1

Nursing Strategy for South Africa

Presentation to the

Portfolio Committee for Health

Cape Town

19 June 2007

2

Purpose

• To brief the Portfolio Committee for Health on the draft Nursing Strategy for South Africa

• To highlight priorities set within the Strategy for Nursing in South Africa

• To give an overview of the Nursing Strategy in relation to implementation of the National Human Resources Plan

3

Introduction

• The Nursing Strategy as a critical part of addressing the serious challenges faced by nursing

• Proposal for its adoption as the basis and a blue-print for strengthening nursing in the country

• To highlight the significance of the nursing profession in health care delivery.

4

Introduction

• To highlight production and status quo of nurses in the country

• Location within the HRH Plan and use of nursing as tracer profession

• Location of nursing within Policy on Health Sciences, Education and Training

• Ownership of the process by National Health Council

5

Overview

• Purpose of a Nursing Strategy:- address challenges faced by nursing- articulate how nursing education & training,

practice, resources, social positioning,regulation and leadership are planned &linked in support of nation's health system

• Goal of a Nursing Strategy:- achieve and maintain an adequate supply of

nurses and strengthen the quality of nursingin the health system

6

Overview

• Intention:- Develop a coherent approach towards dealing

with nursing challenges thus provide a commonplatform

- Each stakeholder to address issues that affecttheir core business

• Strategy must therefore be a unifyingplatform explicitly addressing all nursingissues

7

Overview

• Central to the Nursing Strategy:-Good quality education and training

- Nursing practice (providing an enablingenvironment for nursing service delivery)

- Good nursing leadership in all aspects ofnursing

- Social positioning and better image of nursing- Resources for nursing (promote accessibility of

nursing to all South Africans)

8

Perspectives On Nursing

• Largest category of health professionals• Responsibility of bringing health services

to all communities• Issues associated with nursing workforce

particularly complex & dynamic• Many documented challenges - education

right through to migration• Serious problem of resources especially

infrastructure related

9

Fundamental Issues

• Nursing in a Changing Health System

• Nursing as a Career of Choice

• Regulating nursing

• Educational qualifications

• Scopes of Practice

• Managing the Nursing Workforce

• International/global influences

10

Strategic Focus Areas

• Nursing Practice

• Nursing Education & Training

• Nursing Leadership

• Values in Nursing (Professionalism)

• Nursing Regulation

• Resources for Nursing

• Social Positioning of Nursing

11

Strategic Thrust • The strategy to be broad enough to address

challenges, leveraging on all possiblenetworks i.e.

- How nursing can remain a profession thatoffers access to all whilst lifting the bar interms of quality education and training

- Finding ways of embracing the benefits ofglobalization in a manner that improvesnursing

- How nurses can improve the image of theirprofession

12

Implementation Framework

• Similar approach to HRH Plan• Strategies proposed with understanding that

further development & implementation ofeach strategy will require unifying efforts ofall stakeholders

• Primary responsibility & output measuresfor each strategic focus identified.

• Cost implications of strategies to beconsidered by National Health Council

13

Conceptual Roles

• Sponsoring (government)

• Championing (partners)

14

Concept of Sponsoring

• Provide strategic direction & leadership for the implementation

• Take the lead in communicating the strategy• Promote joint ownership of the strategy

amongst stakeholders• Identify and mobilize resources and support

required• Monitor and evaluate progress of the

implementation of the strategy

15

Concept of Championing

• Putting in place a mechanisms to popularise

the objectives of the strategy

• Driving the implementation of the education,

training & related aspects of the strategy

• Identifying major policy implementation gaps

& engagement with Department of Health

• Assisting and supporting the DOH throughout the implementation process

16

Challenge for Nursing Collective discussed during consultation

• Critical contextual analysis of the quality, delivery & associated factors to education

