Acting General Secretary s Report

Acting General Secretary s Report COMMITTEE OF DELEGATES MEETING 16 January 2018 New South Wales Nurses & Midwives Association held at 50 O Dea Avenue, Waterloo Contents Key Directon 1: Grow our capacity to influence 4 Albury Wodonga Health 4 Nolan House: Staffing HDU unit 4 Allity Aged Care 5 Nurses building collective power 5 Healthscope Private Hospitals 6 Member Growth and Development 6 Hunter New England Local Health District 8 John Hunter Hospital: Non-compliance with NHPPD requirements 8 Mid North Coast Local Health District 9 Coffs Harbour Health Campus: Care of non-maternity patients within Birthrate Plus FTE 9 Milstern Health Pty Ltd 10 Yagoona Nursing Home & The Ritz Nursing Home, Leura: Facility closures 10 Northern NSW Local Health District 10 Lismore Acute Mental Health Unit (Tallowwood): Plan to reduce staffing 10 Northern Sydney Local Health District 11 Hornsby & Ku-ring-gai Hospital: Non-compliance with NHPPD requirements 11 Manly Hospital: Non-compliance with NHPPD requirements 11 Ramsay Health Care 12 Member Growth and Development 12 St Vincent s Health Network 13 St Vincent s Hospital, Darlinghurst: Proposed bed closure over Christmas period 13 Trustee of the Roman Catholic Church for the diocese of Sydney 14 St Mary s Villa: Underpayment of Certificate III AiNs 14 Uniting 15 State-wide introduction of Household Model 15 Caroona Bonalbo Hostel: Facility closure 16 Western Sydney Local Health District 16 Westmead Hospital: Non-compliance with NHPPD requirements 16

Key Direction 2: Be innovative in our advocacy and bargaining 18 Family and Community Services 18 Dispute: Aspects of the forced transition of FACS staff to the NGO sector 18 Uniting 19 2017 Enterprise Agreement 19 Key Direction 3 Promote a world class, well-funded, integrated health system 21 Aged Care Campaign 21 ANMF national campaign 21 Education Program 22 NSWNMA Education Program 2017/2018 22 Aged Care Nurses Forum on Elder Abuse 22 Midwifery Forum 22 Northern Sydney Local Health District / Ministry of Health 23 Northern Beaches Hospital: Transition process 23 NSW Aged Care Roundtable 23 10 Questions to Ask 23 NSW Parliament 24 Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 24 NSWNMA Reference Groups 25 Aged Care 25 Climate Change 25 Midwifery 25 Reconciliation Plan 26 Scholarships 26 Bob Fenwick Mentoring Grants 2018 Program 26 Old People s Welfare Council Grant 26 Submissions and Inquiries 27 Aged Care Workforce Strategy Taskforce 27 Department of Health Specialist Dementia Care Unit 27 Inquiry: Provision of Drug Rehabilitation Services in Regional, Rural & Remote NSW 27 Inquiry: Quality of Care in Residential Aged Care Facilities in Australia 28 NSW Health Palliative Care Roundtables Consultation Paper 28 Work Health and Safety 28 Australian Standards Waste Management in Healthcare facilities 29 SafeWork NSW 29 Workplace WHS inspections 29 16 January 2018 Page 2 of 37

Key Direction 4: Promote the Association as a significant and professional advocate for the health system and our members 30 Environmental Issues 30 Australian Catholic University 30 Planetary Health & Sustainable Healthcare Forum 31 Key Partnerships 31 Ageing on the Edge of NSW 31 Australian Bariatric Innovation Group (AusBIG) 32 National Housing Conference 32 NCOSS Health Equity Alliance 32 Safe and Secure Hospitals Conference 33 Annexure 1 34 New Agreements Approved by Employees 34 16 January 2018 Page 3 of 37

KEY DIRECTION 1 Grow our capacity to influence In order to win better outcomes for our members, the Association* must grow our influence. Influence comes when Association members and member leaders have the ability to use their collective power to enforce rights and achieve new outcomes in their workplaces, their sector and within the health system. We define the health system as inclusive of everywhere our members work. STRATEGIES 1.1 Grow power and influence by increasing the number of Association members 1.2 Identify new member leaders who can build their workplace influence 1.3 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence 1.4 Grow the number of Association members actively engaged across the health, disability and aged care systems 1.5 Ensure a focus on retaining as many members as possible (* Association should be read to mean the New South Wales Nurses and Midwives Association and the Australian Nursing and Midwifery Federation New South Wales Branch) Albury Wodonga Health Nolan House: Staffing HDU unit Nolan House is a 24-bed Acute Mental Health Unit situated on the Albury Health Campus, which has three HDU beds and one seclusion room. In July 2016 members voted unanimously to close the HDU until all works identified to ensure safe patient care had been completed. Members have maintained this closure insisting that HDU clients are transferred to another facility. On 4 December 2017, management attempted to open the HDU. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Strategy 1.5 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible 16 January 2018 Page 4 of 37

