Nursing Staff at Cork University Hospital
Nov 8, 2016 -
Author: Tony McNamara, CEO, Cork University Hospital GroupA Cause for Hope
In 2008 – which seems like an eon ago – this country was forced to implement the most draconian measures designed to address a dire financial situation including the implementation of a moratorium on the employment of staff. This was to have unprecedented implications for the range and quality of public services that agencies could provide and the health sector, with its’ mobile well qualified staff, suffered more than most with high turnover and an inability to replace those staff who left.
It must be said that the speed of change in subsequent years following the Croke Park and Haddington Road pay agreements was remarkable and remains a tribute to public service staff in all professions.
It is now time to move on with the improving financial situation and to reflect on the many reasons for hope in our health service as a result of changes in policy that allow for a recommencement of recruitment including nursing staff.
In Cork University Hospital the combined complement of nursing, midwifery and health care assistant staff is 1,647 and is represented in Figure 1:
Figure 1 Staff Complement in Cork University Hospital
In view of the change in policy to allow for recruitment of all grades of staff, a rigorous programme for recruitment of nursing staff has been underway over the past year. This has taken a number of forms:
- Establishment of a specialist recruitment office to support the Director of Nursing;
- Weekly interviews for nursing staff to fill vacancies;
- Engagement with graduating nurses offering them career pathways that has resulted in 96 of the 102 (94%) nurses qualifying in 2015 and 2016 remaining in Cork University Hospital;
- Engagement of international recruitment companies to source nursing staff.
The result has been a gradual, consistent improvement in the number of nurses employed resulting in a net increase of over 30 RGNs over the past year as demonstrated in Figure 2:
Figure 2 Nurse Recruitment Trend July 2015 – August 2016
In addition, significant work is being undertaken in relation to investing in increasing the skill set of c. 150 Health Care Assistants who will add significantly to the quality of patient care while contributing to supporting nurse staffing. In this regard the employment of grades such as trained Theatre Assistants will support changes in skill mix and free nurses to take on duties appropriate to their expertise in the context of the programme to transfer tasks between grades of staff.
There are now 25 approved nurse vacancies in Cork University Hospital while all posts in the Maternity service are now filled and there remains a challenge to continue recruitment to fill these vacant posts and to reduce dependence on agency staff.
It is important to note the service improvements that these recruitment initiatives and changes in skill mix are now supporting;
- Opening of a 20 bed highly specialist Cystic Fibrosis ward that has significantly improved the quality of care for that cohort of patients;
- Opening of 10 additional acute beds;
- Consolidation of Medical Oncology, Haematology and Radiation Oncology beds on a single ward thereby improving the delivery of integrated care for cancer patients;
- Commencement of a mobile intensive care ambulance service (MICAS) pilot programme for the Southern region.
- Commencement of 7 day functioning of the Acute Medical Assessment Unit in November;
- The provision of leadership and clinical governance for an additional 30 bed transitional care unit;
- Increasing General Intensive Care bed complement to 10 in November with the expectation that a High Dependency Unit will be developed in early 2017 to support the ICU;
- Increase in the level of theatre operating sessions in the coming months commensurate with increasing recruitment of nursing staff and Theatre Assistants.
There is a need to be cautious in relation to the programme of recruitment and there is no suggestion that there will be a short term solution to not only filling funded vacancies but also to increase nurse staffing levels to enable other priority developments to happen in the Hospital.
Yet there can be no denying that the results of the recruitment programme continue to show sustained improvement which must be acknowledged. There are sound reasons for hope that Cork University Hospital is emerging from a period of retrenchment and that the Hospital is on a trajectory of service improvement. This may or may not be replicated in other hospitals throughout Ireland but it does provide an indication that with sound recruitment initiatives and a leadership commitment to addressing this issue, that there are grounds for optimism.
Hopefully this will become increasingly evident in the political, media and public discourse on this matter and that we can begin to celebrate the many positive developments that are happening in our health service rather than hearing a constant refrain of negativity.
J.A. McNamara, Chief Executive Officer
November 2016
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