envelope.
Note: This ratio is aligned with current NHPPD requirements of 5.0
*Provided that ENs who are engaged at the time of transition to the staffing levels will be counted as a RN for the purpose of the patient ratios outlined above.
Note: The ratios are flexible and can apply across a ward/unit, including for all nursing staff and patients. For example, in an ED with a 1:3 ratio, where there are 30 designated treatment spaces with 10 nursing staff – the nursing staff may be allocated across the unit as required by clinical need.
The SSL implementation provides a new minimum percentage of registered nurses (where ratios apply), which is outlined in the table below. The minimum skill mix proportions in the table are to be met within the staffing profiles of the ward/unit. Once a ward/unit has met this minimum skill mix (subject to the shift-by-shift limitation on Assistant In Nursing (AIN) outlined below) and the applicable ratio, additional Enrolled Nursing (EN) and AINs can be engaged as required but won’t count towards the ratio.
The Safe Staffing Levels rollout includes limitations on the proportion of non-Registered Nurses (RN) that can count towards the ratio as follows:
Assistants in Nursing continue to be a valuable part of the NSW Health nursing and midwifery workforce.
NSW Health will create a policy/framework (that will be subject to ongoing review by the Safe Staffing Levels Taskforce) that will provide for a shift limit of 1 AIN per shift (counting towards the staffing ratio) – with the exception of Level 5 and 6 Emergency Departments and intensive care units where AINs will not count towards the minimum ratio.
In rehabilitation wards and C2 wards that are lower acuity (wards to be determined), up to 2 AINs may count.
The taskforce will continue to review the AIN shift limitations, the policy framework, its impact and rollout.
If at the time of implementation there are wards/units with staffing profile numbers higher than the specified staffing and skill mix, the existing staffing numbers and skill mix in those wards/unit will either continue to apply or be subject to prior review and variation. A reduction in staffing profiles or numbers, or a reduction in skill mix, will not occur without a review that considers the clinical needs in the ward or unit taking place. If there is disagreement between NSW Health and the Association about the outcome of the review the award dispute provisions will apply.
The intent of SSL is to enhance the nursing and midwifery workforce (RN/EN). In the lead up to the SSL rollout, should there be normal business reviews that propose reductions in staffing or skill mix, then the above principles will also have application.
NSW Health is committed to implementing all necessary measures to meet the SSL requirements. A transition period will allow wards/units to achieve these staffing changes as quickly and as safely as possible.
The parties will continue to work through transitional arrangements and hold discussions, including:
The taskforce is continuing discussions on implementing safe staffing levels in the following areas:
The taskforce has commenced discussions on the rollout of Safe Staffing Levels (SSL) in dedicated postnatal wards, of which there are seven at Campbelltown, John Hunter, Liverpool, Nepean, Royal Hospital for Women, Royal Prince Alfred and Westmead Hospitals.
Discussions are continuing on the parameters, timeframes and operationalisation for this rollout.
The taskforce is currently engaging with LHDs that run MPS and Peer Group D facilities with an ED to better understand the variations in staffing requirements that exist based the size and scope of services provided; location, including the needs of the community; and other local factors.
