Democratic Nursing Organisation of South Africa

POSITIVE PRACTICE ENVIRONMENT

CAMPAIGN FOR HEALTH

PROFESSIONALS

HEALTH PROFESSIONALS UNITED IN PURSUING

POSITIVE PRACTICE ENVIRONMENT

2013- 2015DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 1

1. Positive Practice Environment Campaign: Health Professionals united in pursuing Positive

Practice Environment 2013- 2015

2. Executive summaries of the Campaign Partners (DENOSA and SAMA)

2.1 Democratic Nursing Organization of South Africa (DENOSA)

The Democratic Nursing Organization of South Africa (DENOSA) is the largest nurses’ trade

union in South Africa with over 82 000 members. It has a dual focus on both trade union and

professional development offering training to nurses. Although DENOSA has its roots in

unionism and representing the workplace interests of members, the organization took notice of

the global developments amongst nursing unions to also include professional development of

their members as part of their core focus. The organization has presence in all nine provinces

and represents nurses across the country.

DENOSA has as its vision ‘nurses united in pursuing service excellence’ and its internal mission is

to support, represent and develop its members as the backbone of South African health care.

The organization is found on ten core values namely: Excellence and professionalism,

Accountability, Transparency, Collectivism, Leadership development (including empowerment),

Organizational growth, Diversity, Integrity and loyalty, Democracy and Visibility.

2.2 South African Medical Association

The South African Medical Association (SAMA) aims to be the representative Association

for the South African medical profession. Its mission is to empower doctors to bring health

to the Nation. SAMA embraces 6 core values which serve as a compass for its actions and

guide the organisation in the conduct of its business as they remain constant and these

are: Leadership, Innovation, Vibrancy, Ubuntu, Professionalism and Principles.

SAMA’s objectives are as follows:

~ To represent doctors with authority and credibility in all matters concerning their interests in

the health care environment

~ To promote the integrity and image of the medical profession

~ To develop medical leadership and skillsDENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 2

~ To provide doctors with knowledge relevant to the demands of medical practice

~ To promote medical education, research and academic excellence

~ To encourage involvement in health promotion and education

~ To influence the health care environment to meet the needs and expectations of the

community by promoting improvements to health reform, policy and legislation.

3. Preamble and the overarching purpose of the campaign

Alarming incidents that take place on a daily basis in health institutions around the country,

resulting in death of patients amongst other things; have soured the relationship between the

healthcare professionals and the communities affected. These incidents are threatening to

overshadow the great strides that the Department of Health has made and continues to make

in bringing about new changes and improvements in the country’s health system. It is against

this background that SAMA and DENOSA, decided to embark on a campaign in a bid to assist

the Department of Health in improving the conditions in health institutions countrywide.

We, the two organizations, acknowledge the great and positive triumphs that both our

democratic government and the Department of Health have made in improving the health

conditions of the masses in our country such as: the National Health Insurance (NHI), the fight

against the burden of disease, and expanded roll-out of ARVs and prevention of new HIV

infections and the positive results thereof.

We therefore come together as health professionals to offer ourselves to be included as

seekers of solutions to these challenges, making use of our insight as professionals to be party

to the endeavors of our Department of Health and the democratic government in resolving

these challenges. We hereby adopt the campaign on Positive Practice Environment (PPE) as a

vehicle to raise awareness, educate and demonstrate our willingness to work hand in hand with

the government to further improve the conditions of service of the health workers. We further

acknowledge the commitment by the government to prioritize infrastructure development.

4. The 8 core pillars of the Positive Practice Environment (PPE) Campaign

Positive Practice Environment for healthcare professionals consists of 8 pillars from which this

campaign is built. These are as follows:DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 3

4.1 Workplace Safety

Safety in the workplace is one of the key constituents of Positive Practice Environment (PPE).

Workplace safety is multi-dimensional in scope and incorporates aspects such as: Occupational

Health, Safety and wellness policies, Personal security, Environmental safety and risk

management, Infection Control, Safe use of medicine, Equipment safety, Safe clinical practice

and Safe care environment. Workplace safety for healthcare professionals is key to quality

healthcare service provision to patients. Safety in the workplace extends beyond just safety of

healthcare professionals into the safety of patients themselves as the beneficiaries of

healthcare services and the care environment.

