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 nursing in the health system

6 Overview Intention: -Develop a coherent approach towards dealing with nursing challenges thus provide a common platform -Each stakeholder to address issues that affect their core business Strategy must therefore be a unifying platform explicitly addressing all nursing issues

7 Overview Central to the Nursing Strategy:- Good quality education and training -Nursing practice (providing an enabling environment for nursing service delivery) -Good nursing leadership in all aspects of nursing -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 possible networks i.e. - How nursing can remain a profession that offers access to all whilst lifting the bar in terms of quality education and training - Finding ways of embracing the benefits of globalization in a manner that improves nursing - How nurses can improve the image of their profession

12 Implementation Framework Similar approach to HRH Plan Strategies proposed with understanding that further development & implementation of each strategy will require unifying efforts of all stakeholders Primary responsibility & output measures for each strategic focus identified. Cost implications of strategies to be considered 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 affairs successfully 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 Health looks forward to the endorsement of the Draft 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