At the time of the proposed bed closure, 20 members supported their peers who were on duty and insisted on speaking with the Chief Executive. Management was forced to negotiate with the members and after a considerable struggle they reached an agreement satisfactory to the members. Albury Hospital and Nolan House branches then met and moved several resolutions supporting their colleagues increasing the pressure on Albury Wodonga Health (AWH). AWH has maintained a consistent theme through the course of these complex negotiations and had insisted that the CCTV would no longer be used in the patients bedrooms in the HDU. The members disagreed with this proposal and sought a compromise. AWH has agreed to staff the HDU and the general ward separately, which will significantly improve care for patients in the general ward. CCTV will remain for six months and will be used on a case-by-case basis in the HDU. Orientation sessions of the new unit and education regarding policies and procedures are being provided by AWH management. WHS issues are being addressed and members have insisted on having input into all workplace inspections. The unit remained closed over the Christmas period despite significant pressure from management as not all WHS issues were resolved. Recruitment of staff is occurring including the addition of a new position of one FTE CNE for six months. Membership was at 81% density but has risen to 93%. Allity Aged Care Nurses building collective power After months of successful campaigning bargaining has commenced with Allity for a new Enterprise Agreement. The employer s intransigence to date has provided fertile ground to increase member engagement, recruit new members, educate about bargaining and identify and develop Member Leaders. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence 16 January 2018 Page 5 of 37

Key Direction 2 Strategy 2.5 Strategy 2.7 Campaign to extend enforceable staffing arrangements for safe patient care into other sectors Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Since the last report to the September 2017 Committee of Delegates, employees at Allity rejected the company s proposed variation to the Agreement. The proposed variation was: 1.8% pay increase 1 October 2017; 1.8% pay increase 1 October 2018; Removal of Care Manager classifications from the Agreement protection; and, New expiry date of 25 January 2019. Although the company did not report the percentage of staff who voted no, it is known from consultation with members that there was significant support for rejection of the company s offer. A Majority Support Determination application was lodged with the Fair Work Commission and during the hearing, Allity finally agreed to commence bargaining and the first negotiation meeting was held on 28 November 2017 where our claims were presented. At the most recent bargaining meeting on 19 December, Allity made an improved offer of 2% per year for four years but continued to press for Care Managers to be removed from the Agreement. They made no other offer on any of the claims, including ratios. The Association is currently engaging with member leaders to determine our response to this substandard offer. Member leaders have taken on an increasingly important role at Allity and have been working to engage non-members over the Christmas and New Year period to ensure the Union is in a strong position to continue to campaign. Membership growth. Education of members and potential members about bargaining and the Union s role in it. Identification and development of Member Leaders. Healthscope Private Hospitals Member Growth and Development In anticipation of the current NSWNMA Healthscope Enterprise Agreement expiring in 2020, an ongoing campaign in preparation of bargaining is well underway. This consists of a focus on growth and development of members, Branches and workplace leaders, in order to grow power and influence. 16 January 2018 Page 6 of 37

Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Strategy 1.5 Key Direction 2 Strategy 2.1 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights Prince of Wales Private Members are utilising the Nursing Practice Decision framework to address skill mix issues concerning night duty paediatric nursing. Mosman Private/Lady Davidson/Prince of Wales Private Member visits and education sessions Healthscope Hospital visits were undertaken to consolidate members understanding of industry superannuation and current pressing issues. Attending members were keen to know and understand and asked specific questions. Matters discussed and addressed included; current compulsory superannuation amounts and future increases, ordinary time earnings definition, payslips, proposed government legislation interference, retail funds agenda, combining multiple accounts, finding lost super, salary sacrifice and superannuation information sessions. The Hills Rehab/Sydney South West Private/Nepean Private Member visits and education sessions Education sessions were provided during recent workplace visits across key target sites. These were conducted to consolidate understanding of the Agreement provisions about shutdown and annual leave. This education was also reinforced through Know Your Rights material emailed and shared on Facebook. Increased NSWNMA visibility and presence. Membership growth. Developing and empowering leaders. Increased social media engagement and awareness. Increased awareness of rights to enforce and question the Enterprise Agreement. Increased members confidence and knowledge of their superannuation rights. 16 January 2018 Page 7 of 37

