Clinic workers in North Rhine-Westphalia have been on strike for weeks for better conditions. Nurses are also at the limit in other regions. The government is now promising fundamental improvements.

In the future, Germany’s hospitals should have to employ as many nurses as are actually needed for good care. To this end, the federal government wants to introduce an instrument for staff assessment in three stages, as announced on Thursday from government circles. Clinics that do not meet the planned new requirements should be punished with sanctions from 2025 at the latest, as it was said.

North Rhine-Westphalia, for example, is currently showing how big the gaps and frustration are in nursing. For ten weeks, employees at six university clinics have been fighting for better working conditions with strikes. The medical director of the Essen University Hospital, Professor Jochen A. Werner, told the German Press Agency that the supply was “massively” impaired. The shortage of staff is exacerbated by the strike measures and by corona-related absences. Sometimes there are already “acutely threatening situations”.

In order to generally improve the situation in the long term, patients are to be divided into eight so-called performance levels every day in the future. This is what the German Hospital Society says in an explanation of the planned new instrument, which the government referred to. Four levels of basic care and four levels of special care are planned. For each level, it should be determined in minutes how long it takes for the care.

The trial phase will start in January

In total, this should result in a time value per patient, with additional calculation variables (“basic and case values”) to be added. The bottom line is that the need for nursing staff should be mapped, according to the hospital company. The officially defined need for nursing time per patient is expected to increase by an average of 8.1 percent as a result of the new instrument.

The legislation for the reform is to be prepared with key points that have now been sent by the government to the parliamentary groups of the traffic light coalition. A test phase is planned from January 1, 2023, according to government circles. A “representative selection” of hospitals is to be involved for the time being.

From January 1, 2024, the personnel assessment tool will be mandatory in all clinics. However, if a hospital has collective bargaining agreements or other contractual agreements to relieve nursing staff, then the hospitals should not have to use the new instrument. Then there should be no threat of sanctions. As the government circles went on to say, a collective agreement to relieve the strain, such as that which the university hospital employees in North Rhine-Westphalia are currently trying to achieve, would be such a possible alternative to the planned personnel assessment instrument.