Nursing manpower in public hospitals

18/05/2016

 

Following is a question by Professor Hon Joseph Lee and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (May 18):

Question:

     Regarding the nursing manpower in public hospitals, will the Government inform this Council:

(1) whether it knows the following information in respect of each of the specialties in various public hospitals in each of the past five years: the number of nurses, the inpatient bed occupancy rate, as well as the respective nurse-to-bed ratios for the three shifts of morning, afternoon and night (set out by name of hospital and by specialty in a table);

(2) as the inpatient bed occupancy rate in various acute hospitals generally exceeded 100 per cent during the recent influenza peak season, of the measures taken by the Hospital Authority (HA) in respect of manpower, resources deployment and operation to relieve the shortage of nursing manpower, as well as the measures in place to deal with the shortage of nursing manpower in the long run; and

(3) given that the Government has mentioned in this year's Policy Address that some 5 000 additional public hospital beds will be provided under its hospital development plan for the coming decade, of the number of beds for specialist services among these additional beds; the projected number of additional nurses to be recruited, occupancy rate of these additional beds, and respective nurse-to-bed ratios for the three shifts of morning, afternoon and night (set out such information by name of hospital); the details of HA's overall nursing manpower plan in the coming decade, and the projected annual numbers of nurses to be recruited (broken down by rank of nurses)?

Reply:

President,

     My reply to Professor Hon Joseph Lee's question on the nursing manpower in public hospitals is as follows:

(1) The Hospital Authority (HA) provides different types and levels of services for patients according to their individual conditions and needs.  To meet the operational needs, HA deploys nursing manpower flexibly, and does not set rigid nurse-to-patient ratios.  Neither has HA prescribed any nurse-to-bed ratios for the morning, afternoon and night shifts.  Nevertheless, HA has developed a workload assessment model to assess the nursing workload and staffing requirements based on factors such as patient number, patient dependency and nursing activities.  HA will take into account the manpower requirements as assessed by this model when planning new services.

     Annex 1 and Annex 2 set out the number of nurses and bed occupancy rates of various HA clusters in the past five years respectively.

Annex 1

Annex 2

(2) In order to cope with the increase in service demand due to the ageing population and prevalence of seasonal influenza, HA has included service capacity enhancement as a key element in the 2015-16 Annual Plan.  Apart from providing 250 new beds, HA will, on top of the additional resources for the provision of these 250 new beds, provide extra doctors, nurses and other supporting staff to strengthen services.  In 2016-17, HA will continue to augment service capacity, including providing 231 additional beds and continuing to recruit healthcare staff.  It is projected that the number of full-time equivalent doctors, nurses and allied health professionals for the year will be increased by 145, 411 and 234 respectively as compared to 2015-16.

     To further cope with the increase in service demand due to the prevalence of seasonal influenza, HA has formulated a series of step-up measures to provide support for discharged patients and emergency services, and enhance bed deployment and patient flow.  Examples of such measures include enhancing support for discharged elderly patients through the Community Geriatric Assessment Service, increasing the service capacity of convalescent hospitals and further facilitating the transfer of patients in stable condition to convalescent hospitals within the cluster.  Moreover, from mid to end March 2016, HA has increased the weekly general out-patient clinic quota by around 2 000 to ease the burden on accident and emergency departments.

     On manpower, HA has implemented the following measures to address manpower shortage:

(a) Special Honorarium Scheme (SHS): To better utilise existing manpower to address service demand during winter surge, HA Head Office will co-ordinate the SHS and provide funding for its implementation.  Greater flexibility for participation is allowed to encourage more colleagues to join the scheme;

(b) Continuous recruitment of full-time and part-time healthcare staff:  Public hospitals will continue to recruit full-time and part-time healthcare staff.  HA Head Office will co-ordinate and provide funding for the recruitment of part-time healthcare staff to strengthen the flexibility in staff deployment, thereby easing the workload of frontline staff; and

(c) Special Retired and Rehire Scheme (SRRS): Depending on service needs and funding availability, HA will consider extending the existing SRRS to retired doctors, nurses, allied health professionals and supporting staff as appropriate subject to an age limit of 65.

