Victorian Numbered Acts Victorian Numbered ActsAfter section 12 of the Principal Act insert —
(1) In February and August each year, the operator of a hospital—
(a) must nominate a ward as a mixed ward for the following 6 month period starting on 1 March or 1 September of that year (as the case requires) if—
(i) the operator has specifically configured the ward to provide, in the course of its ordinary operation, a mixture of clinical services; and
(ii) there is more than one portion of the ward and, accordingly, more than one ratio would apply when determining staff numbers for the entire ward but for subsection (3); and
(b) must publish a notice of the nomination of the ward as a mixed ward on the hospital's Internet site including the following details—
(i) the name of the mixed ward;
(ii) the total number of occupied beds in the mixed ward;
(iii) the different ratios that would apply but for subsection (3);
(iv) the expected number of occupied beds in each portion of the ward during the following 6 month period determined in accordance with subsection (2).
(2) For the purpose of determining the expected number of occupied beds in each portion of the ward, the operator must take into account—
(a) the portions in the ward and the number of occupied beds in each portion during the preceding 12 months; and
(b) any factors during the following 6 month period (or the remainder of the 6 month period if subsection (8) applies) which are likely—
(i) to increase or decrease the number of occupied beds; or
(ii) to change the portions in the ward.
(3) Subject to subsections (4), (5) and (6), the operator of a hospital must staff a nominated mixed ward in accordance with a ratio determined as follows for the relevant 6 month period—
(a) determine the number of staff (excluding any nurse in charge or midwife in charge) for each portion by applying the relevant ratio for that portion;
(b) add the number of staff for each portion;
(c) determine the nominated mixed ward ratio by dividing the total number of occupied beds in the nominated mixed ward by the total number of staff ascertained in paragraph (b).
(4) For the purposes of subsection (3)(a), if the number of occupied beds in a portion is not divisible into a whole number following the application of the relevant ratio for that portion, the number of staff for that portion may be rounded down to the nearest whole number if at least one (but not all) of the portions of the nominated mixed ward is a portion to which section 12(2) would apply if the portion were a ward.
(5) If the number of occupied beds in the nominated mixed ward is not divisible into a whole number following the application of the ratio determined under subsection (3)(c), the operator of the hospital must ensure that the ward is staffed with an additional nurse or midwife (as the case requires) in order to comply with that ratio unless—
(a) section 12(2) would apply to each portion of the nominated mixed ward if each portion were a ward; and
(b) safe patient care would not be compromised if the nominated mixed ward were not staffed with the additional nurse or midwife; and
(c) the number of occupied beds in the nominated mixed ward requires less than or equal to 50 per cent of one additional nurse or midwife in order to comply with that ratio.
(6) If the ratio applying to a portion of a nominated mixed ward requires a nurse in charge or a midwife in charge for that portion, only one nurse in charge or one midwife in charge (as the case requires) is required for the entire nominated mixed ward.
(7) If the operator of a hospital fails to nominate a ward as a mixed ward in accordance with subsection (1)—
(a) the ratio otherwise applying to a portion of the ward that is the highest nurse to patient, or midwife to patient, ratio of the ratios otherwise applying to the portions of the ward is to be applied to the mixed ward as a whole until the operator nominates the mixed ward; and
Example
A mixed ward that the operator has failed to nominate consists of 2 portions. The ratio of one nurse for every 3 patients applies to Portion A. The ratio of one nurse for every 6 patients applies to Portion B. The ratio that applies to the entire ward is one nurse for every 3 patients because this ratio is the higher of the 2 ratios.
(b) if any ratio otherwise applying to a portion of a nominated mixed ward would but for this section require a nurse in charge or a midwife in charge for that portion, only one nurse in charge or one midwife in charge (as the case requires) is required for the entire ward.
Example
A mixed ward that the operator has failed to nominate consists of 2 portions. A nurse in charge is required for Portion A. A nurse in charge is required for Portion B. Despite each portion requiring a nurse in charge, the operator is not required to staff the mixed ward with 2 nurses in charge. One nurse in charge is sufficient.
(8) If the configuration of a nominated mixed ward changes during a specified 6 month period, resulting in significantly different portions or significantly different numbers of occupied beds in its portions, the operator of a hospital—
(a) must make a new nomination in relation to the mixed ward for the remainder of the 6 month period; and
(b) must publish a notice of the new nomination on the hospital's Internet site including the following details—
(i) the name of the mixed ward;
(ii) the total number of occupied beds in the mixed ward;
(iii) the different ratios that would apply but for subsection (3);
(iv) the expected number of occupied beds in each portion of the ward during the remainder of the 6 month period determined in accordance with subsection (2); and
(c) must staff the nominated mixed ward for the remainder of the 6 month period in accordance with a new ratio determined in accordance with subsection (3).
(9) This section does not apply to—
(a) a special care nursery with 8 or more occupied cots; or
(b) a ward with 6 or more birthing suites.
(10) In this section—
"portion", in relation to a mixed ward, means the category of those patients or beds in the ward to which a particular ratio applies.
Example
A mixed ward may have 3 portions: a portion of general medical or surgical beds, a portion of palliative care beds and a portion of coronary care beds.".