2009 National Practice Nurse Workforce Survey Report Page 1

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2 2009 National Practice Nurse Workforce Survey Report Page 1

3 AGPN is the largest representative voice for General Practice in Australia. It is the peak national body of the divisions of General Practice, comprising 111 Network members across Australia, as well as the eight state-based organisations. Approximately 95 per cent of GPs are members of a local division of General Practice. Australian General Practice Network PO Box 4308 MANUKA ACT 2603 Telephone: (02) Facsimile: (02) agpnreception@agpn.com.au Web: AGPN acknowledges the financial support of the Australian Government Department of Health and Ageing National Practice Nurse Workforce Survey Report Page 2

4 Acknowledgements The survey instrument and survey report were prepared by The Nursing in General Practice team together with Connie Ryan, Principal Network Adviser, Australian General Practice Network. Statistical analysis of the survey reports was performed by Piazza Consulting Limited. AGPN would like to acknowledge the state based organisations (SBOs) for their support in circulating the survey instrument to their Network members. AGPN would like to acknowledge Health Workforce Queensland for allowing the use of their online remoteness index (ASGC-RA) search tool which helped to simplify the survey process for respondents. Thanks are extended to the General Practice Network, the General Practice staff and the Practice Nurses, for their valuable time given to complete the survey instrument National Practice Nurse Workforce Survey Report Page 3

5 List of abbreviations ADGP AGPN AHW ANF APNA Division FTE GP PIP PN PN PIP RCNA RRMA SBO SD URL Australian Divisions of General Practice Australian General Practice Network Aboriginal Health Worker Australian Nursing Federation (or a state branch) Australian Practice Nurses Association Division of General Practice Full-time equivalent General Practitioner Practice Incentives Program Practice Nurse Practice Nurse Practice Incentive Program Royal College of Nursing Australia Rural, Remote and Metropolitan Areas State based organisation Standard deviation Universal Resource Locator; internet address 2009 National Practice Nurse Workforce Survey Report Page 4

6 National General Practice Network Practice Nurse Workforce Survey 2010 Table of Contents Acknowledgements...3 List of abbreviations Executive Summary...7 Main findings Introduction Method Survey questionnaire Population and distribution method Sample Confidence Data processing and analysis Quality Assurance and Statistical Clearing House Scope Nursing in General Practice survey response Network Member Organisations Practices General Practitioners Practice Nurses Synopsis of key findings Estimate number of Practice Nurses employed in Australia (headcount) Number of practices employing a Practice Nurse General Practice: Practice Nurse Ratio Practice Data Practice Nurse Data Detailed overview General Practice data Number of General Practices Number of Practice Nurses employed Other nursing services Aboriginal Health Workers Practice Nurse data Composition Hours worked Length of service of nurses in practice Patterns of employment National Practice Nurse Workforce Survey Report Page 5

7 7.2.5 Membership of professional nursing organisation Post graduate qualifications in nursing Closing remarks Appendix to Networks...30 Instructions for Network Member Organisations Instructions for Practice Managers (or Management Delegates) Instructions for Individual Practice Nurses Survey Instrument...33 List of tables Table 1.0: Number of practices returning surveys by state Table 2.0: RA Classification survey response breakdown Table 3.0: Number of nurses in responding General Practices by state Table 4.0: Number of nurses in responding General Practices by RA classification Table 5.0: Estimates of number of Practice Nurses by state Table 6.0: Practices employing a PN by state Table 7.0: Practices registered for PIP Table 8.0: Practices eligible for Practice Nurse PIP Table 9.0: Registered and enrolled Practice Nurses by state Table 10.0: Number of practices responding Table 11.0: Number of Practice Nurses employed in responding practices Table 12.0: Number of practices obtaining contract or sessional nursing services Table 13.0: Number of contract or sessional hours (from practice data) Table 14.0: Number of Aboriginal Health Workers employed Table 15.0: Age distribution of registered and enrolled nurses in General Practice Table 16.0: Length of service for nurses responding to the 2009 survey Table 17.0: Number of Practice Nurses working in another nursing position Table 18.0: Membership of Practice Nurses to professional nursing organisations Table 19.0: Numbers of nurses reporting post-graduate qualifications List of figures Figure 1.0: Percentage of responses by RRMA in sample: 2005 and Figure 2.0: RRMA distribution of Practice Nurses Figure 3.0: Average number of nurses per practice Figure 4.0: Age distribution of registered and enrolled nurses in General Practice Figure 5.0: Nurse membership of a professional nursing organisation National Practice Nurse Workforce Survey Report Page 6

8 1. Executive Summary The Australian General Practice Network (AGPN) 2003 National Practice Nurse Survey Report provided the first comprehensive national compilation of information and statistics regarding employed General Practice Nurses. The survey was repeated in 2005, 2007 and again in In response to division requests to decrease the burden of respondents, AGPN engaged Piazza Consulting to establish a web-based survey methodology to conduct the 2007 survey. This has resulted in higher, and more complete divisional response rates. As divisional data are used for most national estimates the 2007 data provided a more accurate estimation. Piazza Consulting has been engaged to conduct the 2009 survey. Complete reports have provided a more accurate assessment of nationwide Nursing in General Practice. Figures from the Network and their member General Practices have been obtained in substantially less time than previous surveys. 100 percent of the Network responded to this year s survey. The main findings of the survey are outlined on the following page National Practice Nurse Workforce Survey Report Page 7