Hunter New England Local Health District John Hunter Hospital: Non-compliance with NHPPD requirements Significant concerns from members regarding unreasonable staffing levels and excessive and unsafe levels of overtime leading to apparent non-compliance by John Hunter Hospital ( JHH ) to clause 53 of the Award. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance The Association exercised its right of entry to access records at JHH, which revealed an unprecedented level of non-compliance with the NHPPD requirements. The Association s calculations showed some 6,695 nursing hours (or equivalent to 900 days or 23 weeks) below the Award required minimums on NHPPD wards over a seven month period 31 December 2016 and 31 July 2017. In response, the John Hunter Hospital Branch voted to take industrial action in the form of a ban on undertaking follow up phone calls to discharged patients. On the same day HNELHD filed urgent dispute proceedings regarding the Association s bans. On Friday 20 October, following a strong recommendation from the Commission, the JHH Branch voted to lift the bans pending resolution of this issue in the Commission. Commissioner Stanton attended the JHH Campus on 29 November for a further conference of this dispute. There were approximately 30 Branch members in attendance as well as approximately the same number of JHH management. The District reported back as to steps it had undertaken to ensure compliance with NHPPD requirements and additional steps including a review of follow up phone calls and procedures. The Association advised the Commission that a number of issues remained unresolved, including: (i) (ii) (iii) continued regular use of AiNs to fill vacant RN shifts (including the use of pre-booked AiNs); the issue of staffing of specials and close observation beds; the failure to provide additional staff when requested by a NUM or Delegate - a contravention of clause 53(r) of the Award; and, the disputed follow up phone calls that continued to put workload pressure on staff. The Association put that the use of ward staff to care for discharged patients was not contemplated under the NHPPD assessment of staffing levels. 16 January 2018 Page 8 of 37

In the proceedings, JHH representatives conceded that follow up phone calls did not need to be undertaken if staff were too busy to do them and would not need to be carried over to the following day if they were not completed. Members saw this as a concession on the previously held position of JHH. Mid North Coast Local Health District Coffs Harbour Health Campus: Care of non-maternity patients within Birthrate Plus FTE Earlier this year Coffs Harbour Health Campus ( CHHC ) management contacted the Association regarding the implementation of a Midwifery Group Practice within the Maternity Services at CHHC. During the consultation process for the implementation of the Midwifery Group Practice the Association became aware that a significant number of non-maternity patients were being admitted to the post-natal ward and cared for by maternity services nursing staff. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance The Association is concerned that midwifery services nursing staff are being used to care for nonmaternity patients whilst the service has staffing levels in place slightly below Birthrate Plus assessed Full Time Equivalent (FTE) staffing levels required under the Award. The Association is of the view that the regular use of Maternity Services Staff to care for non-maternity patients undermines clause 53 Section V of the Award. In addition, the Association is concerned that NHPPD requirements for non-maternity patients who would otherwise be placed in a general ward are not being met. The NSWNMA has invoked the disputes clause under the Award regarding this issue and a disputes meeting was held on 23 October 2017. This meeting did not resolve the issue and the Association subsequently wrote to the District seeking confirmation that nursing enhancements of 5.5 NHPPD will be put in place for each non-maternity patient admitted to the post-natal ward at CHHC. In response, it would seem that the District has subsequently made modifications to the staffing arrangements that appear consistent with the Association s request. Discussions continue to confirm and finalise. 16 January 2018 Page 9 of 37

Milstern Health Pty Ltd Yagoona Nursing Home & The Ritz Nursing Home, Leura: Facility closures Members at these two sites were informed two weeks before the sites were due to close in mid- December due to sanctions being imposed and the ceasing of federal government funding. The branches notified the Association of the proposed closures; members were extremely shocked and distressed about the closures. Discussions were held between branch officials, administrators and management regarding redundancy payments and education to be provided to members to assist in their resume writing and interview skills. There were concerns that the company would not remunerate their staff. Key Direction 1 Strategy 1.3 Strategy 1.5 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Ensure a focus on retaining as many members as possible Members at The Ritz invited and spoke with their local MPs and considered interviews with the media. A number of site visits were undertaken to support members. Branch officials at The Ritz sourced vacant positions around the area for their colleagues. Staff received their redundancy payouts. Seven (7) new members were recruited. Northern NSW Local Health District Lismore Acute Mental Health Unit (Tallowwood): Plan to reduce staffing A move by Lismore Hospital to reduce staffing and replace the NUM 1 positions with in-charge of shifts triggered industrial action in the form of bed closures by the Branch. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance Following the bed closures, the LHD referred the matter to the Industrial Relations Commission. 16 January 2018 Page 10 of 37

