PRIMARY CARE STAFFING GUIDELINES
Some information designed to assist with setting nursing staff levels in primary care.
Currently, there are no agreed or official ratios for RN staffing levels in primary care. Relevant factors when determining these may include the following variables:
o social deprivation index/socioeconomic factors
o percentage of elderly patients
o percentage of children
o Māori or Pasifika numbers
o chronic disease numbers
o immunisation demand
o telephone triage volume
o admin workload
o standing orders/prescribing scope
o outreach work (workplace visits, home visits, marae clinics)
o aged-care visits
o RN role/functions
o nurse prescribers
o support staff numbers and functions
o general practitioner (GP) and/or nurse practitioner (NP) FTE numbers.
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. Reference: National Health Service, England. (2022). General practice workforce planning and development toolkit. https://www.england.nhs.uk.
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.
Reference: General Practice New Zealand. (2022). General practice workforce discussion document. https://gpnz.org.nz/wp-content/uploads/Workforce-Resources-FINAL-DISCUSSION-DOC.pdf
Note: 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)
o plus one ‘trained’ observer (e.g. RN, EN, HCA, PCA, or admin trained in first aid emergency response).
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