At the beginning of the third wave (Delta), management and COVID-19 clinicians in key Gauteng public sector hospitals worked with the GDOH Acting HOD and HQ officials to submit a proposal to the Solidarity Fund to support the provision of agency nurses to the eight largest public hospitals. This was to respond to the unprecedented need for significantly more COVID-19 beds. The proposal identified the shortage of nursing personnel as the single biggest bottleneck to opening more COVID ICU, high care and covid general beds. Technical support and leadership for the project was provided by the South African Medical Research Council working with the heads of the nursing management at all hospitals and Wits Heath Consortium (Pty) Ltd were appointed as the project managers.
The collaborative partnership between the Solidarity Fund, the Gauteng Department of Health, The South African Medical Research Council and Wits Health Consortium (Pty) Ltd successfully identified, recruited and deployed nurses with the necessary knowledge, skills and competencies for safe patient care to 8 Gauteng hospitals.
From 1 July 2021 to 31 March 2022 the Solidarity Fund through Wits Health Consortium assisted the Gauteng Department of Health with funding for agency nurses to augment staffing in 8 of the Gauteng hospitals. The highly transmittable Delta variant led to an overwhelming increase in infections resulting in increased hospitalization, and it became evident that the Gauteng provincial health services would not be able to cope with the increase demand for beds. The third wave affected Gauteng more than any province in the country. The Solidarity Fund initially donated an initial R16,692 million and then extended the programme with an additional R6,246 million .
The efficacy of the model was trialed at Steve Biko Academic Hospital and was an overwhelming success which was quickly rolled out to the other 7 hospitals in Gauteng.
As a result of this funding a total of 1 428 new beds were opened across ICU, High Care, General Wards in Paediatric, Obstetric and COVID ICU This partnership, through the opening of additional beds, contributed to reduced Covid morbidity, closed critical nursing gaps and reduced the work pressures on the small pool of full-time nursing staff in the hospitals. The project demonstrated how relatively small sums of money, when utilized effectively can qualitatively change health outcomes.
The funding received allowed hospitals to use the additional services of over 10 000 nurses illustrated by Figure 4 below
FIGURE 4. NUMBER OF SHIFT NURSES PLEASE MONTH PER HOSPITAL
The data and experience of the hospitals during the third wave highlighted that the SF-GDoH project made a significant impact in hospitals allowing them stay true to the value of saving lives and allowed community members to access and receive the treatment they so desperately required during this period.
Given the positive outcome of the project during the third wave, an extension was granted that saw the support being provided through the fourth (Omicron) wave.
The project reflects the impact of an investment in the provision of more than 10 000 nursing shifts to the main public sector hospitals in Gauteng during a time of crisis and represents the best examples of the power of partnership in the face of an unprecedented crisis.