9 Main findings Network member organisation data shows the number of Practice Nurses in 2009 as 8914 a 15.3 percent increase since 2007 estimates (7728) From Network member organisation data, it is estimated that on average 56.9 percent of general practices employ one or more Practice Nurses (similar to 2007, 58 percent) In practices that employ a nurse the GP to PN ratio in 2009 is 2.01:1 (headcount) corresponding to a 2.3:1 ratio in In full-time equivalent (FTE) terms the ratio in 2009 is 3.0 GPs : 1 PN, also lower than the 2007 FTE ratio of 3.42 GPs : 1 PN. This continues a trend seen in 2007 of more Practice Nurses per general practitioners In 2009, 84.8 percent of Practice Nurses are registered nurses (79.4 percent in 2007) and 15.2 percent enrolled (15.1 percent in 2007). Similar to 2007 although with a small increase of registered nurses Similarly to previous year s results, the bulk of the Practice Nurse workforce (79.7 percent) is aged 40 years or older (78 percent in 2007) In 2009, there were 67 Aboriginal Health Workers employed in the 826 practices that responded to the survey. This represents a relatively higher proportion than for the 2007 survey that showed that nationwide, 20 Aboriginal Health Workers were employed in the 623 practices that responded The majority of Practice Nurses (79.6 percent) worked part-time and 20.4 percent full-time. This was consistent with the 2007 results showing that 75.5 percent worked part-time 32.3 percent of Practice Nurses in 2009 reported being employed in at least one other nursing job, again similar to 2007 when 30.7 percent were employed in another nursing position. This attributed to the part-time nature of the industry In 2009, the proportion of practices employing one Practice Nurse was 24.8 percent (34.1 percent in 2007). The proportion with more than five Practice Nurses has grown slightly since 2007 (from 6.27 percent) to 6.7 percent in It appears that the overall structure of Practice Nurses per practice is relatively stable since 2007 but a clear trend shows that the majority have more than one From practice data, 49 percent of Practice Nurses are located in RA1 Major cities of Australia, 19 percent in RA2 Inner Regional Australia and 18 percent in RA3 Outer Regional Australia. The remaining 14 percent are located in RA4 and RA5 (Remote and Very Remote Australia) 2009 National Practice Nurse Workforce Survey Report Page 8

10 2. Introduction The Australian General Practice Network (AGPN) is the peak national body for the General Practice Network which includes 111 network member organisations and eight state based organisations (SBOs) across Australia. Through the Network, AGPN has contact with the majority of General Practices and GPs as well as with many other health professionals and the health system. About 95 percent of GPs are members of a local General practice network. Nurses have been employed in Australian General Practices for a number of decades. During the past five years however, there has been an even greater focus on the valuable and diverse roles that nurses can play in supporting GPs in the provision of primary care services. Australian Government policy has been a significant driver for the employment of more nurses in General Practice over this period, and for the development of the clinical role for the nurse particularly in the management of chronic disease. The aims for the Government s Nursing in General Practice Initiative are to support the effective employment of Practice Nurses. The key aims of the program are to: Recruit or access nursing services in General Practices that do not currently employ a nurse, and expand nursing services in existing employing practices Facilitate access for Practice Nurses to a specific range of education and training programs to extend their role, empowering and skilling Practice Nurses to take a leadership role in the provision of specialist nursing services that will best address the current and future challenges of health care provision To achieve these aims the Australian Government has made a significant financial commitment to practice nursing providing funding of $104.3 million in and ; and continuing the funding with $129.9 million for the four years to The majority of the funding is provided through the Practice Incentives Program (PIP) to support practices in rural areas and other areas of need to employ Practice Nurses. In addition, Government funding of $140.3 million over the next four years to and continuing to was provided to support practices in urban areas of workforce shortage to employ Practice Nurses. There has also been a range of other Australian Government initiatives aimed at increased utilisation of practice nursing services, such as: MBS Items for Practice Nurses to provide immunisation, wound care, Pap smears, antenatal checks and chronic disease management on behalf of a General Practitioner Practice Nurse scholarships for education and training Facilitating access for training and support for nurses in regional and rural areas to be points of referral for people experiencing domestic violence AGPN is contracted by the Australian Government Department of Health and Ageing (DoHA) to provide national leadership and coordination for the Nursing in General Practice Program (NiGP) National Practice Nurse Workforce Survey Report Page 9

