PRIMARY CARE STAFFING GUIDELINES

Currently, there are no agreed or official ratios for RN staffing levels in primary care. Relevant factors when determining these may include:

Patient variables such as social deprivation index, chronic disease numbers, percentage of elderly patients, children, or Māori or Pasifika patients

Operational variables such as telephone triage volume, admin workload, or outreach work, and

Other staffing variables including general practitioner (GP) and/or nurse practitioner (NP) FTE numbers, RN role/functions, and support staff numbers and functions.

An Australian example sets 1 RN to each GP (Primary Health Network). 

Applying this for Aotearoa New Zealand, this could be 1 RN for each GP or NP. If for a high-needs situation, it could be 1.5 to 2 RNs for each GP or NP.

UK/NHS general practice suggests 1 RN for every 1,800-2,500 enrolled patients. 

Applying the NHS ratio to Aotearoa New Zealand, this could be 1 RN for every 1,800-2,500 enrolled patients or 1 RN for every 1,000 patients for high-needs populations.

Appointment-capacity modelling offers another approach: Instead of ratios, numbers are set in relation to the number of consultations, for example each RN is assigned 12-20 patient contacts/consultations per day depending on role/functions, e.g. immunisation clinics, cervical screening, chronic disease management, triage, care coordination, etc.

A General Practice New Zealand workforce-modelling document suggests a workforce mix (including nurse FTE per population). Example modelling includes about 7.3-8.4 nurse FTE per 10,000 population, depending on need level. This equates roughly to ~1 nurse per 1,200-1,400 patients for high-needs populations.

These are guidelines only. There are no statutory or specific regulatory guidelines or similar for Aotearoa New Zealand.

Requirements for vaccinations (New Zealand Immunisation Handbook)

Minimum requirements:

o   An authorised vaccinator present (RN, NP, doctor, pharmacist), and

o   One ‘trained’ observer (e.g. RN, EN, HCA, PCA, or admin trained in first aid emergency response).

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