February 2, 2017

2017 Pre-Budget Consultations

Registered Nurses know the people of Newfoundland and Labrador care deeply about access to quality, public health care. Registered nurses play a key role in providing that care.

Health care is the biggest public expenditure and arguably the most important. As the province develops its budget, it is vital to consider the point of view of frontline registered nurses and to work with us to identify efficiencies that are cost-effective, but will not create dangerous gaps in the system. The people of the province are counting on quality, safe patient care to be there for them when they need it.

Government has asked for feedback on four key areas during pre-budget consultations. RNU is focusing on one priority for each area.

A More Efficient Public Service

Solution: Core Staffing Review

In 2014-15, our province spent $48 million in overtime and sick leave for registered nurses alone. A system that relies on overtime is not efficient. Evidence shows that proper registered nurse staffing and fully utilizing their expertise can save the system money while ensuring positive patient outcomes.

As a step toward creating a more efficient public service, RNU is calling for government to complete a core staffing review. A core staffing review would examine the number and type of health care providers currently working in the system. A review of this nature has not been completed in nearly 20 years. How can we determine whether or not we have enough registered nurses to meet the needs of patients if we have no way of assessing the demand? Sicker patients with more complex health needs, an aging population and high incidence of chronic disease are all drivers for increased workload. This review must be based on the needs of the patient. A staffing model based on patient acuity will focus decision-making on the needs of the patient, not a line in a budget.

RNU has been saying for quite some time that incorrect staffing leads to high workload, lack of relief, high overtime, high sick leave, increased risk to patient safety and poorer patient outcomes. These are expensive issues and they are avoidable when staffing is done right. Get RN staffing right, bring overspending down, and drive quality up. A simple concept supported by the evidence.

A Stronger Economic Foundation

Solution: Good jobs

The unemployment rate in Newfoundland and Labrador is 14.4 per cent. According to the economic forecast released by government this fall, the unemployment rate could reach almost 20 per cent by 2019. That’s 1 in 5 people not working.

The answer to a stronger economic foundation is jobs. Good jobs.

Good jobs are jobs that support families and communities, and that exist for people at all stages of their careers and lives. To build a diverse and sustainable economy we need to protect jobs in the public and private sectors. We also need to add new jobs by establishing suitable conditions for economic and employment growth. Read more about jobs and building a strong economic foundation in this report by Common Front NL: http://bit.ly/ABetterFutureNL

Better Services

Solution: Establish RN-Led Primary Health Care Teams

It is well-established that health systems with a strong primary care sector achieve superior health outcomes at lower cost. In the Way Forward vision document, government announced it will expand the number of primary health care teams throughout the province. RNU believes the establishment of teams in Corner Brook and Burin is a positive step toward helping individuals achieve optimal health and well-being.

However, we also believe there is great potential to expand the use of primary health care teams throughout the province as a way to support better outcomes. In addition to expanding the number of primary health care teams, we also feel these teams should be led by Registered Nurses. Registered nurses in primary care roles can improve access to important services, including comprehensive health assessments, health education, screening and other preventative care, management of chronic diseases, and care coordination with other health and social-service providers.

Better Outcomes

Solution: Increase the number of Nurse Practitioners

RNU’s recommendation for better outcomes is focused on health care. We believe government should make it a priority to increase the use of nurse practitioners.

We have just over 100 nurse practitioners practicing in the system in a variety of health care settings. Increasing the use of nurse practitioners will greatly improve access to care. Evidence shows utilization of nurse practitioners leads to timely access to health service, decrease wait times, improved patient outcomes and decreased costs.

Increased funding for Regional Health Authorities (RHAs) would enable additional nurse practitioners to be hired in all regions of the province. In addition to increasing the number of nurse practitioners hired by RHAs, it is also time to explore opportunities for nurse practitioners to operate clinics and be paid under the public system. Why should individuals visit their family doctor at no cost, but have to pay out of pocket to see a nurse practitioner?