11 The aim of the program is to work with the state based organisations (SBOs) to achieve the following national initiatives: Implement a nationally consistent orientation program to provide Practice Nurses new to General Practice with the knowledge and baseline skills required to practice in General Practice settings Implement a nationally consistent introduction to nursing in general practice Explore and make recommendations regarding the requirements for undergraduate nursing students and graduate nursing placements in General Practice Provide funding for SBOs and Divisions to provide nurses in General Practice with training in triage and first line management Assess existing recruitment strategies and make recommendations for potential implementation in General Practices not currently employing nurses Explore and make recommendation on opportunities to assist practices to establish teams with advanced roles for nurses, with a focus on multidisciplinary primary health care practices Explore and provide advice to DoHA on the actual and potential value, models of care and further implementation requirements and options for nurse led clinics in General Practice Establish support Networks for nurses in General Practice, including nurses undertaking training to become nurse practitioners Provide leadership, advice and support to SBOs and divisions to facilitate information sharing and collaboration with and between SBOs and divisions and others addressing the aims of the program Develop and disseminate a tool kit to Networks based on the findings of the Australian General Practice Nurse Research Study. Undertake to repeat the National Practice Nurse Workforce survey Facilitate opportunities for nurses in General Practice to be involved in decision making and advisory mechanisms within the AGPN Network The Principal Network Adviser, Nursing in General Practice provides coordination and leadership for the Nursing in General Practice Program. In late 2003 AGPN (formerly ADGP), with the assistance of Network members, undertook the first national survey of Practice Nurses in order to collect comprehensive national and state/territory data on the Nursing in General Practice workforce in Australia. Prior to 2003 no such comprehensive, national data was available on this specific branch of the nursing profession. The survey was repeated in 2005 which enabled comparisons of the data collected. In 2007 AGPN repeated the PN Workforce Survey with an additional question to collect data on the number of Aboriginal Health Workers employed in General Practice. Additional questions were added to the Practice Nurse Survey collecting comments relating to formal training and factors influencing retention in the Nursing in General Practice workforce. Findings in the 2007 Survey have been compared to the 2005 report National Practice Nurse Workforce Survey Report Page 10

12 3. Method 3.1 Survey questionnaire The survey design was kept largely consistent with the design used in the 2003, 2005 and 2009 surveys with only minor changes. The questionnaire was approved by the Australian Government Statistical Clearing House. The successful use of the online survey in 2007 was repeated for 2009 and provided a simple data collection method. This method also enabled a series of reminders to be sent out through Network member organisations in order to maximise response rates. As per 2007, the online survey instrument consisted of three parts: A Network member organisation survey A practice survey A nurse survey A hardcopy of the survey instrument can be found at Appendix Population and distribution method As per the 2007 survey, the target population for the survey was the 111 Network member organisations and all General Practices in Australia which employed Practice Nurses. The survey webaddress (URL) was ed to each Network member organisation. Each undertook the responsibility for forwarding the survey to each General Practice. Each General Practice was then responsible for forwarding the survey to their Practice Nurses. A paper-based option for responses was also available for practices and nurses with limited access to the internet; completed paper surveys were posted or faxed back to AGPN. In order to protect the confidentiality of respondents a secure site was used for the survey. The period over which the data was collected was November and December Late returns were followed up, either by or directly by telephone by AGPN staff or by Network member organisations. A full (100 percent) response rate for Network member organisations was achieved. 3.3 Sample confidence Total Practice Nurses responding to the survey were n=1586 and n=826 individual practices also submitted a response. While the exact population size of these groups is unknown, these sample sizes are large enough to estimate that overall results should be accurate to within +/- 3.4 percent or better for nurses and practices 1. Network member organisation results are highly reliable as all 111 responded (census). 1 Calculated for the 95 percent confidence interval National Practice Nurse Workforce Survey Report Page 11

13 3.4 Data processing and analysis Almost all of the survey data was entered directly into an online database by respondents. A few were returned in paper-form which was then also entered into the same database. Post entry data verification was conducted to remove any errors or outliers in the entered surveys before analysis. Piazza Research conducted the statistical analysis using its own statistical package (SPSS) and excel. A descriptive analysis of results was conducted and the calculation of various GP to nurse ratios conducted as per previous reports. Results were presented in a tabular, graphical and written format. 3.5 Quality Assurance and Statistical Clearing House approval The survey was approved for use by the Australian Government Statistical Clearing House, approval number This project complies with ISO Market, Opinion and Social Research Standard. 4. Scope The survey instrument used was originally developed to provide a quantitative snapshot of the Practice Nurse workforce. Measurement was made of the number of hours worked by part-time nurses and doctors. The total numbers of full-time nurses and doctors were also measured in the survey. The part-time estimates gained were used to create full-time equivalent (FTE) values; based on a 38 hour working week for full-time Practice Nurses and nine or more sessions per week for full time GPs. The measurement of the remoteness index has also changed since 2007 with the survey moving away from the RRMA scale of remoteness to the more up-date Standard Geographic Classification Remoteness Areas Classification (RA). Care should be taken when comparing results by remoteness level from this year to previous years as the two different remoteness indices are not directly comparable National Practice Nurse Workforce Survey Report Page 12

14 5. Nursing in General Practice survey response 5.1 Network member organisations All 111 Network member organisations responded to the 2009 survey ensuring high quality data. This response rate was achieved with the assistance from AGPN following up those yet to respond before the survey closing date. 5.2 Practices From Network member organisation data, the number of General Practices currently in Australia who are Network members is A total of 820 practices returned survey across the states in A higher response than the 632 returned in the Table 1.0: Number of practices returning surveys by state State NSW VIC QLD SA WA TAS NT ACT TOTAL The geographic distribution of practices responding to the survey was given by the Australian Standard Geographic Classification Remoteness Areas classification and are detailed in Table 2.0. Readers should note that previous results (2005 and 2007) were provided using the superseded Rural, Remote and Metropolitan Classification (RRMA) which does not align with the new RA classification; consequently direct comparison between these years cannot be made. Table 2.0: RA Classification survey response breakdown RA Classification Number Percent RA1 - Major cities of Australia RA2 - Inner Regional Australia RA3 - Outer Regional Australia RA4 - Remote Australia RA5 - Very Remote Australia Total practices were unable to provide their RA classification National Practice Nurse Workforce Survey Report Page 13