The matter will be subject to arbitration on an initial preliminary point raised by the LHD regarding the authority or capacity for the Commission to make orders in the manner sought by the Association. Northern Sydney Local Health District Hornsby & Ku-ring-gai Hospital: Non-compliance with NHPPD requirements Significant concerns were raised by members regarding the apparent non-compliance by Hornsby Hospital to clause 53 of the Award. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Strategy 2.7 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups On 22 November 2017, Association officers undertook a records review at Hornsby Hospital exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. Despite the reluctance of the Hospital to provide unabridged copies of requested documents, access revealed breaches of a magnitude not inconsistent with those found at John Hunter Hospital. The Association notified the Commission of a dispute and highlighted the level of noncompliance. Recommendations are being sought in similar terms to those achieved for Belmont Hospital. One sticking point is the replacement of, for example, an eight hour shift in its entirety, rather than a partial backfill of a lesser time. The Commission has requested that the Association confer with the Ministry on this point. Manly Hospital: Non-compliance with NHPPD requirements Concerns were raised by members regarding the apparent non-compliance by Manly Hospital to clause 53 of the Award. 16 January 2018 Page 11 of 37

Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Key Direction 2 Strategy 2.3 Strategy 2.7 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups In response to concerns raised by members, Association officers have notified Manly Hospital of its intention to undertake a records review by exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. Access to documents was sought on 11 January 2018. Ramsay Health Care Member Growth and Development The NSWNMA Ramsay Enterprise Agreement campaign has commenced with claim endorsement meetings underway. The current Agreement expires in March 2018. The Association s focus is on growth and development of members, Branches and workplace leaders, in order to grow power and influence. Negotiations commenced in November with the bargaining team including eight delegates representing the majority of nursing specialities. Delegates come from Lake Macquarie Private, Westmead Private, Kareena Private, Wollongong Private, St George Private, North Shore Private, Tamara Private and Castlecrag Private Hospitals. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Strategy 1.5 Key Direction 2 Strategy 2.1 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights 16 January 2018 Page 12 of 37

Claims presented The Association presented our claims in two parts to Ramsay management. The first part, comprising pay and conditions, was presented in the week preceding the first bargaining meeting held on 21 November 2017. Part two of the claim: Safe Staffing and Ratios conditions was presented prior to the second meeting held on 29 November 2017. Endorsement Meetings Standing together for safe staffing Members from across all Ramsay Hospitals, day surgeries and clinics endorsed the draft claims for Pay and Conditions and Safe Staffing and Ratios. Each Ramsay Hospital passed a resolution to endorse the claims and commit to participating in the campaign for safe staffing and improved pay and conditions which was signed and presented to their site management. Negotiations Negotiations commenced on 21 November with a second meeting held on 29 November 2017. Negotiations are planned to resume on 31 January 2018. Facebook Facebook engagement has increased and now exceeds 1106 Page likes. Additionally, member engagement occurred via Santa Christmas List photos publicising safe staffing claim. St George & Kareena Workload Issues The St George Private and Kareena Private Hospital Branches have met to discuss their workload concerns and have been continuing negotiations with management. Increased NSWNMA visibility and presence. Membership growth with an identified target to achieve aims of Key Direction strategy 1.1 Grow power and influence by increasing the number of Association members. Identify, develop and empowering member leaders. Increased social media engagement and awareness. Increased awareness of rights to enforce and question the Enterprise Agreement. Engagement in the new Enterprise Agreement campaign and ratios clearly supported as a key part of the agenda for the new agreement. St Vincent s Health Network St Vincent s Hospital, Darlinghurst: Proposed bed closure over Christmas period Key Direction 1 Strategy 1.1 Grow power and influence by increasing the number of Association members Strategy 1.2 Identify new member leaders who can build their workplace influence 16 January 2018 Page 13 of 37

