Workforce Survey

League Table for Adult Diabetes Nurse Specialist/Educator Services in New Zealand

Compiled by NZSSD Executive 2009

 

Background:

The NZSSD Executive requested workforce information from each DHB towards the end of 2008. NZSSD takes no responsibility for the accuracy of the information provided, although we have attempted to verify data that appears incongruous. This information is compiled below and each DHB is ranked in terms of diabetes nurse specialist service provision based on population. It should be noted that some DHB's may provide their services in a different manner, for example, relying more heavily on diabetes nurses specialists, and therefore requiring more diabetes nurse specialist services. There are currently no recommended levels of Diabetes Nurse Specialist services for New Zealand known to us. However it is recognised world wide that Diabetes Education is essential to enable people with diabetes to effectively manage their condition and maintain an acceptable level of health [1-4].

These figures do not break down the hours for Diabetes Nurse Specialist working in different areas e.g. paediatrics, antenatal or in the community. It could be that the larger centres especially may have specific nurses that may be working in these areas that have not been accounted for in the statistics. In general smaller centres have nurses that cover all areas. It may be useful in the future to specify hours spent in paediatrics and antenatal around the country to establish if these areas are adequately catered for.

Findings:

  1. There is significant variation in the provision of Diabetes Nurse Specialist services between DHB's.
  2. The national mean is 2.79 FTE Diabetes Nurse Specialists per 100,000 population.
  3. The national range is 1.08 to 4.87 per 100,000 population.

Conclusion:

There is significant variability in the provision of Diabetes Nurse Specialist Services in New Zealand. This must lead to inequities in service delivery between DHB's. While some areas provide Diabetes Nurse Specialist services in a different way, perhaps to make up for deficiencies in Medical specialist services hours, there are many that would appear to be simply under resourced. With the incidence of diabetes in New Zealand increasing [5] and the Ministry of Health emphasis on targeting improved diabetes management [6] it would indicate that many areas in New Zealand are understaffed and that reducing numbers in any DHB would be counter productive.

 

Area Total Population ranking Diabetes Nurse Educator/ Specialist Diabetes Nurse Educator/ Specialist per 100,000 pop Ranking
Waikato 355000 3 17.3 4.87 1
Hutt Valley 141000 12 6.75 4.78 2
West Coast 32000 21 1.4 4.37 3
Nelson / Marlborough 135000 13 5.2 3.85 4
Capital and Coast 282000 6 10.35 3.84 5
Wairarapa 39000 20 1.5 3.80 6
Northland 154000 10 5.8 3.76 7
Midcentral 165000 9 5.9 3.57 8
Hawkes Bay 153000 10 4.4 2.87 9
Whanganui 63000 18 1.8 2.85 10
Lakes 102000 16 2.7 2.64 11
Counties Manukau 468000 4 10.8 2.30 12
Auckland 439000 5 9 2.05 13
Taranaki 107000 14 2.2 2.05 14
Bay of Plenty 204000 7 4 1.96 15
Southland 110000 14 2 1.81 16
South Canterbury 55000 17 1 1.81 17
Tairawhiti 45000 19 0.8 1.77 18
Waitemata 516000 1 6.5 1.25 19
Canterbury 491000 2 6.1 1.24 20
Otago 185000 8 2 1.08 21
           
Total 4241000   Total: 58.52  
      Average: 2.79  

Recommendations:

  1. Inform the Minister of Health of this information, particularly the inadequate and inequitable provision of Diabetes Nurse Specialist services in New Zealand.
  2. A nationally agreed target for Diabetes Nurse Specialist Services should be established to reduce the inequity in service provision between DHB's.
  3. DHB's should be instructed to meet this target within a reasonable time frame e.g. 5 years.
  4. Diabetes should be recognised as an under-resourced discipline and more Diabetes Nurse Specialist positions should be resourced.

References:

  1. Lisa Kiblinger and Norbert L. Braza. The Impact of Diabetes Education on Improving Patient Outcomes. Insulin Journal Volume 2, Issue, January 2007, Pages 24-30.
    http://www.insulinjournal.com/pdfs/v2i104V2I1
    INSULIN    2007TheImpactofDiabetesEducation.pdf
  2. Standards for outcomes measurement of diabetes self-management education. American Association of Diabetes Educators. Diabetes Educ. 2003 Sep-Oct;29(5):804, 808-10, 813-6.
    http://www.diabeteseducator.org/export/sites/aade/
    resources/pdf/PS-Outcomes.pdf
  3. International Diabees Federation. IDF Consultative Section on Diabetes Education. http://www.idf.org/Diabetes_Education. Last accessed 22.06.09
  4. International Diabetes Federation. Position Statement - Diabetes Education. http://www.idf.org/home/index.cfm?node=1093. Last accessed 22.06.09
  5. Ministry of Health. Diabetes in New Zealand: Models and Forecasts 1996–2011. March 2002.http://www.moh.govt.nz/moh.nsf/0/16a3945b4714f9fccc256b74000f3551?OpenDocument#forecasting. Last accessed 22.06.09
  6. Ministry of Health. Health Targets. Improving Diabetes and Cardiovascular Serviceshttp://www.moh.govt.nz/moh.nsf/indexmh/healthtargets-targets-diabetes. Last accessed 22.06.09