15 Figure 1.0: Percentage of practices responding by RA in 2009 sample 5.3 General Practitioners The total number of GPs (headcount) on which this analysis was conducted is 3896 corresponding to 3342 full-time equivalent (FTE). FTE is defined as working nine or more sessions per week. The average number of GPs (headcount) working in each practice for 2009 was 4.96 (S.D. = 3.25), a small increase from the 2007 average of Practice Nurses The total number of Practice Nurses (headcount of full-time and part-time) on which this analysis was conducted is This is comparable to a full-time equivalent (FTE = working 38 hours or more per week) of 1,112.4 Practice Nurses, representing an increase of FTE nurses since In 2009 there was an average of 2.34 (S.D. = 1.98) Practice Nurses per practice (headcount) this represents an overall per practice increase of 0.4 Practice Nurses since The corresponding average of full-time equivalent Practice Nurses in 2009 is 1.35 (S.D. = 1.39), an increase of 0.12 FTE nurses per practice since Total full-time plus part-time from 2009 practice data FTE Practice Nurses = PN per practice (headcount = 1.94 (S.D =2.42) average FTE Practice Nurses per practice =1.23 (S.D. =0.84) National Practice Nurse Workforce Survey Report Page 14

16 Table 3.0: Number of nurses in responding General Practices by state 7 State NSW VIC QLD SA WA TAS NT ACT Total Number of Nurses in Practice Table 4.0: Number of nurses in responding General Practices by RA classification. RA Classification Practice estimates for number of PNs employed Percentage ( percent) RA1 - Major cities of Australia RA2 - Inner Regional Australia RA3 - Outer Regional Australia RA4 - Remote Australia RA5 - Very Remote Australia Total Figure 2.0: Geographic distribution of Practice Nurses 7 Calculations based upon practice data figures of number of nurses employed by those practices able to specify their RA classification National Practice Nurse Workforce Survey Report Page 15

17 6. Synopsis of key findings 6.1 Estimate number of Practice Nurses employed in Australia (headcount) Network member organisations report a total of 8914 Practice Nurses (headcount), employed in Australia at the time of the survey. Network member organisation estimates of the number of nurses employed per state is provided in Table 5.0. Table 5.0: Estimates of number of Practice Nurses by state Overall estimate of number of Practice Nurses State 2007 estimates 2009 estimates Percent change from 2007 NSW VIC QLD SA WA TAS NT ACT Total Number of practices employing a Practice Nurse Of the 826 practices whose responses were analysed, 87.7 percent (724) employ one or more Practice Nurses. From Network member organisation estimates, of the 6843 practices, 56.9 percent of practices are thought to employ a Practice Nurse. A breakdown of estimated number of General Practices employing a nurse by state is provided in Table National Practice Nurse Workforce Survey Report Page 16

18 Table 6.0: Practices employing a Practice Nurse by state Practices State employing a Practice Nurse Total number of practices Percentage of practices employing a Practice Nurse NSW VIC QLD SA WA TAS NT ACT Total GP: PN Ratio The 2009 GP:PN ratio (headcount) is 2.01 GPs to 1 PN, falling from the 2007 ratio of 2.31:1. The current FTE ratio 3.0 GPs: 1 PN again falling from the 2007 figure of 3.42:1 PN. 6.4 Practice Data Of the 826 practices responding 87.7 percent have one or more Practice Nurses, comparable with the 2007 result (89.9 percent). The proportion with only one Practice Nurse is 24.8 percent (compared with 34.1 percent in 2007). Those with more than five Practice Nurses was 6.7 percent (6.27 percent in 2007). From this analysis it appears that the relative structure of Practice Nurses across Australia is relatively stable since 2007 but a clear trend showing that the majority have one or more National Practice Nurse Workforce Survey Report Page 17

19 The distribution of nurses employed per practice is provided in Figure 3.0 below. Figure 3.0: Frequency distribution of nurses per practice Almost all practices (90.8 percent) are registered for the Practice Incentive Program and 66.5 percent report eligibility for the PIP Practice Nurse incentives. A substantial proportion though (14.8 percent) are unsure of their eligibility for the PIP Practice Nurse incentives. Table 7.0: Practices registered for PIP Registered for PIP Number Percent Yes No Unsure Total Table 8.0: Practices eligible for Practice Nurse PIP Eligible for PN PIP Number Percent Yes No Unsure Total National Practice Nurse Workforce Survey Report Page 18

20 6.5 Practice Nurse data The 2009 survey shows that 84.8 percent of Practice Nurses are registered nurses and 15.2 percent being enrolled. These results are slightly higher than the 2007 survey results of 79.4 percent being registered. Table 9.0 presents a nurse category breakdown by state. Table 9.0: Registered and enrolled Practice Nurses by state Nurse status NSW VIC QLD SA WA TAS NT ACT Registered Enrolled percent percent percent percent percent percent 91.1 percent 8.9 percent percent percent percent percent percent percent percent 0.0 percent Total The 2009 survey results show that nationally, only 1.8 percent are male Practice Nurses (a similar result to 2007 when 1.4 percent of respondents were male) National Practice Nurse Workforce Survey Report Page 19