Strategy 1.3 Strategy 1.4 Strategy 1.5 Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible During a branch meeting on 11 December 2017 members raised concerns about a rumour that more than the usual number of beds would be closing over the Christmas downtime. Members sought clarification with an urgent resolution asking the hospital s Executive to confirm or deny the bed closures. The resolution was presented on 12 December 2017, with the HR department claiming it was unreasonable to respond within 48 hours. The Association denied this claim and demanded that the Executive respond within the timeframe. Management then held a staff information forum on 13 December 2017 confirming that approximately 50% of the beds were closing and members asked the Association to present a failure to consult and status quo Fair Work action. A meeting with the hospital s HR, Association and member representatives occurred on 15 December 2017 and clarification was sought regarding some issues raised by members and the Association. In the meantime, the branch held a community awareness gathering in nearby Green Park which was well attended by 130 members and numerous media outlets. Member s actions ensured that consultation occurred. Association officers ensured that member s industrial rights were protected and maintained the status quo until all assurances were given by the employer. The beds were closed for the period sought by the hospital Executive. The community and media are now aware of the potential failures of the public-private partnership (PPP) or non-government organisation (NGO) model. This action produced an increased involvement of members in branch meetings and associated activities. Follow up meetings are being arranged with the hospital s HR department to discuss the effects of the closures to ensure that such a process is better dealt with in the future. The Branch is leading the re-establishment of a Reasonable Workloads Committee. Trustee of the Roman Catholic Church for the diocese of Sydney St Mary s Villa: Underpayment of Certificate III AiNs During bargaining with the facility, Association officers discovered that the previous agreement did not have a provision that would have Assistants in Nursing (AiNs) holding a Certificate III paid at the top pay rate as is required in the Nurses Award 2010. 16 January 2018 Page 14 of 37

Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Strategy 1.5 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems Ensure a focus on retaining as many members as possible Site visits were conducted to identify member leaders who had been affected. From this group a Workplace Organising Committee (WOC) was formed. In consultation with the Association, the WOC proceeded to identify all members who had been affected and the period of employment that these staff members had been affected. Furthermore, the WOC worked to identify former staff members who may also have been affected by the error. The WOC ultimately submitted a letter to management outlining their concerns, the employees who had been affected, and the pay discrepancy that had been identified during each year of the agreement. Management conceded that there was an issue to be investigated and had their payroll team conduct an audit. A branch was formed out of the WOC. 12 members were recruited during the campaign. All affected staff were reimbursed the funds owed to them. Uniting State-wide introduction of Household Model Two further sites Aldersgate Nursing Home at Leichhardt and Bowden Brae Nursing Home at Normanhurst have now transferred to this model. Uniting started implementing the Household Model in early 2017, with a view to transitioning 50% of their NSW and ACT facilities. The model creates households around groups of residents, to be more responsive to their needs, as in a home style setting. The household is headed by a Homemaker who may be a nurse or Care Service Employee. The RN sits outside the household as part of the clinical support team. The remaining members of the household team are AiNs/CSEs who will all perform generic functions in the direct care of the residents in their household. Key Direction 1 Strategy 1.5 Ensure a focus on retaining as many members as possible 16 January 2018 Page 15 of 37

The Association held an information meeting on site and with members to provide advice on potential workloads matters with the new model of care. Shift patterns will change, with no loss of contracted hours. No positions will be lost, and interviews have been conducted by the employer to make individual accommodations. All information sessions attended. Individual member support will be provided to members. Caroona Bonalbo Hostel: Facility closure This facility is on a site leased from NSW Health, with the lease due to expire and will not be renewed. The Ministry plans to offer flexible packages to the residents to encourage them to move across to the Bonalbo Subsidiary Hospital, and will be recruiting nursing staff from the Uniting facility for the expanded public hospital. The CSEs who move across will be employed as AiNs. Key Direction 1 Strategy 1.1 Grow power and influence by increasing the number of Association members Association organisers have contacted members at the public hospital to advise the potential to recruit members from the Uniting facility, with the possibility of forming a branch as the public hospital expands. Association organisers have made contact with the public hospital members to advise them of the NSW Health proposals; a site visit is being planned. Western Sydney Local Health District Westmead Hospital: Non-compliance with NHPPD requirements Concerns have been received from members regarding the apparent non-compliance by Westmead Hospital to clause 53 of the Award. Key Direction 1 Strategy 1.1 Strategy 1.2 Strategy 1.3 Strategy 1.4 Grow power and influence by increasing the number of Association members Identify new member leaders who can build their workplace influence Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Grow the number of Association members actively engaged across the health, disability and aged care systems 16 January 2018 Page 16 of 37