The nature of occupation for healthcare professionals is a risky one and therefore requires a

working environment supportive of the type work they undertake on a day-to-day basis. This

prompts for strict adherence to safety policies by all involved in the healthcare system. A safe

working environment enables healthcare workers to perform their duties without fear of

danger or possible harm to their well-being.

4.2 Payment

There have recently been reports of health professionals who have gone for months without

getting paid salaries. Non-payment of healthcare professionals may lead to unmotivated

healthcare personnel which in turn may lead to thoughts of leaving the profession. It is

therefore essential that qualified and efficient human resources are capacitated to ensure that

professionals are paid correctly and on time.

Payment in this regard not only refers to payment of healthcare professionals in the form of

remuneration but also refers to timely payment for the necessities in health facilities such as:

suppliers, security personnel, caterers, cleaners, maintenance etc. The functionality of these

enables the smooth day-to-day running of operations in healthcare facilities.

4.3 Equipment

Equipment in healthcare facilities is one of the most essential resources without which

healthcare facilities cannot function optimally. Various medical procedures require useful and

appropriate equipment that is up-to-date and is of good quality and standard. The challenge

with equipment is that its lifespan is quite dynamic and therefore requires constant upgrading

maintenance. There also needs to be a strict mechanism in place that would ensure that

hospital equipment is maintained and serviced regularly to ensure its optimal and effective

usage.DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 4

4.4 Supplies

Lack of basic necessities that enable professionals to carry out their day-to-day operations is a

challenge in many of the healthcare facilities in our country. This includes supply of all the

essential necessities such as: medication, protective wear, essential equipment, water, etc

without which the healthcare facilities cannot function effectively.

4.5 Resources

Resources and supplies are closely related elements. However, resources are not limited to

consumables as they also include aspects such as: human resources, financial resources,

essential healthcare facilities all of which enable the smooth running of healthcare facilities.

Many health facilities operate without sufficient essential resources and therefore there needs

to be sufficient allocation in the healthcare budget in this regard.

4.6 Education

The appointment of poorly qualified personnel in key managerial positions in our healthcare

facilities has been a challenge that has cost the healthcare system in our country dearly. It is

therefore important that adequately qualified personnel are placed in key managerial positions.

In this regard we welcome the Department of Health’s initiative to introduce an academy for

CEOs where newly appointed CEOs are trained prior to assumption of duty. Given the highly

dynamic environment in which we are influenced by the technological developments and

innovations, it is essential that health professionals continuously take advantage of professional

development opportunities. This could be facilitated through the official introduction of

Continuous Professional Development (CPD) points which would encourage health

professionals to undertake training and educational activities to upgrade their qualifications

whilst practicing.

4.7 Support

Lack of support for professional development activities for healthcare professionals wishing to

acquire training and educational opportunities discourages healthcare professionals. This

includes both financial and moral support for health professionals. Support also refers to the

degree of support amongst various healthcare professionals themselves as well as support

between managerial personnel and personnel at operational level. Lack of support breeds lack

of synergy and hampers working relations.DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 5

4.8 Respect

The appalling conditions in healthcare facilities have resulted in lack of respect for healthcare

professionals by the communities they serve. The image of healthcare professionals in this

regard is tarnished and therefore it is incumbent upon all involved in the healthcare system to

address these challenges so as to restore the image of healthcare professionals.

5. Objectives of the campaign

The objectives of the campaign are as follows:

 To raise awareness to all involved in the healthcare system about Positive Practice

Environment

 To facilitate mass mobilization

 To influence health and safety policies

 To profile the health profession

6. Scope of the campaign

The campaign will be coordinated nationally by the two organizations and it will be officially

launched at this level. The activities of the campaign will however be cascaded down to

provinces and subsequently to institutions.

The campaign will involve the following key stakeholders in the health system:

 The National Department of Health

 Department of Public Service and Administration

 South African Nursing Council and the Health Professions Council of South Africa

 Department of Labour

 Members of both DENOSA and SAMA

 Communities (Hospital Boards, Local radio stations, patients etc)DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 6

7. Lifespan of the campaign

The campaign is intended to run over two years. However, the time spent on each of the pillars

of the campaign will be dependent upon the effectiveness of each of the activities around these

pillars.