21 7. Detailed overview 7.1 General Practice data Number of General Practices Table 10.0: Number of practices responding NSW VIC QLD SA WA TAS NT 16 2 ACT Not Specified NIL 6 TOTAL Number of Practice Nurses employed in responding practices Table 11.0: Number of Practice Nurses employed in responding practices NSW VIC QLD SA WA TAS NT ACT TOTAL Total number of Practice Nurses employed at responding practices National Practice Nurse Workforce Survey Report Page 20

22 7.1.3 Other nursing services Some practices receive nursing services on a contract or sessional basis from an external source. This may be in addition or an alternative to direct employment of a nurse for the practice. An increase of 4.4 percent of practices report receiving nurses on a contract or sessional basis (13.7 percent, n=111), slightly higher than for 2007 (9.3 percent). For practices who obtained additional nursing services the most common source was a Network member organisation (53) or private contractor (42). Table 12.0: Number of practices obtaining contract or sessional nursing services State NSW VIC QLD SA WA TAS NT ACT Total Network member organisation Area health service Private contractor Pharmaceutical Company Other Total no. practices obtaining at least 1 contract or sessional nurse Table 13.0: Number of contract or sessional hours (from practice data) State NSW VIC QLD SA WA TAS NT ACT Total Network member organisation Area health service Private contractor Pharmaceutical Company Other hours Total hours per weeks National Practice Nurse Workforce Survey Report Page 21

23 7.1.4 Aboriginal Health Workers From responding practice data, there were 67 Aboriginal Health Workers employed in practice nursing. A state by state break down is provided in Table Overall Aboriginal Health Workers comprise 1.7 percent of the practice nursing workforce (3872) reported from practice responses. Table 14.0: Number of Aboriginal Health Workers employed State NSW VIC QLD SA WA TAS NT ACT Total Aboriginal Health Workers employed Practice Nurse data Composition Age As for previous years, the bulk of the Practice Nurse workforce (79.7 percent) is aged 40 years or more (2007 survey result = 78 percent). Table 15.0 below provides a breakdown of the age group and percentage of registered and enrolled nurses. Table 15.0: Age distribution of registered and enrolled nurses in General Practice Age group Registered nurse ( percent) Enrolled nurse percent Registered nurse ( percent) Enrolled nurse percent < 30 5 percent 10 percent 5 percent 6 percent percent 16 percent 16 percent 12 percent percent 49 percent 35 percent 44 percent percent 20 percent 37 percent 35 percent percent 4 percent 7 percent 3 percent 2009 National Practice Nurse Workforce Survey Report Page 22

24 Figure 4.0: Age distribution of registered and enrolled nurses in General Practice 9 Sex Almost all (98.2 percent) of Practice Nurses were female (similar to 2007, 98.6 percent) and 1.8 percent males (1.4 percent in 2007) Hours worked The majority of Practice Nurses (79.6 percent) worked part-time and 20.4 percent full-time. This is broadly similar to the 2007 result where 75.5 percent worked part-time Length of service of nurses in practice The 2009 Workforce Survey reported 18.2 percent of Practice Nurses have less than one year of experience which has fallen slightly from 2007 levels (2007, percent). Comparatively, 60.2 percent of Practice Nurses have between two and ten years of experience (similar to 2007, percent). Table 16.0 below outlines the length of service for those nurses who responded to the 2009 survey. 9 Totals for 2007 exclude No Answer response (approximately 5.5 percent of data) National Practice Nurse Workforce Survey Report Page 23

25 Table 16.0: Length of service for nurses responding to the 2009 survey Length of PN service Number Percent 0-1 Years Years Years Years Years Total Patterns of employment Similarly to the 2007 result of 30.7 percent, the 2009 results showed that 32.3 percent of Practice Nurses report being employed in at least one other nursing job, which is attributed to the part-time nature of General Practice nursing positions in Australia. Table 17.0: Number of Practice Nurses working in another nursing position 10 State NSW VIC QLD SA WA TAS NT ACT Total Public hospital Private hospital Aged care facility Another General Practice Other organisation Total number nurses employed in 1 or more other organisation(s) Total number of Practice Nurse responses Table based on responses to Q5a If yes please indicate which other organisation/s you are employed by? 2009 National Practice Nurse Workforce Survey Report Page 24

26 7.2.5 Membership of professional nursing organisation Table 18.0: Membership of Practice Nurses to professional nursing organisations Total Percent 11 from 2007 percent Change Royal College of Nursing Australia The College of Nursing (NSW) Australian Nursing Federation (or a state branch) Australian Practice Nurses Association Association of Australian Rural Nurses Australian Diabetes Educators Association Other organisation In 2009, 63.7 percent of Practice Nurses reported being a member of a professional nursing organisation; a similar result to the 2007 survey where 62.7 percent reported membership. The Australian Nursing Federation (35.9 percent) followed by the Australian Practice Nurses Association (31.6 percent) were the two most popular professional membership organisations amongst Practice Nurses. A similar result to the 2007 survey showing membership to both these organisations growing by 0.4 percent-2 percent since Figure 5.0: Nurse membership of a professional nursing organisation 11 Percent calculated over the 1580 nurses who gave a valid response to Q7 Are you a member of a professional nursing organisation? 2009 National Practice Nurse Workforce Survey Report Page 25