Key Direction 2 Strategy 2.3 Strategy 2.7 Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups On 20 December 2017, Association officers undertook a records review at Westmead Hospital exercising right of entry to access documents relating to non-compliance with clause 53 of the Award. This access revealed breaches of a magnitude similar to that of John Hunter Hospital. Records and data continue to be compiled. 16 January 2018 Page 17 of 37

KEY DIRECTION 2 Be innovative in our advocacy and bargaining New challenges and environments require new thinking and continuous improvement of professional and industrial advocacy and bargaining. The Association will directly represent and organise members and their workplaces, as well as engage with the community and other key stakeholders, to achieve advancement in professional and industrial outcomes. STRATEGIES 2.1 Review and implement improved Association approaches and processes for collective bargaining and enforcement of rights 2.2 Ensure that advocacy and bargaining aligns with our growing capacity to influence 2.3 Ensure existing Ratios systems are implemented and enforced properly through member education and member leader vigilance 2.4 Actively use political and community lobbying campaigns to assist with advocacy and bargaining outcomes 2.5 Campaign to extend enforceable staffing arrangements for safe patient care into other sectors 2.6 Review Association approaches and processes for linking professional advocacy to organising and growth 2.7 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Family and Community Services Dispute: Aspects of the forced transition of FACS staff to the NGO sector Issues continue to arise with the rollout of the NDIS and the decision of the NSW Government to vacate the disability field entirely, which will result in FACS employees being transferred without their consent to various NGO providers. Key Direction 2 Strategy 2.7 Key Direction 1 Strategy 1.2 Strategy 1.5 Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Identify new member leaders who can build their workplace influence Ensure a focus on retaining as many members as possible 16 January 2018 Page 18 of 37

Key Direction 3 Strategy 3.2 Identify the features of a world class, well-funded, integrated health system The Association felt it had no alternative but to notify the Industrial Relations Commission of a dispute relating to global and/or threshold issues of the forced transfer of FACS staff. At the conclusion of the conciliation phase of the dispute, two matters remained outstanding. Recognition of previous public sector service if returning to the government sector This remains the subject of discussions and representations with NSW Treasury (NSW PSIR). The Association had also written directly to the Minister for Disability Services and the Public Service Commissioner seeking their respective intervention. Enforceability of employment commitments made by the NSW Government This issue relates to the enforceability of terms and conditions of employment of transferring FACS staff when employed by a NGO provider. This was subject of a Full Bench hearing on 5 October 2017. A decision is pending. Uniting 2017 Enterprise Agreement Negotiations for a new Enterprise Agreement for Uniting members have been concluded with a positive staff vote. Key Direction 2 Strategy 2.2 Strategy 2.5 Key Direction 1 Strategy 1.3 Ensure that advocacy and bargaining aligns with our growing capacity to influence Campaign to extend enforceable staffing arrangements for safe patient care into other sectors Equip Association member leaders with the skills, knowledge and confidence to lead members to use their influence Negotiations for a new Uniting Aged Care Enterprise Agreement occurred from June to November last year. The outcome was an Enterprise Agreement which was endorsed by employees in November. It is now waiting for approval by the Fair Work Commission. The negotiated agreement contains: improved staffing arrangements the employer commits to use their best endeavours to backfill vacancies with like classifications and to provide information relevant to workload on the request of employees; a clause that allows existing staff in AiN classifications to remain in the AiN stream, including on promotion, is significant, given that Uniting has a majority of CSEs in their workforce; 2.4% per annum pay and allowance increases for the majority of covered employees; and, 16 January 2018 Page 19 of 37

2.4% pay increase from 1 July 2017 for former Blue Care employees whose wages are then frozen until the main Uniting rates catch up. Former Blue Care employees also have a number of their conditions grand-parented or bought out. (Background: Blue Care facilities in Northern NSW were transferred to Uniting in 2016. Until the commencement of this new Enterprise Agreement the employees at these facilities were covered by a Blue Care Agreement with pay and conditions which were largely superior to Uniting.) The Association s negotiating team included two members employed by Uniting. The Union decided not to make a recommendation to members on how to vote, yes or no largely because of the concerning final offer for former Blue Care members. Improved staffing arrangements for safe patient care in the aged care sector. Maintenance of existing Branch structures and continued member leader activity facilitated by the ability of members in AiN classifications to remain in those classification. Continued development of member leaders skills, knowledge and confidence. To lead members to use their influence through the active involvement in negotiations. 16 January 2018 Page 20 of 37

