Replies to LegCo questions
LCQ3: Nursing manpower in public hospitals
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.
(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.
Thank you, Mr President.
Ends/Wednesday, May 18, 2016
Issued at HKT 16:32
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LCQ3 Annex 1
LCQ3 Annex 2