27 7.2.6 Post graduate qualifications in nursing In the 2009 survey 64.6 percent of Practice Nurses reported having an additional post graduate nursing qualification (up from 62.3 percent in 2007) 12. Accredited Nurse Immuniser (31.27 percent) and Midwifery (18.48 percent) were the two most popular post graduate qualifications. Table 19.0: Numbers of nurses reporting post-graduate qualifications Number Percent(2009) 13 Percent(2007) Accredited Nurse Immuniser Other Midwifery Women's Health Nurse Asthma Educator Emergency Nursing Diabetes Educator Intensive Care Nursing Total number of nurses specifying at least 1 additional qualification (NB: Nurses can specify more than one qualification each.) Additional comments Nurses were able to provide additional comments regarding the formal training they are currently undertaking as well as factors that influence Practice Nurse retention in the workforce. While many simply re-stated the type of training they were doing, there were four main ideas expressed relating to training. Nurses commonly expressed that training was enjoyable and useful for their work (n=57), frustration was expressed that training was often expensive and training time unpaid (n=27), some requested more training opportunities in general or training with other peers in the Network (16), others commented that there was a lack of time for training due to workload and other commitments (12). 12 Based on responses to Q8. Do you have additional qualifications in speciality areas of nursing? Y/N 13 Percentage of nurses (who specified a qualification) over total survey sample size n=1, National Practice Nurse Workforce Survey Report Page 26

28 Typical training comments: The educators are generally very good. Plenty of resources available. I enjoy continuing professional training. Training in general practice is vital as techniques change all the time. Am about to undertake a diabetes course but there is little financial support for time. I wish courses (even two day) weren't so expensive. I am not allocated any time to do any courses. I do not get paid to do any further education. Excellent workshops provided to ensure I am kept up to date but seems to be a decline in the number of workshops. Would be good to have a General Practice Nurse Networking meeting regularly to have CPD and Networking. Internet self-based learning is good but some more opportunities for group learning would be good. Difficult to get away from busy practice for training. Difficult attending formal training as have 11 month baby and childcare issues National Practice Nurse Workforce Survey Report Page 27

29 Many comments regarding the retention of Practice Nurses were made. By far, comments regarding a lack of pay or pay inequity with hospital nurses were the most common issue mentioned regarding retention (n=242). The family friendly or flexible working hours for the Practice Nurse was seen as a positive for retention (n=88) as was the variety of work and patient presentations (n=56). Many felt that the supportive working environment in practice nursing (with supportive peers and a good team spirit) was a critical retention issue (n=50). Achieving professional recognition from other health professionals and colleagues was also an important factor influencing retention (n=39) and for some (n=31) good support from Network member organisations was key. Several (n=25) pointed to an ever increasing workload for Practice Nurses being a potential impediment to retaining nurses. Typical retention comments: There s a need for an award wage specific to Practice Nurse experience and qualifications. There is an inequality of pay rate compared to hospital nurses. Flexible working hours fits well with family. It s better than working shift work in hospitals. I love the diversity of Practice Nursing. I find when working in the field of General Practice, you come across so many different areas of nursing which is very fulfilling. Positive factor - working closely in a smaller team (compared to a hospital-based team) it is easier to feel appreciated by staff and patients. Positive - Work with GPs who use a collaborative approach, working as a team. I'm treated as a professional, I control my own workload. I am made to feel like an important part of a team National Practice Nurse Workforce Survey Report Page 28

30 8. Closing remarks The 2009 National Practice Nurse Workforce survey results reflect a continued increase in the number if nurses employed in Australian General Practices. There is also a trend for those practices currently employing a nurse to employ an additional nurse or nurses. There has been a slight increase in the number of practices employing a nurse. The Australian Government Nursing in General Practice Initiative led by the Australian General Practice Network aims to continue to support additional practices to recruit and retain Practice Nurses, and to maximise the contribution of all Practice Nurses to quality primary care services. Further information can be obtained from Connie Ryan, Principal Network Adviser Nursing in General Practice, Australian General Practice Network: cryan@agpn.com.au or phone (02) National Practice Nurse Workforce Survey Report Page 29