• Analysis of strategic role of nursing institutions• Increasing the pool of educators & nursing

scientists• Nurturing & entrenching the culture of research,

writing & publishing in nursing• Ensuring innovation is entrenched in nursing• Defining practically the social positioning of

nursing & addressing values

17

Key Issues raised during consultation

• Education & Training- Qualifications- Educators- Research• Scopes of Practice- Repositioning of nursing- Values & human rights approach• Nursing workforce planning• Regulating the nursing workforce

18

Key Issues Raised continued

• Implementation of new Scopes of Practice• Ensuring good standard education & training- Clinical & theoretical competence- Integration of theory and practice- Research• Recruitment and selection of learners• Capacity in nursing {capacity understood as ability of

People, organizations and society to manage their affairssuccessfully

• Nurse Educators & Leadership

19

Implementation aspects of the Nursing Strategy

Strategic Focus Area 1: Nursing Practice

• Establishing and enabling legislative environment– Implementable policies in place– Legislation aligned to nursing practice– Policy on public nursing agency in place

20

Implementation aspects of the Nursing Strategy

• Improved quality of nursing practice / promote and assure quality of care– Finalized scope of practice in place– Evidence based practice– Operational plans in line with service

delivery needs and resources

21

Implementation aspects of the Nursing Strategy

• Improve skills and competency levels of nurses in accordance with the competency framework and revised scope of practice– Competency assessment system in place– Skills plan in place– Skills Development Programme in place– CPD activities identified and aligned to

revised scope of practice

22

Implementation aspects of the Nursing Strategy

• Develop collaborative partnerships with key stakeholders– Identify stakeholders and their roles to

participate in the national nurse production, placement and retention strategy for nurses

– Adoption of National Nursing Strategy for South Africa

– Sustained partnership

23

Implementation aspects of the Nursing Strategy

• Develop Nursing Staff establishments that are responsive to service delivery needs– Nursing staffing norms and standards in

accordance with service needs in place– Career paths for all categories in place

especially clinical specialties– Retention strategy implemented

24

Implementation aspects of the Nursing Strategy

• Strengthen role of Nursing in Health Service Delivery– Locate nursing strategically at provincial, local and

international levels– Ensure and approve quality of supervision– Build quality nursing teams– Upgrade current enrolled and professional nurses

in line with new scopes of practice– Establish provincial and national forums for

sharing best practices on nursing

25

Strategic Focus Area 2 – Education and Training

• Improve quality of nurse educators– Improved conditions of service– Ensure all nurse educators appropriately qualified

and updated in current skills

• Ensure harmonization of education and training– Finalize recommendations of the Nursing SGB

through the SANC– Nursing Education aligned with legislative

requirements, training linked to service needs

26

Strategic Focus Area 2 – Education and Training

• Integrate practice and theoretical knowledge– Strengthen collaboration with nursing

education institutions and service providers– Provide capacity for mentorship and

preceptor programmes – Ensure qualifications are aligned to needs– Proper integration of practice and

theoretical knowledge

27

Strategic Focus Area 2 – Education and Training

• Increased production of nursing professionals– Identify and accredit health facilities for

clinical education and training to increase capacity to accommodate increased production requirements

– Audit and increase training capacity of nursing colleges and training courses

– Develop a recruitment and selection strategy for young nurses

28

Strategic Focus Area 2 – Education and Training

• Skills improvement– Identify, develop and strengthen CPD

activities in line with the Nursing Act– Align CPD to clinical outcomes

29

Strategic Focus Area 2 – Education and Training

• Recruitment and Retention of Nurse Educators– Develop sustainable retention strategies

– Career pathing and succession planning

– Develop quality management systems at Nursing Education Institutions

– Audit quality of nursing education

– Audit quality and skills of nurse educators

– Improve capacity of Nursing Education Institutions

30

Strategic Focus Area 2 – Education and Training

• Improve quality of nursing education– Nursing Education Institutions to be

integrated into higher education institutions– Facilitate registration of nursing education

institutions as FET and HET institutions– Review the role of nursing auxiliaries

within the health care system

31

Strategic Focus Area 2 – Education and Training

• Ensure implementation strategy for recognition of prior learning (RPL) for nurses– Establish RPL assessment centres in

