Hospitals and psychiatric institutions 2.2.6 Lack of qualified staff Working conditions should be improved The lack of personnel in the medical and nursing area puts the staff under a considerable strain, which can culminate in a difficult situation in the care of patients. It is difficult to find qualified staff, the reasons for this being above all the low pay in the nursing area and the lack of flexibility in work shifts. Ottakring Hospital The NPM observed that in Ottakring Hospital in Vienna, formerly known as Wilhelminen Hospital, several nursing positions were not filled, which means that it is not possible to comply with the defined staffing ratio for patient care. In a statement of opinion, the City of Vienna explained that the Vienna municipal hospitals recruit their own staff and advertise vacancies. Thanks to recruitment programmes, the staff situation in the nursing area could be substantially improved since the time of the monitoring visit. Landstrasse Hospital On a monitoring visit to Landstraße Hospital, formerly known as Rudolfstiftung, it was observed that 2.5 medical specialist positions were not filled in the department of general psychiatry due to a lack of suitable applications. Lack of doctors threatens quality of treatment This deficit places severe restrictions on the psychiatric treatment services, which can result in a negative impact on the quality of treatment and thus health. Furthermore, the lack of staff means an increased workload for the existing doctors. Besides, this can result in limited time for teamwork, sharing expertise, further education and training. The NPM therefore recommended analysing the causes of the lack of medical specialists in the department and creating incentives to find suitable medical specialists in psychiatry and psychotherapeutic medicine. Therapeutic programmes insufficient The hours per week in the therapeutic area were below the minimum personnel requirements set forth in the performance-related hospital financing model, based on the existing beds and day-care places. Human resources were particularly tight in the area of ergotherapy. The NPM recommended creating permanent positions for therapists too. Intensive recruitment required The City of Vienna explained that medical specialist positions were not filled because one employee was on maternity leave and another had handed in their notice. There were 1.87 positions vacant in July 2020. In addition, a senior physician returned to work in August 2020 after parental leave. Three doctors currently undergoing their medical specialist training will complete their qualification in the coming three years, which should help to alleviate the situation. Notwithstanding, it was assured that job advertisements are being constantly adapted and optimised. The staffing in the therapeutic area is also being evaluated. Staffing night shifts The NPM observed that staffing nurses on night shifts is difficult. Staffing with just one nurse every second night results in almost unmanageable situations in Floridsdorf Hospital, for example. The City of Vienna reacted with continuous 59