Sector Update from the Chief Nurses Office - February 2020
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Sector Update from the Chief Nurses Office
February 2020
CNO Office Update
Welcome to the first update for 2020 – while a happy new year salutation is now somewhat
dated as we enter the second month of the year, we have the whole year to celebrate 2020
as International Year of the Nurse.
As one of the first countries to officially welcome in 2020 it was such an honour to send out
the first celebration acknowledgment tweet just after midnight on the 1st January 2020.
There is no doubt that 2020 will be a significant year for nursing and the wider health sector,
what we can count on is that nursing will have an important role to play in being part of the
many developments that will occur over the year and beyond.
New Years Honours list
It was a delight to see four nurses being honoured on the 2020 New Year Honours list. Duly
acknowledged for their respective services to health, nursing and the community these nurses
reflect the passion and commitment of the profession. Congratulations to them all:
• Frances Hughes - Companion of the New Zealand Order of Merit for services to mental
health and nursing
• Jenny Carryer - Companion of the New Zealand Order of Merit for services to health,
particularly nursing
• Annette Milligan - New Zealand Order of Merit for services to health, particularly
nursing
• Carrol Elliott - Member of the New Zealand Order of Merit for services to nursing and
the community
2020 International Year of the Nurse and Midwife and Nursing Now
Campaigns
The Nursing Now campaign was initiated in Aotearoa, New Zealand on 5 December 2019 via
a soft launch on the steps of Parliament. The campaign links with the launch of the World
Health Organisation endorsement of 2020 International Year of the Nurse and Midwife. Our
Midwifery colleagues are well underway with their planning, while the National Nurse Leaders
group (NNL) are overseeing the planning for nursing activities and events.
Work is continuing developing a national website to host all the activities and a calendar of
celebrations.Refer https://www.health.govt.nz/our-work/nursing/international-year-nurse-and-
nursing-now-campaigns
For any event or hui that you may be organising that you would like featured on the New
Zealand Nursing Now / 2020 Year of the Nurse website and calendar, please email details to
the chiefnurse@health.govt.nz email.Novel coronavirus
Up-to-date information and advice on the novel coronavirus is available on the Ministry’s
website. This information is updated daily (at the time of writing) and now includes specific
advice for health professionals. The Primary Care Quick Reference Guide, Advice for Primary
Care Reception Staff and a Triage Checklist form have also been updated at the time of writing
this (4 February). These documents provide health professionals, including hospital-based,
community-based and public health practitioners, with information on how to identify and
investigate any cases of novel coronavirus, as well as how to apply appropriate contact tracing
and infection control measures to prevent its spread.
https://www.health.govt.nz/our-work/diseases-and-conditions/novel-coronavirus-2019-ncov
In addition, the Ministry are holding regular media conferences.
Surgical Mesh Restorative Justice Forums
The report on the surgical mesh forums from Victoria University’s Diana Unwin Chair in
Restorative Justice has been completed. ‘Hearing and Responding to the Stories of Survivors
of Surgical Mesh, Ngā korero a ngā mōrehu – he urupare’ summarises the themes that
emerged from a restorative process to hear from New Zealand men and women affected by
surgical mesh.
The report highlights the severity of the harm and the impact on the lives of those who have
experienced complications from surgical mesh.
Mesh injured New Zealanders have described life-changing physical and psychosocial
harms including losses to their physical wellbeing, relationships, identity, employment and
financial status. They also expressed a loss of trust in healthcare providers and institutions.
The report groups the needs to address surgical mesh harm into the following workstreams:
• credentialling of surgeons
• specialist multidisciplinary mesh services
• informed consent
• safety culture and systems
• acknowledgment of harm
• responding to mesh harm both now and in the future.
Actions required to address these were discussed at a workshop in November 2019 attended
by the Ministry, patient advocates Mesh Down Under, ACC, the Medical and Nursing Councils,
professional colleges, the Health & Disability Commission, the Health Quality & Safety
Commission and the New Zealand Private Surgical Hospitals Association.
Actions agreed to as part of this meeting are included in the report.
The Ministry is committed to progressing these actions and working with the other agencies
to support those who’ve been affected and minimise future harm.
Voluntary Bonding Scheme 2020 Intake – New Graduate Nurses
Eligible professions, specialties and communities for the 2020 intake of the Scheme have
been announced.