31 Appendix 1 to Network Member Organisations DearNetworkMemberOrganisation,PracticeManagersandPracticeNurses, The Australian General Practice Network (AGPN) in conjunction with your State Based Organisation is seeking your assistance in conducting a survey of nurses working in General Practice. The information collected is the only comprehensive national dataset on the Practice Nurse workforce. The survey results provide important information to inform policy makers, government and researchers. AGPN has been collectingthisinformationeverytwoyearssince2003.thisinformationassistsinplanningfortheprovision ofongoingsupportforpracticenurserecruitment,retentionandprofessionaldevelopment. The2009surveyhasbeendesignedasawebbasedsurveyinresponsetofeedbackinordertolessonthe burdenuponrespondents.thesurveyhasthreeparts: 1) NetworkMemberSurvey(CoverSheet) 2) PracticeSurvey 3) IndividualNurseSurvey This providesyouwiththeinformationandinstructionsaboutusingthesurvey.please readthese instructionscarefully.allnetworkmemberorganisationswillbeprovidedwithacopyofthedataresults fromtheirparticipatingpracticesandpracticenurses.inorderforthistooccurpracticesandnursesmust nominatetheirnetworkmemberorganisationnumber(providedbellowbyyourlocalnetworkmember)on thesurveyform.note:individualpracticesandnurseswillnotbeidentifiedinanyofthesurveyresults.all data received will be treated in confidence. The survey is hosted on a secure website to protect your privacyandconfidentiality. TIMEFRAME:PLEASECOMPLETETHISSURVEYBYMonday14December2009 Network Member Organisation (Division) Number: (to be entered by the member organisationbeforeforwardingtopractices) 2009 National Practice Nurse Workforce Survey Report Page 30

32 1)INSTRUCTIONSFORNETWORKMEMBERORGANISATIONS Youarerequiredto: 1) CompletetheNetworkmembersurveybyclickingthesurveylinkatthebottomof thispageandfollowingtheinstructions. 2) The first page will direct you to your correct survey. Choose Network Member Organisation andyouwillbetakentothesurveyloginpage.onthesurveylogin pagepress StartNewSurvey andyouwillbegeneratedauniquecode.please writedownthiscode,asyouwillneeditifyouwishtosaveyoursurveyasadraft andreturntocompleteitlater. 3) Youmaycheckandprintyouranswersaftercompletingthesurvey.Onceyouare satisfiedwithyouranswers,click SubmitSurvey. 4) Forwardthis ,whichshouldincludeyourNETWORKMEMBERORGANISATION (DIVISION)numberasDISPLAYEDatthetopofthisletter,topracticemanagers(or their delegates) within your Network. (Practice managers are to complete the practicesurveyandalsoforwardthelinktotheirindividualpracticenurses). 2)INSTRUCTIONSFORPRACTICEMANAGERS(ORMANAGEMENTDELEGATES) Yourpracticeisrequiredto: 1) CompletethePracticeSurveybyclickingthesurveylinkatthebottomofthispage andfollowingtheinstructions. 2) Theintroductorypagewilldirectyoutoyourcorrectsurvey.Choose Practice and youwillbetakentothepracticesurveyloginpage.onthesurveyloginpagepress StartNewSurvey andyouwillbegeneratedauniquecode.pleasewritedown thiscode,asyouwillneeditifyouwishtosaveyoursurveyasadraftandreturnto completeitlater. 3) On the first page of the actual survey enter your correct Network Member Organisationnumberwhenasked. 4) Youmaycheckandprintyouranswersaftercompletingthesurvey.Onceyouare satisfiedwithyouranswers,click SubmitSurvey. 5) Forward this , which should include your Network Member Organisation (Division)numberasDISPLAYEDatthetopofthisletter,toeachPracticeNursewho is working at your practice. (Practice Nurses are to complete their own survey as well) National Practice Nurse Workforce Survey Report Page 31

33 3)INSTRUCTIONSFORINDIVIDUALPRACTICENURSES AsanindividualPracticeNurse,youarerequiredto: 1) CompletethePracticeNurseSurveybyclickingthesurveylinkatthebottomofthis pageandfollowingtheinstructions. 2) The introductory page will direct you to your correct survey. Choose Nurse and youwillbetakentotheindividualnursesurveyloginpage.onthesurveyloginpage press StartNewSurvey andyouwillbegeneratedauniquecode.pleasewrite downthis code,asyouwillneedit if youwishto saveyoursurveyas adraftand returntocompleteitlater. 3) On the first page of the actual survey enter your correct Network Member Organisation(Division)numberwhenasked.YourNetworkmemberorganisation numberislocatedatthetopofthisletter. 4) You may check and print your answers at the end of the survey. Once you are satisfiedwithyouranswers,click SubmitSurvey. SurveyLink: ClickHereToStartTheSurvey Ifthislinkdoesn'twork(your browserdoesnotsupporthtml),pleasecopyandpastethefollowinglink intoawebbrowser: Ifyouneedassistancewiththesurveyplease VanessaRobinsonConlonfromPiazzaResearch(our ConnieRyan PrincipalNetworkAdviserNursinginGeneralPractice AustralianGeneralPracticeNetwork POBox4308MANUKAACT2603 phone(02) mobile fax(02) webwww.agpn.com.au 2009 National Practice Nurse Workforce Survey Report Page 32

34 Survey Instrument National Practice Nurse Workforce Survey 2009 Thank you for participating in the National Practice Nurse Workforce Survey PLEASE NOTE: To complete this survey you must provide your correct Network Member Organisation (Division) Number. Please indicate whether you are a: 1 NETWORK MEMBER ORGANISATION (DIVISION) (go to Division Cover Sheet ) 2 PRACTICE (go to Practice Survey ) 3 NURSE (go to Individual Nurse Survey ) The Australian Government Statistical Clearing House Approval Number National Practice Nurse Workforce Survey Report Page 33

