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ADDENDUMTOTHEPRESIDENTIALJOBSSUMMITFRAMEWORKAGREEMENT

Partnership to address health imperatives

Nursing Note: ThisisaBusinessproposalthatissupportedbyotherSocialPartnersonconditionthatafter the Jobs Summit, a revised proposal which includes the estimated costs and financialcontributionbytheprivatesectorwillbetabledforengagement.Thisengagementwillincludetherolesoftheprivateandpublicsectorsintheimplementationoftheproposal.ProgrammedescriptionSouthAfrica faces a significant shortageof nursing healthcare professionals. Yet, the variouscategories of unemployed nurses exacerbates the national crisis of high unemployment. Itimpedes the provision of and access to quality healthcare services across South Africa andposesanimpedimenttosuccessfulenvisageddeliveryoftheNationalHealthInsurance(NHI).Currently initiatives in the trainingofnursesare fragmentedwhich results in inefficiencies inthesystem. Socialpartnersagreedthat itwouldbevaluabletomobilizetheprivateandandpublichealthcaresectortopartnerwitheachothertoaddressthischronicshortageofqualifiedauxiliary, staff, registered and professional nurses in South Africa. By so doing, thesestakeholderswillprovideenablecapacitationof thenationalhealthcaresystemwhileequallycreatingjobopportunitiesforvirtually50000youths.

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This agreement is premised on the assumption that a collective effort at collaborativealignmentandco-accountabilityfortheoutputbetweentheDepartmentofHealth,theprivatesector and the various professional and educational bodies can result in a positive andsignificant impactontheemployment levelsofcurrentlyunemployed,aspirationalandcaringindividualsandsignificantlyinfluencetheaccesstoqualityofcare.AreasofinterventionSocialPartnershaveidentifiedthreebroadareasthatrequireintervention:• The first category relates to a pool of qualified Registered Nurses that were funded by

provincial departments through a bursary scheme but could not be placed due tounavailabilityoffundedposts(Kelly,2016);

• ThesecondcategoryrelatestoamuchlargerpoolofnewlyqualifiedEnrolledNurses(ENs)andEnrolledNursingAssistants(ENAs).ThesurveyconductedbytheSouthAfricanNursingCouncil(2015)indicatesthat63.93%ofENAsand57.09%ofENsthatqualifiedinthe2013and2014periodsremainunemployed.Itisimportanttonotethatthissurveywasbasedona sample of 10000 students with a response rate of 30% but nonetheless affirms aconcerninggrowthofunemploymentamongstnewlyqualifiednurses,

• The third category of unemployed “qualified” nurses is more complex to quantify as itrelatestostudentswhoweretrainedbyprivatenursingcolleges,someofwhichareneitherregisterednoraccredited(HealthandWelfareSeta,2016;Mkhize,Dr,2016).

Socialpartnersagreedtoestablishasenior,appropriatelyauthorisedprojectteam,comprisingofrepresentationfromallkeystakeholderswhichshouldinclude:• Department of Health (DoH) representatives, including the Chief NursingOfficer and the

HumanResourceDevelopmentDirector;• SouthAfricanNursingCouncil(SANC);• HealthandWelfareSectorEducationandTrainingAuthority(HWSETA);• DepartmentofHigherEducationandTraining(DHET);• CouncilforHigherEducation(CHE);• EstablishedprivateNursingEducationInstitutions(NEI);and• Othernursingeducationinstitutionsanduniversities.Itwas agreed that the project team should be fully authorised to investigate and develop adetailed andpractical proposal,with strict delivery timetables, basedon student output andemploymentof individuals.Thisteamshouldbeofappropriatesize,expertiseandexperiencetobeagile,committedandaccountabletothecommonaim.Thisanalysiswillinclude,butnotbelimitedto:

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• Evaluatingthecurrentstatusofallsectorsofeducationandtrainingofnurses• Establishreliablebenchmarkdataregardingrealnursingvacancies.The project team should be tasked with developing simplified, efficient, low cost processesbetweenvariousbodieswhichwillneedtoincludeagreementsonthefollowingkeypoints:• Streamlining accreditation of institutions and the new nursing programmes to ensure

timeousdeliveryoftraining;• Large scale, full accreditation and registration of institutions and programmes with a

standardised curriculum per programme e.g. enrolled nursing assistant, staff nurse andregistered and professional nurse for each NEI to use which would minimise therequirementofeachNEIhavingtodevelopandapplyforaccreditation;

• Extensionofcurrentlyaccreditedclinicalandeducationfacilitiesforanextendedtransitionalperiodtoachievetheoutputrequired;

• Fundingoffeesandregistrationcosts;• Agreementthat‘new’qualificationswillbetrained;• ScopeofPracticeforalloccupationstobepromulgatedandpublished;Theprojectteamwillalsoneedtoagreecertaindetailedlogisticalitemsincluding;recruitmentand selection processes; identification of clinical facilities and support needed to meeteducationandtrainingrequirements;employeebenefitsandsalarylevels,employmentpoliciesetc.; and education and trainingmaterials and a standardised fundingmodel (infrastructure,studentsandstaff)amongstotheractivities.SupportingprojectsAsixprongedapproachisproposedandincludes:• Up-skillingofthecurrentlyunemployedEnrolledNursestowardsaRegisteredNurseviathe

2yearBridgingProgramme;• Provide education for entrants onto the Higher Certificate: Auxiliary Nursing (NQF 5) to

specificallymeetthedemand.• Provideeducationforentrantsontothe3yearDiplomainNursing:StaffNurse(NQF6);• Provideeducationforentrants intothe4yearbachelor’sdegreeinnursingandmidwifery

(NQF8);• Provide opportunity to train non-nursing categories such as the Operating Department

Assistant(ODA)inathreeyearDiploma;and• Exploring possible partnerships to get the unemployed Registered Nurses who were

awardedbursariesbytheprovincialdepartmentsintoemployment.Whilst it appears thatmuchwork still needs to be put in place, there is already substantialinfrastructure in place and there are numerous organisations that have for some time beenattempting to achieve various elements of the proposed plan, although in an uncoordinatedandfragmentedfashion.

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