2Registered nurses working in aged care, mental health and addictions, district nursing, Well
Child Tamariki Ora and Primary/Practice Nursing within: Māori or Pacific Providers, the
Auckland, Counties Manukau, Waitemata, and Taranaki DHB regions. Changes from 2019
include the addition of Enrolled Nurses (working in Mental Health and Addiction or Aged Care)
as an eligible nursing scope.
The 2020 Intake Registration of Interest (ROI) period will be open on the Ministry’s website
from 4 February to 16 March 2020 at midnight. Registrations must be received within the six
week registration period, and late registrations generally cannot be considered.
The Voluntary Bonding Scheme aims to incentivise health professionals who agree to work
hard-to-staff communities or specialties for the first three-to-five years of their career. For
more information, including the eligible hard-to-staff areas, the full Terms and Conditions, and
to register for the Scheme, see following link to the Ministry’s website:
https://www.health.govt.nz/our-work/health-workforce/voluntary-bonding-scheme/voluntary-
bonding-scheme-2020-intake-information.
Safe Staffing Accord Update
The Ministry, NZNO and the DHBs are progressing the commitments of the Accord:
Part A
• An interim process for distribution of increased volumes and distribution of NEtP has
been decided for 2020.
• Contracts, service specifications and accountability mechanisms are being developed.
• Funding of full employment of graduates who apply via ACE will commence with the
mid-year 2020 intake.
• The Nursing Accord Operations Group is working with Central TAS to strengthen data
analysis to measure success of employment within six months and placement settings
of new graduate nurses.
• The subgroup for implementing the Enrolled Nurse Support into Practice Programme
(ENSIPP) is close to finalising service specifications and a national learning framework
for the programme. The Group is also working closely with Central TAS on developing
the allocation and matching process.
Part B
• The Ministry continues to review and refine its accountability levers for implementation
of CCDM.
• Further discussion with Nursing Accord signatories is needed to agree the level and
nature of oversight required and the continued role the Group will play.
• The second National Reporting Framework reporting is due to be submitted by DHBs
on the 20 February. Consequently, advice will be prepared for the Minister.
Part C
• A ‘bundles of intervention’ approach has been agreed, with multiple actions to address
contributing factors and to enable relevance to the varied employment settings.
• A subgroup has been formed to refine actions, with Central TAS and DHB GMsHR
completing a stocktake of current retention and recruitment activities across DHBs.
• Links to a campaign for 2020 International Year of the Nurse and Midwife are under
development.
• Budget bid for 2020 for a re-entry to nursing initiative is being prepared.
3Mental health and addictions
Toni dal Din has been appointed to the role Deputy-Director of Mental Health at the Ministry
on a secondment. This is a statutory role that has usually been filled by a Psychiatrist. Jane
Bodkin continues to work closely with the Mental Health Directorate on professional mental
health nursing and workforce issues.
Budget 19 allocated $1.9 billion over four years in a mental wellbeing package. This included
$455 million for a new model of primary mental health care so that people can access free
and immediate advice and support, when and where they need it.
Mental health nursing initiatives are part of this investment including new initiatives and
building on existing initiatives:
• An additional 77 funded Nurse Entry to Specialty Practice (NESP) positions
• Expansion of the Mental Health and Addictions Credentialling Programme for Primary
Health Care Nurses
• Investment in training and supporting nurse practitioner and enrolled nurse workforce with
a focus on primary mental health (see below).
Work is underway to begin a national recruitment campaign for mental health nurses over four
years.
Review of the medicines list for registered nurse prescribers in
primary health and speciality teams
The Nursing Council is reviewing its list of medicines for registered nurse prescribers working
in primary health and specialty teams. This is an interim measure until future changes to the
Therapeutics Medicines Bill are enacted. The registered nurse prescribing model remains
focused on primary health settings and speciality teams where a diagnosis has:
• already been made, or
• the diagnosis is relatively uncomplicated, or
• builds on an identified underlying disease process.
The Ministry will consult on proposed additional medicines in mid-2020.
Nurse Practitioner Training Programme and Supported Placements
for Nurse Practitioners and Enrolled Nurses
An open tender process has been developed for an expanded nurse practitioner training
programme (NPTP), the RFP process also includes funding for supported placements for NPs
and ENs.