35 (Network Member Organisation (Division) Cover Sheet) Q1.Name of Network Member Organisation (Division)(mandatory): Q2.Network Member Organisation (Division) Number (mandatory): Q3.Name of Divisional returning officer: Q4.Contact phone number: Q5.Number of practices in the Network Member Organisation (Division): Q6. How many of the practices in your Network Member Organisation (Division) employ a Practice Nurse? Q7. In total how many Practice Nurses are employed in the practices in your Network Member Organisation (Division)? Thank you for taking the time to assist with this survey National Practice Nurse Workforce Survey Report Page 34

36 National Practice Nurse Workforce Survey 2009 Practice Survey To be completed by the Practice Manager or their delegate Please fill out mandatory fields below: PLEASE NOTE: At NO stage will this information be used to identify you OR link your identity to your answers. Practice name is required to manage response rates and reminders. Division number is required to analyse overall data by division. What is your Network Member Organisation (Division) Number? (This question is mandatory) What is the name of your practice? (This question is mandatory) 2009 National Practice Nurse Workforce Survey Report Page 35

37 National Practice Nurse Workforce Survey 2009 Practice Survey To be completed by the Practice Manager or their delegate 1. How many GPs work in your practice? a) Number of full time GPs (i.e. working nine or more sessions per week at the practice - one session equals four hours) b) Number of part time GPs For the number of part time GPs you have, please indicate the number of sessions per week worked for each part time GP - one session equals four hours. No. of Sessions / Week a. GP No 1 b. GP No 2 c. GP No 3 d. GP No 4 e. GP No 5 f. GP No 6 g. GP No 7 h. GP No 8 i. GP No 9 j. GP No 10 k. GP No 11 l. GP No 12 m. GP No 13 n. GP No 14 o. GP No 15 p. GP No 16 q. GP No 17 r. GP No 18 s. GP No 19 t. GP No 20 u. GP No 21 v. GP No 22 w. GP No 23 x. GP No 24 y. GP No National Practice Nurse Workforce Survey Report Page 36

38 2. What is the Remoteness Area (RA) Classification of the practice? (Your division can help with this if you don t know) (Or follow this link: 3. Is the practice registered for the Practice Incentives Program (PIP)? Yes 1 No 2 Unsure 3 4. Is the practice eligible for the current PIP for Nursing in General Practice? Yes 1 No 2 Unsure 3 5. How many Practice Nurses are employed by your practice? (Please exclude contract or sessional nurses as these are included in Q6) a) Number of full time nurses (i.e. working 38 hours or more per week) b) Number of part time nurses For the number of part time nurses you have, please indicate the number of hours worked for each part time nurse. No of Hours/week a. Nurse No 1 b. Nurse No 2 c. Nurse No 3 d. Nurse No 4 e. Nurse No 5 f. Nurse No 6 g. Nurse No 7 h. Nurse No 8 i. Nurse No 9 j. Nurse No 10 k. Nurse No National Practice Nurse Workforce Survey Report Page 37

39 l. Nurse No 12 m. Nurse No 13 n. Nurse No 14 o. Nurse No 15 p. Nurse No 16 q. Nurse No 17 r. Nurse No 18 s. Nurse No 19 t. Nurse No 20 u. Nurse No 21 v. Nurse No 22 w. Nurse No 23 x. Nurse No 24 y. Nurse No Apart from the nurses listed previously does your practice receive nursing services on a contract or sessional basis from another organisation such as a community health service or Division of General Practice? Yes 1 (Go to Q6a) No 2 (Go to Q7) Unsure 3 (Go to Q7) 6a. On the previous page you indicated that your practice receives nursing services on a contract or sessional basis from another organisation such as a community health service or Division of General Practice. Please complete for each nurse: No. of hours at the practice Employing organisation Tick all that apply Type of Service Tick all that apply per week Nurse No 1 Division of General Practice 1 Asthma Education 1 Area Health Service 1 Diabetes Education 1 Private Contractor 1 Health Assessments 1 Pharmaceutical Company 1 Generalist Nursing 1 Services Other 1 Other National Practice Nurse Workforce Survey Report Page 38

40 No. of hours at the practice Employing organisation Tick all that apply Type of Service Tick all that apply per week Nurse No 2 Division of General Practice 1 Asthma Education 1 Area Health Service 1 Diabetes Education 1 Private Contractor 1 Health Assessments 1 Pharmaceutical Company 1 Generalist Nursing 1 Services Other 1 Other 1 No. of hours at the practice Employing organisation Tick all that apply Type of Service Tick all that apply per week Nurse No 3 Division of General Practice 1 Asthma Education 1 Area Health Service 1 Diabetes Education 1 Private Contractor 1 Health Assessments 1 Pharmaceutical Company 1 Generalist Nursing 1 Services Other 1 Other 1 7. How many Aboriginal Health Workers are employed in your practice? Thank you for taking the time to complete the questionnaire National Practice Nurse Workforce Survey Report Page 39

41 National Practice Nurse Workforce Survey 2009 Individual Nurse Survey Please fill out mandatory fields below. PLEASE NOTE: At NO stage will this information be used to identify you OR link your identity to your answers. Practice name is required to manage response rates and reminders. Division number is required to analyse overall data by division. What is your Network Member Organisation (Division) Number? (This question is mandatory) What is the name of your practice? (This question is mandatory) 2009 National Practice Nurse Workforce Survey Report Page 40