Nursing
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Item Evaluating the impact of a new pay agreement on New Zealand nursing(Wiley-Blackwell, 2009) Buchan, James; North, N.Aim: This paper examines the labour market impact of a new national pay award for nurses implemented in New Zealand in 2004/5 - the Multi-Employer Collective Agreement (MECA). Background: The health system in New Zealand is unusual in that, while retaining a public sector system, the focus of pay determination for nurses over the last 20 years has shifted first from national to local pay determination, and then more recently reversed this trend, moving back to a national level pay determination. The shift back to a national pay determination approach in 2004/5 is therefore worthy of examination, both in terms of its labour market impact, and as a case study in the use of national level pay determination. Methods: The research was conducted in 2007-8. A rapid appraisal method was used, based on key stakeholder interviews, a document and literature review and a review and analysis of available data on the New Zealand nurse labour market, and trends in application rates to schools of nursing were assessed. In addition, interviews with managers of two District Health Boards, and interviews with five non-government employers of nurses, were conducted. Results: Indicators pointing to improvements included: steady (though not rapid) growth in staff numbers; reduced difficulty in recruiting; reduced vacancy rates; and increased application rates to schools of nursing. Managers interviewed in the study supported these positive indications, but some health-care employers not covered by the pay award reported negative knock-on effects (e.g. needing to match DHB rates, increased retention and recruitment difficulties). Conclusions: Available nurse labour market data provide an incomplete but compelling picture of the positive impacts of the MECA in a period of a very tight labour market. While much of the content of the 2004/5 agreement could be characterized as a 'normal' pay bargaining contract, there were also issues that differentiated it from the norm. In particular, it included an agreement to establish a safe staffing commission to assess the impact and implications of low staffing levels, nursing workload, and to establish guidelines on safe staffing and healthy workplaces. 2009 International Council of Nurses.Item The end of growth? Analysing NHS nurse staffing(Blackwell, 2013-09) Buchan, James; Seccombe, I.Aim: To present an overview of UK National Health Service nurse staffing changes across the last 10 years. Background: National Health Service funding is now being constrained as part of the overall measures to reduce UK public expenditure. This has implications for future staffing levels and deployment. Government and professional associations are disagreeing about the current extent of actual and likely National Health Service nurse staffing decline. Design: The paper reviews 'official' data and evidence on National Health Service staffing to assess actual National Health Service nurse staffing trends in recent years, highlights the results of scenario modeling of future National Health Service nursing numbers and relates this to national policies on staffing. Discussion: The available evidence now points to nurse staffing growth having tailed off and a likely pattern of overall decline in National Health Service nurse staffing is emerging. This is a policy concern in the UK, but also in many other countries. Implications for nursing: Whilst there has been a 'recession benefit' to the UK nursing labour market, this supply side boost cannot continue indefinitely. Any continued trend towards reduced intakes to training and reduced staffing levels will intensify the debate about the appropriate staffing levels and skills mix. Conclusions: We have seen significant National Health Service nurse staffing growth in the last 10 years, which is likely now to reverse. The real measure of the effectiveness of local and national National Health Service nursing workforce policy is not how many nurses are employed, it is that sufficient are deployed to provide safe care. 2012 Blackwell Publishing Ltd.