The Request for Proposal (RFP) is on the Government Electronics Tender Site (GETS) site
https://www.gets.govt.nz/MOH/ExternalTenderDetails.htm?id=21971579. Respondents are
asked to submit proposals by 20 February 2020. The Ministry is seeking collaborative
responses between educators, employers, and other parties.
The RFP has two parts;
Part One: Nurse Practitioner Training Programme (NPTP)
• The aim is to expand the current training programme (NPTP) with a focus on those
who will work in a substantive mental health and/or addictions role in primary mental
health and to increase the numbers and support for Māori nurse practitioner and Pacific
nurse practitioner candidates.
• This RFP includes findings from the 2017 Evaluation of the current NPTP delivered by
the University of Auckland and Massey University including subsequent feedback from
4the nursing profession, employers and educators and this has been used to inform the
development of the RFP.
Part Two: Supported placements for nurse practitioners and enrolled nurses in primary mental
health settings
• The aim of the supported placement of nurse practitioners and enrolled nurses (with
wrap around support) is to showcase nurse practitioners and enrolled nurses in primary
mental health care settings and to increase access to mental health and addictions
support for people in high needs populations.
• Jane Bodkin has been working closely with colleagues across the Ministry on this
including the Health Workforce Directorate, Mental Health Directorate and the Māori
Health Directorate.
Well Child Tamariki Ora Review
Margareth Broodkoorn continues to Chair the Well Child Tamariki Ora (WCTO) advisory group
and Ramai Lord is part of the working group within the Ministry.
The WCTO Review team is currently working through the analysis phase of the review,
bringing together the key themes heard through stakeholder engagement, evidence captured
through available data collection, rapid evidence reviews and the case studies completed to
date. The team intend communicating with all WCTO stakeholders in the coming weeks,
including some initial high level themes and next steps.
Rural Interprofessional Health Schools
A steering committee will be put in place to guide the next phase of scoping with what will be
referred to as the Rural Interprofessional Health School (as opposed to rural hubs). The
committee will first meet on 13 February, chaired by Anna Clark and has both Ministry and
sector representation.
Rural nurse practitioner placements
A contract with the Rural GP Network has been signed to provide support for four Nurse
Practitioner (NP) placements in rural locations for two years. The agreement started on 1
January 2020, and the Ministry will work with the Rural GP Network in the development of the
placement process.
Abortion Legalisation Bill
The Ministry is preparing for the possibility that the Abortion Legislation Bill 2019 will pass into
law sometime in early 2020. Consequences of the Bill passing into law will be:
• Abortion will immediately be decriminalised
• The Ministry of Health will take over from the Ministry of Justice as kaitiaki of services
relating to abortion.
A change in legislation will result in immediate changes to the way women move through the
abortion process and the different parts to and roles within the abortion care pathway will also
be affected. In anticipation the Ministry is working with the sector to develop a new abortion
care pathway that will support all women seeking abortion and providers concerned.
5A Care Pathways workshop was held on 10 December 2019 with practitioners, experts, and
organisations involved in the current care pathway for abortion, and Ministry staff including the
Office of the Chair Clinical Officers. The workshop identified implementation considerations
for a care pathway that enables safe and efficient services for all women seeking an abortion.
A second workshop will be held in February 2020 to provide an opportunity for a more in-depth
conversation on how the Ministry can support providers in the implementation of the new care
pathway. The Ministry has established a team to help to prepare for implementation if the Bill
passes. The team can be contacted at ALR@health.govt.nz
End of Life Choice Bill
The End of Life Choice Bill passed 69 votes to 51 at its third and final vote in the House 14
November 2019 and will go to referendum alongside the 2020 general election. The Bill makes
it legal to request assisted dying, or euthanasia, from doctors, and legal for health practitioners
to assist people die under certain conditions. The option would be open to those who have
been diagnosed as terminally ill and with less than six months left to live.
Doctors and nurses are prohibited from starting conversations about euthanasia under the
law, so a patient has to request it themselves. They would have to go through a series of
checks with two doctors, including one appointed through the Ministry of Health.
If the patient meets all the criteria, they will be provided a form to return, if and when they've
picked a time, place and method for how they want to die. They have six months to use it and
if they don't, they have to go through the whole process from the start.
Patients can choose whether to have medications delivered orally or by injection and whether
to initiate it themselves or have a doctor or nurse do it at a place of the patient's choosing,
including at home. Health practitioners are allowed to opt out of participating in any part of the
process and the bill states they're not meant to penalised by their employers for doing so.
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