8. The approach of the campaign

The broad role of stakeholders as identified in the campaign is to ensure that the following

aspects as listed below are covered; Adherence and compliance on legislative and other policy

decisions, Education through mass mobilisation and awareness, Advocacy and profiling of the

health profession.

The aforementioned stakeholder will each be expected to play a role in the campaign and the

expectant role of each of the stakeholders is hereby outlined.

8.1 Department of Health (DoH)

The Department of Health is expected to work jointly with healthcare professionals in seeking

solutions to the healthcare challenges in the health system. Greater support for the campaign is

also anticipated from the Department of Health.

8.2 Department of Public Service and Administration (DPSA)

The DPSA through the Public Health and Social Development Sectoral Bargaining Council

(PHSDBC) its wing will assist on bargaining issues. The absence of minimum service agreement

for healthcare workers in the country will make it difficult to demonstrate some of the

campaign activities such as picketing given that health services are regarded as an essential

service and therefore support by the DPSA in this regard is highly anticipated.

8.3 Department of Labour (DoL)

The DoL as the custodian of policies and laws governing Health and safety in the workplace will

be expected to ensure rigorous compliance by the employer with Health and Safety policies and

act on those institutions which are not compliant with these policies. The DoL is also expected

to ensure that institutions are inspected to ensure that occupational health and safety

mechanisms and measures are adhered to.

8.4 Health Professions Council of South Africa (HPCSA) South African Nursing Council (SANC)DENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 7

As the regulatory bodies of healthcare professions SANC and the HPCSA will be expected to play

the advocacy role for health and safety of professionals.

8.5 Communities

Hospital Boards are the main stakeholder on health matters as far as community interest on

health is concerned.

The Hospital Boards will act as a link between communities and hospitals in outlining and

communicating the challenges within each of the hospitals. Community members including

patients themselves will be expected to support this campaign through realizing the ills of the

system and work hand-in-hand with health professionals in addressing them.

8.6 Members of DENOSA and SAMA

Through their structures at all levels members of the two organizations are expected to actively

participate in the campaign activities as ambassadors and foot soldiers to realize its goal and

purpose. The vibrancy of the structures at provincial, regional and branch levels will also assist

in ensuring the successful implementation of this campaign.

9. Campaign activities

The campaign activities will be derived from the 8 main pillars of the campaign. The campaign

will take a three-phased approach as follows:

Phase One: Safety and Payment

Phase Two: Supplies, Resources and Equipment

Phase Three: Education, Support and Respect

The following specific activities are envisaged namely:

 Increased awareness through: media clips, videos, newspapers, weekly or bi-weekly

internal newsletters

 Print material: posters, pamphlets, stickers

 Demonstration through picketing

 Press conferences

 Engaging relevant stakeholders through meetings and discussion platforms

 Use existing calendar events of both partners to drive the campaignDENOSA/ SAMA POSITIVE PRACTICE ENVIRONMENT CAMPAIGN 2013- 2015 Page 8

10. Monitoring and Evaluation

The task team shall develop a monitoring and evaluation tool wherein quarterly reviews will be

done to assess the developments, successes and the effectiveness of the campaign activities

and put remedial measures in place. The tool will contain specific indicators by which the

effectiveness of the campaign will be measured.

11. Resources

The partners will engage in fund-raising activities to support the campaign. The financial and

human resources aspect of the campaign will be equally carried by DENOSA and SAMA.

12. Conclusion

The success or failure of this campaign will be highly dependent on the dedication and

cooperation of each of the stakeholders involved, working hand-in-hand towards achieving a

common goal which is that of ensuring a Positive Practice Environment for health professionals.

Furthermore, the support for the campaign from each of the stakeholders will play a pivotal

role in ensuring that it becomes a success. The two organizations as the custodians and

proponents of this campaign will dedicate necessary resources to facilitate its implementation

at all levels. It is therefore incumbent upon all the stakeholders involved to ensure that the

campaign succeeds whilst ensuring that a safer and healthier working environment for health

professionals is achieved and that patients are safer in hospitals and in healthcare facilities.