KEY DIRECTION 3 Promote a world class, well-funded, integrated health system Increasingly, health is becoming a defining political issue in our country and budget decisions impact on the delivery of care. The Association will be an effective advocate for delivery of quality outcomes of care in an ever-changing health system and influence policy and decisionmakers to invest in prevention and universality. STRATEGIES 3.1 Consult with Association members on their vision of an integrated health system 3.2 Identify the features of a world class, well-funded, integrated health system 3.3 Develop an education program for Association members and member leaders 3.4 Develop initiatives, affiliations and partnerships on issues that affect Association members 3.5 Advocate and influence decision makers on key issues that affect Association members and the delivery of care Aged Care Campaign ANMF national campaign Key Direction 3 Strategy 3.2 Identify the features of a world class, well-funded, integrated health system All the state branches of the Australian Nursing and Midwifery Federation (ANMF) are currently in discussion for a national paid media campaign that would launch in March and a national day of action in May. In line with previous major campaigns, the NSWNMA is in the process of some internal structural changes in order to more effectively prosecute an on the ground marginal seats campaign in the lead up to the federal election that would aim at building and growing power in the aged care sector. A dedicated campaign officer will also be appointed, from within current staffing numbers, to coordinate the state aspect of the national campaign. Campaign planning is being progressed. 16 January 2018 Page 21 of 37

Education Program NSWNMA Education Program 2017/2018 Key Direction 3 Strategy 3.3 Develop an education program for NSWNMA members and member leaders The Association s 2018 education program has now been released with an increased number of courses rolled out throughout the metropolitan and regional areas. A complete list of the 2018 education program will be in the February issue of the Lamp, and is available on the Association s website, http://www.nswnma.asn.au/education/education-calendar/. Extra courses will be added to the calendar throughout the year. All Association courses are open to members and non-members and can be booked online through the education section of the Association website. The program will be promoted in each monthly edition of the Lamp and will be promoted through email and by distribution of promotional flyers. Aged Care Nurses Forum on Elder Abuse An Aged Care Nurses Forum on Elder Abuse took place in Bathurst on 20 November 2017. Further Elder Abuse forums are scheduled for 14 February in Tamworth and 29 August in Batemans Bay. All will be co-presented with the Senior Rights Service. The forums aim to provide aged care members with the skills to recognise and respond to abuse, including legal advice on assisted decision making, power of attorney and guardianship. The Bathurst forum was well attended and highlights the ongoing demand for education in regional areas. The annual Aged Care Nurses Forum will be held at the NSWNMA Waterloo office and is scheduled for Wednesday 24 October 2018. Midwifery Forum The inaugural Midwifery Forum was held on 24 November 2017. 65 people registered to attend the Forum and was well received. The midwives who presented worked in a variety of settings including private practice, midwifery group practice and education within the public health system. All spoke about how they practice midwifery and their context of practice. The 2018 Midwifery Forum is scheduled for Friday, 2 November 2018. 16 January 2018 Page 22 of 37

Northern Sydney Local Health District / Ministry of Health Northern Beaches Hospital: Transition process The NSW Government has contracted Healthscope to build and operate (and be the employing entity of staff) at a new Northern Beaches Hospital located at Frenchs Forest. This new hospital would be in lieu of public health services currently provided at Manly and Mona Vale Hospitals, with Manly Hospital closing entirely, and residual services remaining at Mona Vale Hospital. Public health unions had been seeking definitive answers on a number of longstanding (global) issues related to this redevelopment. Key Direction 3 Strategy 3.4 Key Direction 1 Strategy 1.5 Key Direction 2 Strategy 2.7 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Ensure a focus on retaining as many members as possible Strategically use legal and industrial tribunals to deliver outcomes for individual members or groups Northern Sydney Local Health District ( District ) released in October 2017 a document that set out a suggested expression of interest ( EOI ) process that establishes the framework to manage the transition of staff from Manly and Mona Vale Hospitals to the Northern Beaches Hospital. After receiving feedback from members, the Association and workplace representatives from both hospitals met with the District to discuss the EOI process released, and provide feedback and possible suggested modifications. This was followed up in writing. The Association has continued to provide to NSLHD and the Ministry feedback on all aspects of the proposed transition, which continue to demonstrate that much work still needs to be done, as with each new discussion, possible new questions arise. All attempts to expedite the matching process and to gain access to more prescriptive detail regarding positions, structures have been resisted in varying degrees. It is now said that under the contractual terms entered into with Healthscope, they have no obligation to provide final and definitive staffing information till February 2018. This had never been previously raised. NSW Aged Care Roundtable 10 Questions to Ask Key Direction 3 Strategy 3.1 Strategy 3.2 Strategy 3.3 Strategy 3.4 Strategy 3.5 Consult with Association members on their vision of an integrated health system Identify the features of a world class, well-funded, integrated health system Develop an education program for Association members and member leaders Develop initiatives, affiliations and partnerships on issues that affect Association members Advocate and influence decision makers on key issues that affect Association members and the delivery of care 16 January 2018 Page 23 of 37

