On Monday, Waitaki District Health Services (WDHS) announced decisions made after consultation as part of its proposed staff restructuring and layout change at Oamaru Hospital.
Consultation closed in late March after it was extended by about two weeks, which resulted in 185individual submissions.
A document distributed to staff on Monday and obtained by the Otago Daily Times detailed the decisions and how staff feedback influenced them.
WDHS chief executive Ruth Kibble said while changes had been made to the staff restructuring originally proposed with a view to reducing costs, she was confident the company would be able to turn around its projected $1million-plus deficit for the 2018-19 financial year.
The Waitaki Community Hospital Action Group confirmed its protest march, planned before the announcement, would go ahead tomorrow, because of concerns over the support of staff, the retention of services and the hospital's financial state, among others.
On changes to Allied Health services leadership and a reduction of the full-time-equivalent (FTE) occupational therapy role to 0.4 FTE, feedback was mixed and identified a need for strong leadership across Allied Health under a revised structure.
WDHS backed down on the proposed changes and will instead appoint a "designated professional leader" to each group, co-ordinated by a director of nursing and operations.
A proposal to disestablish the 0.2 FTE additional quality role will go ahead and the two staff sharing the role will be rostered for clinical duties. The disestablishment of the nurse educator role was rejected by staff over concerns about an objective to have all staff "working at top of scope".
Instead, a new clinical trainer role would be created.
Staff supported the "high value" placed on nursing practitioners and the recruitment of permanent staff to reduce costs associated with locum doctors, but expressed concern about an ability to deliver outpatients clinical services.
WDHS scrapped plans to reduce inpatient enrolled nurse numbers after extensive feedback on a proposal to change nurse staffing levels in the 20-bed inpatient area.
Staff accepted that care could be enhanced as long as staffing was adequate and that the value of enrolled nurses, who staff said were not being utilised fully, should not be ignored.
In the new acute care area, a merger of the high-dependency unit and emergency department, two nurses and a shared healthcare assistant will work each shift.
That was supported by staff, but concerns were raised about the possible impact if staffing was not adequate in other areas of the hospital.
It was confirmed the duty nurse manager and nurse co-ordinator roles would be disestablished, which some staff said were "the glue" of the organisation.
Affected staff would be rostered on in clinical areas.
It was decided not to move the responsibility of chemotherapy work to the outpatients department, and the position would remain a 5.7 FTE position after staff opposed the proposed changes, based largely on the need for district nursing to continue to oversee services.
