New Zealand Nurses Organisation media release, 8 May 2024

The New Zealand Nurses Organisation NZNO Tōpūtanga Tapuhi Kaitiaki o Aotearoa has received information under the Official Information Act revealing the alarming nurse staffing crisis in New Zealand hospitals.

During the year ending 31 December 2023 more than a quarter of nursing shifts were below target staffing numbers, and some wards operated below safe staffing levels nearly all of the time.

NZNO Chief Executive Paul Goulter said the nursing staffing crisis remains a daily reality, with nurses continuing to leave because of burnout and concerns about pay and their health and safety at work.

“We have an impoverished health system that continues to be eroded by the Coalition Government’s spending restraints and frontline service cuts.

“Te Whatu Ora staffing data from 2023 reveals just how dire the situation has become and it’s no surprise nurses are leaving faster than they can be replaced.”

Mr Goulter said that of particular concern was ‘shifts below target’ at wards for the treatment of children, cancer (oncology), surgical needs, women’s health and mental health. Shifts below target indicate a heightened level of risk for patient safety, patient outcomes and nursing workforce safety. Patient mortality increases with exposure to increased numbers of shifts below target.

“More than half of the country’s children’s wards are understaffed at least 20 percent of the time. The Neonatal Intensive Care ward at Waipapa Christchurch Hospital (865 shifts below target) was understaffed for nearly 80 percent of all shifts last year.

“Five out of eight adult inpatient oncology wards were understaffed 20 percent of the time or more, with the most understaffed being Waikato Hospital Ward M05 (638 shifts below target). This fell below the rate of understaffing of Starship Hospital’s children’s cancer Ward 27B, which reported 791 shifts below target or nearly three quarters of all shifts in 2023.

“Fifty-six percent of surgical wards are understaffed 20 percent of the time or more, with the most understaffed being Waikato Hospital’s M08 Neurosurgery Ward (735 shifts below target)

“Almost half of women’s health wards are understaffed 20 percent of the time or more, with the most understaffed with Middlemore Hospital accounting for five of the six highest shifts below target reports.”

But mental health wards report the most acute levels of understaffing. Three wards reported more than 1000 shifts below target, with the Mason Clinic’s Tane Whakapiripiri ward in Waitematā being understaffed 99.45 percent of the time. This means only six shifts were safely staffed there in 2023. 

Mr Goulter said this is what failure to properly fund health looks like on the front line and that the data shows we simply cannot afford any further service or funding cuts.

“Budget 2024 will be released at the end of the month and may be the Coalition Government’s last chance to show they care about health and to address the staffing problem by funding proper patient care for our loved ones and whānau into the future.”

On Thursday 9 May nurses across Aotearoa New Zealand will be holding public rallies at more than 20 locations across the country where they will picket and speak about safe staffing issues and solutions such as legally mandated nurse-to-patient ratios.

-Ends-

Media enquiries: Rob Zorn, NZNO Media and Communications Advisor: 027 431 2617 | media@nzno.org.nz

More information – Te Whatu Ora shifts below target 2023

Through a recent OIA request, NZNO received shift below target data from Te Whatu Ora from 540 public health wards over the reporting period 1 January 2022 – 31 December 2023. This report includes detailed analysis of trends and insights into the scale and extent of understaffing in public hospitals reported through the CCDM programme.

The full OIA response from Te Whatu Ora is available to journalists on request.

Shifts below target

Shifts below target indicate a heightened level of risk for patient safety, patient outcomes and nursing workforce safety and morale. Shifts below target mean there is inadequate staffing in either the numbers of staff on the floor or the skill mix and competencies of staff available to provide patient care. This can increase the incidence of adverse events or near misses such as falls or medication errors, care rationing where care is missed, delayed or sub-optimally delivered or in some cases work left undone due to lack of time, resource, or communication. Patient mortality increases with exposure to increased number of shifts below target.

Official information request

Te Whatu Ora’s response to our official information request reveals that widespread and sustained understaffing remains at crisis levels across Aotearoa New Zealand. Here are some salient points from the data provided in answer to our OIA request; mostly from 1 January – 31 December 2023.

• On average more than one in four (26 percent) Te Whatu Ora hospital shifts (n=158,966) were understaffed in 2023.
• The three Auckland districts (Auckland, Counties and Waitematā) accounted for just over one third (34.5 percent) of all understaffed shifts reported last year, reporting a combined 54,834 shifts below target in 2023.
• This single district reporting the highest number of shifts below target in 2023 was Capital, Coast and Hutt Valley, reporting 22,163 shifts below target.
• Of the 540 Te Whatu Ora hospital wards where shifts below target data was provided, 297 reported shifts below target for at least 20 percent of all shifts in 2023.
• There were 168 wards that reported shifts below target of at least 33 percent of the time in 2023. Seventy-eight wards reported shifts below target rates greater than 50 percent of the time.
• Twenty Te Whatu Ora hospital wards reported shifts below target for more than two thirds of all shifts.
• The four wards reporting the highest levels of understaffing are in the mental health sector, all reporting more shifts below target for more than 90 percent of shifts in 2023 in Waitematā and Capital, Coast and Hutt Valley districts.
• Mental health related wards comprise 7 of the 20 most understaffed wards in 2023.
• More than half (55.5 percent) of the 63 children’s wards for which data was provided reported shifts below target more than 20 percent of the time. Fifteen children’s wards reported shifts below target more than 50 percent of the time.
• The most understaffed children’s ward in 2023 was the Neonatal Intensive Care ward at Waipapa Christchurch Hospital, reporting 865 shifts below target.
• Five of the eight adult inpatient oncology wards reported shifts below target more than 20 percent of the time.
• The most understaffed oncology ward was Waikato Hospital ward M05 Haematology Oncology, reporting 638 shifts below target in 2023, more than half of all shifts.
• Fifty-six percent of surgical wards reported shifts below target more than 20 percent of the time.
• The most understaffed surgical ward in 2023 was Waikato Hospital’s M08 Neurosurgery ward, reporting 735 shifts below target. This is a 53 percent increase in reported shifts below target from 2022.
• Thirty-seven (nearly half) of the 79 women’s health wards reported shifts below target more than 20 percent of the time. Of these 24 reported shifts below target more than a third of the time.
• Middlemore Hospital accounts for five of the top six highest shifts below target reports in women’s health wards in 2023.
• All five of the women’s health and maternity wards at Middlemore Hospital were understaffed at a rate more than 50 percent of the time.
• Fifty-two (57 percent, n=91) of mental health wards reported shifts below target more than 20 percent of the time.
• Mental health wards report the most acute levels of understaffing in the health system.
• Three wards reported over 1000 shifts below target in 2023. The Mason Clinic’s Tane Whakapiripiri ward in Waitematā was understaffed for 99.45 percent of all shifts in 2023, and the Te Aka ward was understaffed for 97.72 percent of all shifts.