Association officers continue to engage members of the NSW Aged Care Roundtable and met on 14 December with a further meeting planned for 8 February. The main focus of the roundtable continues to be the development of consumer information leaflets 10 Questions in support of the federal aged care safe staffing and skills mix campaign. An Allied Health leaflet has been drafted by Allied Health Professions Australia. Further leaflets on dementia and mental health have been completed and are awaiting a formal launch. A poster has been developed promoting the series, endorsed by member and supporting organisations. NSW Parliament Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 Disallowance motion to be debated in the NSW Parliament. Key Direction 3 Strategy 3.4 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Delegates would recall from previous updates that the then Baird NSW Government (without any prior warning or consideration to consult) had the Government Sector Employment Amendment (Transfers to Non-Government Sector) Regulation 2016 ( Regulation ) gazetted. The Regulation further eroded the rights of government sector workers whose role may be subject to privatisation. Unions NSW and affiliates have agitated with cross bench members of the NSW Legislative Council to support a disallowance motion on the Regulation (i.e. have it set aside) tabled by the ALP Opposition. After numerous adjournments, this debate has again recently been postponed till Wednesday 7 March 2018. Some indication of the NSW Government s determination to ensure that staff choice is illusionary in future processes and privatisations can be gleaned from information released to members working at Maitland Hospital, which make clear that: if you do not apply for or accept employment with the Hospital Operator and you cannot be redeployed within NSW Health, policies and laws that apply across all of the NSW Government mean that you will not be entitled to a redundancy or severance payment from NSW Health. [Emphasis added] 16 January 2018 Page 24 of 37

NSWNMA Reference Groups Key Direction 3 Strategy 3.5 Aged Care Advocate and influence decision makers on key issues that affect NSWNMA members and the delivery of care The Aged Care Reference Group (ACRG) met before Committee of Delegates (CoD) on 21 November 2017 and will meet before each future CoD to maximise attendance and member engagement. Members were asked for their input to inform the current aged care workforce taskforce consultations. An update on the aged care roundtable was given. Members were asked for their input in relation to the NSW Palliative Care strategy consultation. Climate Change The Climate Change Reference Group (CCARG) met on 16 November 2017. An Environmental Health Seminar will be held on Friday 6 April 2018 (venue tbc). NSWNMA member Jacquie Myers presented her three day Residential Workshop on community activism to the Reference Group which was well received. She gave an overview of the proceedings and updated the group on her activism experiences. Midwifery The Midwifery Reference Group (MRG) met on 22 November 2017. The MRG members discussed the recent Midwifery Forum and the Midwifery Staffing Survey. The MRG members were also able to provide valuable feedback regarding the Association s submission for the Parliament of NSW inquiry Support for new parents and babies in New South Wales. 16 January 2018 Page 25 of 37

Reconciliation Plan Key Direction 3 Strategy 3.4 Develop initiatives, affiliations and partnerships on issues that affect Association members The NSWNMA continues to work with Reconciliation Australia to achieve endorsement of the Association s Reconciliation Plan (RAP). The 2018 work plan will be finalised at the first meeting of the RAP Working Group on 31 January. We expect the Association s RAP to be endorsed by Reconciliation Australia by the end of the month. A clear implementation strategy for 2018 has been drafted. Scholarships Key Direction 3 Strategy 3.4 Develop initiatives, affiliations and partnerships on issues that affect NSWNMA members Bob Fenwick Mentoring Grants 2018 Program Planning for the next round (2018) of the Bob Fenwick Mentoring Grants Program 2018 has commenced. The opening date for applications will be 1 February 2018 and close on 11 March 2018. Placements will occur from May through to end of July 2018. Application forms will be available on the Association website. Delegates are asked to inform your mental health colleagues of this opportunity for participation in the Grants Program for 2018. Old People s Welfare Council Grant The Old People s Welfare Council have offered aged care members further funding for a program of education in 2018. Members employed in aged care settings or who engage in aged care related work will be invited to apply for funding for a professional course or formal education to enhance their skills during 2018. 16 January 2018 Page 26 of 37