A new survey has found two in five frontline nurses in New Zealand are being asked to take extra shifts weekly, often resulting in a "poor" mental state.
The findings are evidence of why the health system needs reforming, Health Minister Andrew Little, who ordered the report, said on Thursday.
"I ordered this review back in August because of the long-standing concerns of the Nurses' Organisation and the Public Service Association about a lack of follow-through by District Health Boards (DHBs) on the safe-staffing accord for public hospitals," Little said.
"The review report, which I'm releasing today, confirms those concerns."
Health organisations have urged the Government to declare a health workforce emergency and take urgent action as New Zealand braces for a major Omicron outbreak.
"Across all sectors, from DHB to primary care and iwi providers, we simply can't keep up. Come Omicron, and come winter, we will see the system collapsing under the strain," Kerri Nuku from the New Zealand Nurses Organisation (NZNO) said in January.
She called for Government-funded nursing recruitment drives, free nursing study, prioritised managed isolation spots specifically for nurses and health care workers, supply of the best PPE, rapid antigen tests and robust home isolation procedures.
But last week it was reported a group of New Zealand-trained nurses - some working with COVID-19 patients - were considering leaving the country because they couldn't get a visa, despite the staffing shortages.
The Nursing Safe Staffing Review has found 83 percent of staff said patients in understaffed shifts were not receiving complete care and 53 percent of frontline nurses reported being in a poor or very poor mental state on understaffed shifts.
The recommendations of the review, led by former NZNO associate professional services manager Hilary Graham-Smith, include increasing nursing supply "immediately" and re-designing key components of the CCDM programme to ensure it is fit-for-purpose.
The Care Capacity Demand Management Programme (CCDM) was agreed to in 2006 by the previous Labour Government to monitor and manage nursing staffing levels in hospitals.
CCDM is a programme adopted to help ensure there are enough nurses on-site at particular times and locations.
Addressing staff shortages was a key demand of nurses who went on strike last year over pay and working conditions.
CCDM was to be implemented in 2009 under the previous National Government and it was due for completion across all DHBs by June last year - but that didn't happen.
"When Labour returned to Government we committed to proper implementation of CCDM by June 2021 and we provided additional funding for District Health Boards to do it," Little said.
"However, just seven DHBs met that deadline. This is not acceptable. This inconsistency between DHBs is one of the reasons why we are reforming the health system."
The half-a-billion-dollar health system restructure Little mentioned were announced in April last year. The Government will create a new organisation, Health NZ, to replace the 20 District Health Boards. It will work in partnership with a new Māori Health Authority.
"Under the reformed health system, the 20 DHBs will be replaced in July by a single national agency, Health New Zealand, which will be better able to plan for and manage the nursing workforce right across the country," Little said.
"It is critically important that we fix the nursing shortage for the sake of our overworked nurses and to ensure the safety of patients and our health reforms will make nationwide workforce planning much easier as well as ensuring greater accountably."
The National Party opposes the health reforms, insisting such significant resources should be spent more wisely during a pandemic. The Government has given itself a mammoth "one-off" $6 billion operating allowances for 2022 to pay for the reforms.
"Andrew Little is wrecking the health system and the hard work and goodwill of health workers in the middle of a pandemic," National's health spokesperson Shane Reti said in October.
"Labour did not campaign on complete removal of all DHBs, a commissioning Maori Health Authority or a Māori health veto," Dr Reti said. "The Government has no mandate for these changes."
