After years of campaigning for safe staffing levels, nurse-to-patient ratios will be rolled out across Western Australia in October. 

WA’s North Metropolitan Health Service (NMHS) will begin implementing nurse and midwife to patient ratios across its general medical and general surgical wards. 

This first phase of the staged implementation will commence at the NMHS at Sir Charles Gairdner Hospital and Osborne Park Hospital. NMHS will see ratios of one nurse to every four patients during the day and one nurse to every seven patients at night, starting with the general medical and general surgical wards. 

The introduction of nurse-to-patient ratios marks a historic milestone for the Western Australian healthcare system, said ANF Western Australian Branch Secretary Janet Reah. 

“It is the result of years of relentless advocacy by the ANF to ensure safer working conditions for our nurses and midwives. This change not only supports our workforce but also enhances patient safety and care quality.”  

Successful pilot

It follows a successful ratios pilot program at Perth Children’s Hospital (PCH) emergency department (ED), where ratios demonstrated a positive impact on staffing levels, morale and patient care.  

Last year PCH ED became the first ward in the state to pilot ratios, replacing the Nursing Hours Per Patient Per Day model as part of a planned, progressive rollout of the new workforce model. 

Ratios introduced at PCH ED saw rostered staffing levels lift to one nurse for every three patients. The successful rollout of ratios at PCH ED highlighted the benefit of a focused, phased approach to implementation. 

In December 2022, the Western Australian government committed to phasing in nurse-to-patient ratios in every public hospital within two years. 

WA Health Minister Amber-Jade Sanderson said the Cook Labor Government had grown the state’s healthcare workforce by 30% since 2017 – including an additional 4,000 full time equivalent (FTE) nurses. “Nurse and midwife to patient ratios have been on the ANF’s log of claims for more than 20 years, and we’re proud to be the government getting on with introducing this historic change.” 

The government has committed to introducing nurse and midwife to patient ratios at all WA Health hospitals and has formed a ratios taskforce, which includes representatives from the ANF to oversee the rollout. The ANF’s representatives on the taskforce were focused on ensuring a structured and effective implementation process, Ms Reah said. 

WA Nurse-to-Patient Ratios Special Projects Officer David Poole said Sir Charles Gairdner Hospital and Osborne Park’s centrality made it a logical place to start the ratios rollout.  

“The success in the pilot of ratios at PCH ED, demonstrated the need for a phased approach to implementation, which has set a precedent to follow at other health service providers. By starting with medical and surgical wards at NMHS we are confident that we will see similar positive outcomes.  

“This phased approach allows for a smoother transition and ensures that our nurses can provide the best care possible,” said Mr Poole. 

This first phase of the rollout meant WA could also begin a vital focus on midwifery ratios, said Midwife-to-Patient Ratios Special Projects Officer Jane-Anne Gardner.  

“This represents a significant step towards enhancing patient care and improving working conditions for nurses and midwives in WA. The NMHS’s phased, feedback driven approach and implementation strategy will pave the way for incorporating ‘Counting the Babies’ into the midwife-to-patient ratios for maternity services in the future phases,” said Ms Gardner. 

Main image: Sir Charles Gairdner Hospital viewed from Kings Park. Photo by Gnangarra