Exploring the characteristics of nursing agencies in South Africa

Omolola I Olojede,Laetitia C Rispel

doi:10.3402/gha.v8.27878

Abstract

BackgroundNursing agencies are temporary employment service providers or labour brokers that supply nurses to health establishments.ObjectiveThis study was conducted to determine the characteristics of nursing agencies and their relationship with clients in the health sector.MethodsDuring 2011, a cross-sectional national survey of 106 nursing agencies was conducted. After obtaining informed consent, telephone interviews were conducted with a representative of the selected nursing agency using a pretested structured questionnaire. Questions focused on the following: ownership, date of establishment, province of operation, distribution of clients across private and public health facilities; existence of a code of conduct; nature of the contractual relationship between nursing agencies and their clients, and numbers and cadres of nurses contracted. The survey data were analysed using STATA® 12.ResultsFifty-two nursing agencies participated in the survey, representing a 49% response rate. The study found that 32 nursing agencies (62%) served private-sector clients only, which included private hospitals, homes for elderly people, patients in private homes, and private industry/company clinics, and only four (8%) of the agencies served the public sector only. Twenty-seven percent of nursing agencies provided services to homes for elderly individuals. Nursing agencies were more likely to have contracts with private-sector clients (84%) than with public-sector clients (16%) (p = 0.04). Although 98% of nursing agencies reported that they had a code of conduct, the proportion was higher for private-sector clients (73%) compared to public-sector clients (27%). In terms of quality checks and monitoring, 81% of agencies agreed with a statement that they checked the nursing council registration of nurses, 82% agreed with a statement that they requested certified copies of a nurse's qualifications. Only 21% indicated that they conducted reference checks of nurses with their past employers.ConclusionsNursing agencies should enhance their quality assurance mechanisms when engaging contracted staff. Overall, the study findings suggest the need for improved governance and management of nursing agencies in South Africa.

Highlights

There is global emphasis on transforming health workforce education in support of universal health coverage
There is a good foundation to provide stewardship for the implementation of the recommendations contained in this volume, which are based on empirical findings and complement those contained in the Strategic Plan [2]
Social accountability, which is an essential component of transformative education, necessitates that attention be paid to the issues of governance, responsive curricula, educator preparedness, and appropriate student recruitment and selection

Summary

Introduction

There is global emphasis on transforming health workforce education in support of universal health coverage. Methods: Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 front-line nurses in four South African provinces. Objective: The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. At the time of the study in the second half of 2011, Hospital 2 (a large regional hospital) had stopped using agency nurses due to cash flow problems and because of a directive from the Provincial Department of Health to discontinue the use of agency staff Both hospitals had utilised agency nurses in the 2009/10 financial year on a daily basis, in the maternity and critical care units. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care

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