1. Making nursing care more attractive A multi-annual plan to make nursing care more attractive in Belgium (2008-2011)

2. Making nursing care more attractive An ambitious plan 4 areas for action 1.Easing workload and stress for the nursing staff 2.Qualifications 3.Remuneration 4.Social recognition and participation in decision-making 3 sectors 1.Hospitals 2.Nursing and residential homes for older people 3.Home care 2 objectives 1.Enhancing the attractiveness of the nursing profession 2.Providing professionals able to meet patients nursing needs and changes

3. Making nursing care more attractive In progress: 1. Implementing the 2005-2010 Social Agreement 1 extra FTE nurses or auxiliary per 30 hospital beds can be used by hospitals to create a moving team (2009-2011) 2. Relaunching Training project 600 auxiliary nurses know the nurse job, are motivated to do it, need help to study auxiliary nurse salaries is given to employer to liberate her to go back nursing school and engage someone else for the auxiliary nurse's job (a lot on labour market !) Target group: 350 FTE every year (= 536 person in 2009) =19 million /year 3. Digitalising nursing information in patient records Nurses have to care, not to collect data, ND-HMDS (used for financial or health statistics) must be automatically extracted from nursing files (from 2009 : 16,3 million /year) Planned : 1.Extra non-nursing jobs : providing administrative and logistic assistance to care units 2.Stimulating ergonomic investments (study in progress about recommendations) 3.Ensuring a better match between funding and nursing needs (study in progress) 4.Providing finance for the promotion of care that helps to maintain or recover residents independence + support and counsel from a nurse specialized in geriatric care Action 1: easing workload and stress

4. Making nursing care more attractive The EU fringe Belgium about nursing qualifications and EU36 directive (2 levels, great autonomy for schools, sometimes not enough hours…) : an opportunity to take a new model ? Continuous training is necessary to guarantee that qualifications are matched by needs -Hospitals : gradually increase the funding (1 million in 2009 = + 7,5%) -Nursing and residential homes for older people / home care services: implementing an accreditation scheme which provides for a higher reimbursement rate for some services on the condition that a continuous training programme is attested (home care services: 1,75 million in 2010, others : system in study) "Different patient patterns mean different nursing needs - Different qualifications mean different functions". This differentiation will occur as follows: -Further investigation on differentiating functions on the basis of patient patterns and Studies on the nursing contents of the Hospital Minimum Data Set (ND-HMDS) Imposing a growing number of specialized nurses by means of existing standards -A gradual recognition process, in a coherent framework, having regard to priority care needs -2008 : geriatric specialization and expertise, 2009 oncology specialization (2010 : paediatric, diabetology ?) Stimulating Masters degrees in nursing and obstetrical care Considering how to legally extend autonomous practices and care prescriptions. Action 2: qualifications (proposals)

5. Making nursing care more attractive 1. Upgrading irregular services Continuity of care means a high number of working hours restricting family and social activities and leading to additional costs. Bonus per hour for services in the early morning or evening (6 a.m. - 7 a.m. / 7 p.m. – 10 p.m.) 63 millions for 2010 2. Increasing financial value of basic specialties and special competences officially recognized expertise and specialization + Practice in the relevant sector is compulsory between 5 and 10 % of the current pay scale : 27 millions for 2010 3. Nursing executives Further improving the value of executive tasks, first by extending the so-called complément fonctionnel (extra bonus for managerial activities) and afterwards by granting a pay level compatible with relevant legal training requirements (from 2009 : 800 net/year/head nurse) 4. Home care – in study Differentiating functions, tasks and responsibilities = adapting the health care reimbursement scheme Supporting and upgrading nursing consulting Upgrading treatments by specialised nurses Upgrading group practices (including between self-employed nurses) Supporting inter-professional co-operation and alternatives to hospitalisation Action 3: remuneration

6. Making nursing care more attractive Proposals: Consolidating the positioning in health care establishments: - In hospitals: head of the nursing department and nurse managers - In nursing and residential homes for older people: further staff structuring GETTING BETTER KNOWN by launching a publicity campaign in the spring of 2009 with nurses ambasadors Improving participation in decision-making processes at all levels : 1.In the KCE: adding 2 members to the BD, nominated by professional organisations 2.Multi-partite Structure for Hospital Policy-Making: - ensuring nursing representation as such - setting up a section (still to be determined) with nurse representatives 3.At the INAMI (National Institute for Health and Disability Insurance): reviewing the composition of the Commissions de convention (Agreement Committees) 4.At the Conseil fédéral pour la qualité de lactivité infirmière (Federal Council for Nursing Quality): adding and financing nursing peer groups (1 for each basic specialty) as part of the Federal Council 5.In hospitals: mapping out the tasks and functioning of the Nursing Council by ensuring the participation of nurses from baseline With regard to ethical matters, the creation of a National Order for Nursing must be discuted Structural funding for nursing professional organisations: the INAMI will grant funds for the UGIB. Action 4: social recognition and participation in decision-making