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Care Point - Care Capacity Demand Management

How CCDM improves health system reslience

What is the Care Point campaign?

Care Point is the NZNO campaign which promotes the implementation of the Care Capacity Demand Management (CCDM) Programme in District Health Boards. The CCDM programme matches patient demand with staff capacity to ensure the right number of staff with the right mix of skills are available.

Getting CCDM? Get involved!

Over the next few months we'll be highlighting each component of the care capacity demand management (CCDM) programme. The main components are

  • Staffing Methodology, which includes Work Analysis and FTE calculation, 
  • Variance Response Management, which has six tools and processes
  • Core Data Set, which is used to audit how well CCDM is working

Staffing methodology


The staffing methodology is made up of two tools, the FTE Calculation and the Work Analysis. Together these tools provide a method to determine the staffing FTE, the best work patterns and staff mix. The FTE is calculated from the required patient care hours, roster testing and available staffing hours (allowing for leave and study entitlements). The Work Analysis is derived from staff recording their activities over a minimum 2 week period. Staff also complete an end of shift survey on care rationing, missed breaks and staff satisfaction. The two tools are used together or at separate times. Results are then collated and analysed to inform roster patterns, budgeting and workforce planning.


The FTE Calculation and Work Analysis provides an opportunity to change the way things are done, by highlighting what is actually required to deliver patient care. The information collected helps identify where staffing (FTE and mix), work patterns or processes could be improved. This in turn will help ensure the budget reflects the current requirements for nursing care and that patients get the right care when they need it.


Completion of the FTE Calculation and Work Analysis is a team effort. The FTE Calculation requires input from the validated patient acuity system coordinator, unit and ward managers and business analysts. The Work Analysis is completed by nurses, health care assistants and has recently been piloted with allied health. All Care Capacity Demand Management (CCDM) tools and processes involve a collaborative approach from the health union and DHB partners.


Determining when to conduct the FTE Calculation and Work Analysis occurs through a process of prioritisation and decision making by the CCDM Council. The FTE Calculation should be an annual process for all ward/units using the validated patient acuity data. The Work Analysis should be conducted at least once for every ward/unit and thereafter periodically on the basis of identified need e.g. significant change in service delivery. FTE Calculation and Work Analysis findings are reviewed by the Local Data Council and CCDM Council.


Where to next depends on the findings of the FTE Calculation and Work Analysis. The study team identify opportunities for improvement e.g. FTE, staff mix, work patterns such as shift start and finish times, or processes. Agreed recommendations are documented in an 30, 60, 90 day action plan that is monitored by the Local Data Council and reported to the CCDM Council.

How does the Safe Staffing Healthy Workplaces Unit fit in?

A partnership between the District Health Boards and NZNO and the other health unions is key to the successful implementation of the CCDM programme. The work is facilitated and lead by the Safe Staffing Healthy Workplaces Unit.

Health unions and DHBs - a partnership approach

The Safe Staffing Healthy Workplaces Unit was established in 2007, and tasked to develop a programme to implement the recommendations from the 2006 Report of the Committee of Inquiry on Safe Staffing Healthy Workplaces.

The Report represented a shared commitment by the District Health Boards and NZNO to work together to agree on:

  • a mechanism for nurses, midwives and employers to respond immediately if workloads exceed the determined levels, and
  • a sustainable solution to safe staffing issues, developed in a way that has the confidence of nurses and midwives.

This commitment has led to the development of the CCDM programme, using the TrendCare software tool.

Introductory video to the Care Capacity Demand Management programme