provinces– Implement RPL in all provinces

32

Strategic Focus Area 2 – Education and Training

• Promote professional development for nurses– Improve selection criteria for trainees– Conduct pre-selection interviews– Conduct pre-selection medical assessment

for prospective students– Develop a plan for training and re-training

in relation to reviewed scopes of practice

33

Strategic Focus Area 2 – Education and Training

• Improve research capacity of nurses– Conduct extensive training in research

methodology– Facilitate nursing research amongst

academic institutions and health facilities

34

Strategic Focus Area 3 – Nursing Leadership

• Identify and position nursing leadership in all aspects i.e. registration, practice, education and labour– Identify and position nursing leadership

strategically in organizational structures at all levels i.e. nationally and internationally

35

Strategic Focus Area 3 – Nursing Leadership

• Enhance nursing leadership capacity to ensure good governance at all levels– Audit of skills and competencies, training and

development plan

– Leadership development programmes in place

– Recognize, utilize and reward expertise

– Develop and implement mentorship and coaching programmes

– Deploy nurses to situations which enhance and develop their leadership capacity

36

Strategic Focus Area 3 – Nursing Leadership

• Identify and nurture potential and emerging nurse leaders– Increased growth of leadership numbers of

nurses involved in academic issues pertaining to health and nursing

37

Strategic Focus Area 3 – Nursing Leadership

• Attract young nurses to nursing academia– Encourage academic leaders to positively

influence young nurses into academic debates on health systems

38

Strategic Focus Area 4 – Nursing Regulation

• Implement the Nursing Act, 2005 (Act No. 33 of 2005)– Establish the Nursing Council in terms of the new

Act

– Regulate registration and licensing of nurses

– Regulate scopes of practice, nursing education

– Implement community service for nurses

– Introduce CPD for nurses

– Regulate ethical code and conduct of nurses

39

Strategic Focus Area 4 – Nursing Regulation

• Ensure high standards of professional self governance– Adherence to corporate governance by the

professional regulator (SANC) in accordance with the new Nursing Act

– Perform periodic governance audits

• Ensure quality service and protection of the public– Educational programmes, professional

values responsive to public needs

40

Strategic Focus Area 4 – Nursing Regulation

• International Benchmarking– Policies compare with international best

practice– Nursing legal framework benchmarked and

updated regularly

41

Strategic Focus Area 5 – Social Positioning of Nursing

• Restore the image of nursing and maintain professionalism

• Improve understanding of political focus of the country

• Improve social infrastructural support i.e. accommodation, EAP and housing subsidies

42

Strategic Focus Area 5 – Social Positioning of Nursing

• Promote nursing as a career of choice– Market nursing as a career of choice– Create attractive employment opportunities

for nurses– Recruitment and marketing strategy for

nursing implemented

43

Strategic Focus Area 6 – Resources for Nursing

• Ensure safe nurse practice with appropriate nursing resources– Guidelines on safe nursing practice

• Ensure sustainability of nursing– Adequate funding of nursing services– Attractive incentives and remuneration

structures for nursing posts– Adequate provision for continued education

and development

44

Strategic Focus Area 6 – Resources for Nursing

• Quality assurance of clinical learning facilities– Audit of clinical facilities– Assess quality of learning facilities and

upgrade– Enabling accreditation processes to take

place internally and externally– Provide adequate funding for nursing

research

45

Strategic Focus Area 6 – Resources for Nursing

• Improve workforce planning– Work-study to address needs of institutions

with the illnesses of staff and HIV in mind to review the staff establishment of health institutions

– Develop Human Resource Plans (Nursing) institutional, district, provincial and national level

– Develop capacity for Human Resource Planning

46

Strategic Focus Area 6 – Resources for Nursing

• Developing nursing academics / nurse educators– Develop a National Health Sciences

Academic Programme

47

CONCLUSION

In conclusion the Department of Healthlooks forward to the endorsement of theDraft Nursing Strategy for South Africa

with a view of developing similar strategies for other health care

professionals so critical for effective health

care delivery within the country

THANK YOU