     In addition, HA also continues to launch a series of measures to retain talents.  These measures include:

(a) Enhancement of promotion opportunities: During the period from 2008-09 to 2015-16, HA created 106 Nurse Consultant posts.  In 2014-15, an additional Senior Nursing Officer post was created for each of the cluster hospitals.  During the past three years, a total of 1 358 nurses were promoted;

(b) Provision of more training opportunities:  The Institute of Advanced Nursing Studies of HA offers 26 nursing specialist training courses each year for nurses to continuously pursue further studies after graduation.  HA will also provide subsidies for over 100 senior nurses to undergo further studies and training overseas each year;

(c) Enhancement of preceptorship support:  Under HA's preceptorship program, experienced nurses are recruited through formats such as special allowance and part-time employment to serve as preceptors to provide guidance for newly recruited nurses in an actual clinical setting, thereby familiarising them with ward procedures and environment as well as alleviating the work pressure of other experienced nursing staff in coaching new nurses.  HA will also provide simulation training for newly recruited nurses to enhance their first aid and emergency handling skills;

(d) Improvement of work environment:  HA has installed 6 000 additional electrically-operated beds and over 500 ceiling hoist systems to facilitate the lifting and transfer of patients.  This can help simplify the burdensome work processes of ward staff and improve the work environment and facilities, thereby relieving the work pressure of frontline nurses; and

(e) Recruitment of additional ward clerks and ward assistants:  HA will recruit additional ward clerks and ward assistants to assist nurses in carrying out clerical work and providing patient care to ease the workload of nurses.

     With the implementation of various measures to improve manpower supply, the number of nurses in HA has been increasing in the past few years.  The number of full-time equivalent nurses increased from 22 759 on March 31, 2014 to 24 548 on March 31, 2016.  In 2016-17, HA plans to recruit more than 1 700 nurses and it is expected that the number of nurses will be increased to 24 959 on March 31, 2017.

(3) HA will take forward the construction, expansion and redevelopment of various hospital projects in the coming 10 years to provide about 5 000 additional beds to meet the healthcare service needs of the public. 

     In enhancing the hardware and service capacity of hospitals, HA also attaches great importance to healthcare manpower supply.  Nevertheless, as mentioned in (1) above, HA will deploy nursing manpower flexibly to meet the operational needs and will not set rigid nurse-to-patient or nurse-to-bed ratios.  Other details such as the number of beds in different specialties, the number of additional nurses required and the expected bed occupancy rate will be worked out at a later stage.

     HA has a mechanism in place to assess manpower requirements and conduct manpower planning to ensure the sufficient provision of healthcare staff to meet the needs.  Moreover, HA has been recruiting full-time and part-time nursing staff and it will actively employ any suitable candidates who meet the job requirements.

     On the training of local nurses, there are currently over 2 800 nursing training places in Hong Kong each year.  The University of Hong Kong, Chinese University of Hong Kong and Hong Kong Polytechnic University provide a total of 630 University Grants Committee-funded degree places annually.  HA, private hospitals and other higher education institutions also operate a variety of self-financing nursing programmes, offering 400, 310 and 1 537 places respectively each year.  The Government provides subsidies for students to pursue designated self-financing undergraduate programmes in nursing discipline starting from 2015-16 academic year.  The number of subsidised places increased from 420 in 2015-16 academic year by 60 to 480 in 2016-17 academic year.  HA anticipates that with the increasing number of nursing graduates in the coming years, the problem of shortage in nursing manpower will be alleviated.

     On the training of non-local nurses, the Nursing Council of Hong Kong has increased the frequency of the Licensing Examination from once to twice a year since 2016 to attract more non-locally trained nurses to practise in Hong Kong, thereby alleviating the problem of the shortage in nursing manpower in the local public and private healthcare system.

     In response to the challenges of an ageing population and increasing demand for healthcare services with higher expectations, the Government is conducting a strategic review on healthcare manpower planning and professional development in Hong Kong.  The review aims to make recommendations that would enable our society to better meet the projected demand for healthcare professionals including nurses as well as to foster professional development.  We expect that the review will be completed in mid-2016.  The Government will then publish the report and consult stakeholders on how to take forward the recommendations accordingly.

     HA will continue to monitor the manpower situation and implement various measures to attract and retain staff, with a view to relieving the situation of the shortage in nursing manpower.  In addition, appropriate arrangements will be made in manpower planning to ensure sufficient provision of healthcare manpower and facilities to meet service demand upon completion of various hospital development and redevelopment/expansion projects.

 

 
Last Updated 2016-05-18