Replies to LegCo questions

LCQ17: Nursing services for specialties of Hospital Authority

Following is a question by the Professor Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (January 21):

Question:

Some nursing staff of specialties have pointed out that under the rapid development of healthcare services, the nursing manpower planning for specialties has a direct impact on the quality of healthcare services. In this connection, will the Government inform this Council whether it knows:

(1) the current number of specialties in various public hospitals, with a breakdown by hospital cluster and name of hospital;

(2) the current number of nurse consultants in various specialties of public hospitals, with a breakdown by hospital cluster and name of hospital; of the duties of nurse consultants in various specialties;

(3) the respective current numbers of advanced practice nurses and nurse specialists in various specialties of public hospitals, with a breakdown by hospital cluster and name of hospital;

(4) whether the Hospital Authority (HA) has set ratios of nurse consultants to advanced practice nurses/nurse specialists for various specialties; if HA has, of the details; if not; the reasons for that;

(5) whether HA has formulated a policy of "one nurse consultant for each specialty", in order to maintain and enhance the effectiveness of nursing services; if HA has, of the implementation of the policy; if not, the reasons for that;

(6) among the registered nurses currently employed by HA, of the number and percentage of those who have received specialist training; whether HA has plans to increase local and overseas specialist training opportunities to dovetail the development of nursing services; if HA has such plans, of the details; if not, the reasons for that; and

(7) whether HA has any concrete plan to improve the quality of nursing services; if HA has such plans, of the details; if not, the reasons for that?

Reply:

President,

With an ageing population and advancement in medical technology, the Hospital Authority (HA) has taken active measures to enhance the quality of nursing services.

My reply to the various parts of the question is as follows:

(1) General specialty services are provided under the cluster arrangement of the HA. Major specialty services provided by the clusters of HA are listed as follows:

(i) Emergency Medicine
(ii) Anaesthesiology
(iii) Ear, Nose and Throat
(iv) Family Medicine
(v) Medicine
(vi) Obstetrics and Gynaecology
(vii) Ophthalmology
(viii) Orthopaedics and Traumatology
(ix) Paediatrics
(x) Pathology
(xi) Psychiatry
(xii) Radiology
(xiii) Surgery

In general, classification of the specialty and sub-specialty services of the HA are based on the classification by the Hong Kong Academy of Medicine and respective Colleges. The arrangement of specialties and sub-specialties of each HA hospital may vary. Provision of certain sub-specialty services such as Cardio-thoracic Surgery and Oncology is centralised in a few hospital clusters. Through inter-cluster and inter-hospital support, patients can receive a comprehensive range of specialty services.

(2) and (3) There are a total of 93 nurse consultants and 4 551 advanced practice nurses / nurse specialists / nursing officers / ward managers in the HA, providing nursing services in Medicine, Obstetrics and Gynaecology, Orthopaedics and Traumatology, Paediatrics, Psychiatry, Surgery, Emergency Medicine, Critical Care Medicine and other specialties. The breakdown for each hospital cluster is set out in Annex.

Nurse consultants have the following five major functions and duties in respect of specialist services:

(i) Expert practice: act as clinical care consultants, provide patient-oriented nursing services for patients with complex conditions and co-ordinate different specialties in the hospital;

(ii) Specialist service development: formulate specialty service development model, launch new service plans and strengthen the interface between hospitals and the community;

(iii) Specialty education: provide specialty education via the cluster network;

(iv) Continuous quality improvement planning: work out the plan for continuous improvement in the quality of nursing specialty services; and

(v) Specialty research: promote evidence-based nursing and put it into practice.

(4) and (5) Apart from supporting the development of the nursing profession, the main reason for creating the post of nurse consultant is to improve the services of the HA through the enhanced nursing profession, so as to meet the increasing public demand for healthcare services.

In consider creating new positions of nurse consultant, besides considering actual needs for nursing services, the HA also needs to take into account opportunities for nurse consultants to play a leading role in clinical care and facilitate nursing specialty service development, as well as other factors such as strategic priorities of medical services, service mode, service target, opinions of healthcare partners and patients, and sustainability of service requirements. Therefore, currently the HA has not adopted the policy of "one nurse consultant for each specialty", nor has it set the ratios of nurse consultant to advanced practice nurse/nurse specialist.

However, the HA will prudently review the actual service needs and consider the service mode and demand to keep improving the quality of nursing services. Additional posts of nurse consultant will also be created to cope with the strategic priorities in the annual plans of the HA for better healthcare services. Since 2011, HA has employed an additional 86 nurse consultants.

(6) and (7) The HA endeavours to facilitate the nursing specialty training to keep abreast with the development of healthcare services. Its Institute of Advanced Nursing Studies organises 26 specialty training courses which provide about 1 100 places each year. As at September 30, 2014, a cumulative total of 5 032 registered nurses had received specialty training in the institute, accounting for about a quarter of the total number of nurses in HA (excluding enrolled nurses, part-time employees and temporary staff).

In addition to nursing specialty training, the institute also organises skill enhancement programmes for different specialties to augment the knowledge and skills of nurses. The programmes dovetail with the policy objectives and services of the HA, and also tie in with the development of nursing services. The institute organises 270 to 300 enhancement programmes on specialty nursing care for about 9 000 to 11 000 participants every year.

Currently, nurses can also enroll in the specialty training programmes organised by tertiary institutions. To encourage continuous specialty training of nurses, the HA provides training subsidy for the nurses taking recognised specialty training programmes of tertiary institutions.

In addition to the provision of local training opportunities, the HA has launched a corporate scholarship programme since 2009-10 to sponsor the participation of advanced practice nurses and senior nurses in a four-week overseas training course on professional knowledge and skills. From 2010 to January 2015, a total of 522 nurses have received sponsorship for overseas training.

The HA attaches great importance to the specialty training of nurses, and will continue to review regularly the training needs of different specialties and formulate the direction for nursing specialty training, with a view to supporting the development of specialty services and enhancing the quality of nursing services.

Ends/Wednesday, January 21, 2015
Issued at HKT 14:01

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LCQ17 Annex