22 October 2024
Grace R
[FYI request #28509 email]
Tēnā koe Grace
Your request for official information, reference: HNZ00066385
Thank you for your email on 25 September 2024, asking Health New Zealand | Te Whatu Ora for
the following under the Official Information Act 1982 (the Act): Please see outlined below a
response to each part of your request.
Response
1.Information outlining the initial cause of action, or concern that prompted the need to
develop and implement a new uniform policy within Waikato MH&A services at a time when
health services are trying to conserve costs.
In late 2022 a query was raised by staff, in relation to the multiple dif erent arrangements and
expectations in surrounding uniform or uniform allowances for nursing and mental health
assistants/psychiatric assistants working in different areas of the Mental Health and Addictions
Inpatient services, based at the Waikato Hospital campus. An internal, informal review process
commenced as a result, including review of:
• The Dress, Hygiene and Professional Standards Policy (2124)
• PSA Collective Employment Agreement (PSA MECA)
• NZNO Collective Employment Agreement (NZNO MECA)
Involved in this process of review and exploration were:
• Office of the Chief Nurse
• Human Resources Business Partner
• Nurse Director– Mental Health and Addictions
• Director of Acute Adult, Forensic Mental Health and MHSOP Services
The outcome of this process confirmed that whilst the organization policy is “silent” on the specific
requirement for nursing and mental health assistants/psychiatric assistants working in these services
to wear a uniform, employee agreements under the MECAs carry an expectation that nursing and
mental health assistants/psychiatric assistants in any Mental Health inpatient setting should receive
allowances (of differing levels) or suitable uniforms.
Customary practice within inpatient services had differed across wards and services for some time,
with verbal agreements and differing expectations, resulting in discrepancies and confusion in some
areas with; Charge Nurse Managers largely choosing to wear uniforms, some staff choosing to wear
uniform at some times, some staff formulating their own “uniforms” and other staff choosing not to
wear uniform at all.
There was also a discrepancy in staff receiving allowances and the level of allowance differing.
It was agreed a clear position was required to ensure fairness and consistency for all Mental Health
and Addictions nursing and mental health assistants/psychiatric assistants.
The above information relates to the cause of action and concern that prompted the development of
a whole of service directive on uniform use and availability. Cost containment issues and budgetary
constraints have not played any part in the decision-making process, as this is a specified
requirement of Health NZ Waikato as an employer.
2.Related correspondence and consultation process (not limited to copies of agendas,
minutes, emails, teams-conversation and associated communications) related to the
inception, development, and evaluation of the newly implemented uniform policy for Waikato
MH&A mental health assistants and nurses working in the Waikato region (both inpatient and
community).
The process of development of the directive for Mental Health and Addictions services nursing and
mental health assistants/psychiatric assistants continued throughout late 2022 and 2023. As a
result, there was extensive email communication internally, a series of staff meetings, union
engagements and a final proposal formulated.
Due to the volume of documentation, the period of time covered and the wide engagement and
consultation process, Health NZ is unable to provide all the documentation within the requested
timeframe and your request for this part of information is very broad, and substantial manual collation
would be required to locate and prepare all documents within scope of your request. As such, I refuse
your request under section 18(f) of the Act. However, key documents which we believe reflect the
spirit of the request are attached at Appendix 1.
3.Any information including staff or union feedback related to the new uniform policy (such
as related surveys/feedback).
The process of feedback, involving union representatives, included a number of staff meetings, both
in person and virtually. Nursing and mental health assistants/psychiatric assistants in both
community and inpatient settings were invited to complete a confidential survey.
This information is withheld under section 9(2) (ba)(i) of the Act, as there was an express expectation
of confidentiality for staff participating in this process. Disclosure of this information publicly would
likely prejudice staff participation in any similar processes in the future. I do not consider that the
public interest in releasing the information outweighs this harm.
4. Total cost of developing and implementing a new uniform policy for MH&A staff. Including a
breakdown of:
a. cost per uniform item,
b. cost of new uniform per FTE
c. total staff affected,
d. expected future financial costs related to (but not limited to) wear and tear; staff turnover;
damaged clothing; ordering errors; maternity clothing, etc
Whilst we are not aware of any current negotiations with uniform suppliers, organisation wide
purchasing procedure applies to all sourcing of uniforms. It is not possible to separate fully costs for
just mental health and addictions services or indeed the definitive number of mental health and
addictions staff affected as community staff stil have a choice as to whether to wear uniform or not.
An indicative answer to this point would be confirming the Directive for Mental Health and Addictions
nursing and mental health assistants in the Waikato District impacts both community and inpatient
staff. Many community staff may choose not to wear the uniforms offered. Limiting the number of
staff directed to make the change as opposed to those for who the option is now clarified, suggests
approximately 250 staff are impacted.
5 Information identifying the decision-making process and rationale for bringing in a new
uniform policy/memo for MH&A nurses and MHAs.
The decision-making process is noted in the “Proposal: Increase in nursing uniform budget required
to enable nurses and mental health assistants working in mental health and addictions services to
have access to a uniform” attached at Appendix 1.
6 Information related to risk assessment for staff H&S and impact on patient H&S, health
outcomes, and patient privacy. Including information such as, but not limited to:
a. Any Datix’s related to risks/hazards or potential risks/hazards resulting from standard
issues nursing and/or MHA uniform’s while working in the Waikato MH&A services.
Risk assessment processes undertaken as part of the process of clarifying policy and reaching a
clear position for all nursing and mental health assistants/psychiatric assistants included review of
incident information and engagement with Health and Safety staff.
A review of Datix (Health New Zealand, Te Whatu Ora Waikato’s electronic incident and risk
management system) returned no active risks, hazards relating to uniforms or non-uniforms. This
information therefore does not exist and is refused under section 18(e) of the Act.
b.
Any Datix’s related to risks/hazards or potential risks/hazards resulting from MHAs
and/or nurses staff wearing civilian clothing while working in Waikato MH&A services.
Any patient or staff complaints related to the new uniform policy
A review of Datix (Health New Zealand Waikato’s electronic incident and risk management system)
returned no staff complaints relating to uniforms, non-uniforms or the clarified policy. This
information therefore refused under section 18(e) of the Act as it does not exist.
7. Any information that provides this policy has a positive impact on the MH&S and patients
accessing these services.
The roll out of the standardized approach to uniforms across the mental health and addictions
services inpatient units is not yet complete, although early feedback from the adult wards is positive.
We wil continue to monitor very closely feedback from our staff, tangata whaiora, whānau and
stakeholders, as well as continue to engage with unions as we progress through the transition phase.
We recognize this is a change for everyone involved and continue to encourage our staff to actively
provide feedback on their experience through the transition, via their line management, unions,
health and safety representatives or professional reporting lines.
Appendix 1 Contents:
Dress, Hygiene and Professional Standards Policy
1 – 10
Memo – Proposal: Increase in Nursing Uniform Budget….
11 – 13
Memo – Proposed Directives to Nurses and Mental Health Assistants
14 – 16
Memo – Uniform for Nurses and Mental Health Assistants
17 – 18
Memo – Information for Leaders about Uniforms
19 - 20
How to get in touch
If you have any questions, you can contact us at
[email address].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Health NZ may proactively
release a copy of this response on our website. Al requester data, including your name and
contact details, wil be removed prior to release.
Nāku iti noa, nā
Danielle Coe
Manager (OIAs) – Government Services
Office of the Chief Executive
TeWhatuOra.govt.nz
Health NZ, PO Box 793,
Wel ington 6140, New Zealand
