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Practice based learning

Safety critical nurse-to-patient ratios

Setting limits on the maximum number of patients per registered nurse in every UK health care setting

The evidence is clear. The risk of death increases by 3% each day a patient experiences a registered nurse staffing shortage. We need staffing levels that protect nursing staff and patient safety.

High numbers of nursing vacancies are having a devastating impact on nursing staff and their patients. Many nurses are caring for unsafe numbers of patients and facing overwhelming pressure and burnout. Patient care is put at unacceptable risk when there are too few nurses to deliver safe care.

We've brought together senior nurse leaders from across the UK to hear from international workforce experts, assess the evidence and agree our collective vision for the future. This will include our work here at the RCN to set safety-critical limits on the maximum number of patients per nurse – in every health and social care setting in every part of the UK.

Right staff, right skills, right place, right time 

This isn’t just about numbers.

We often hear about nurses being redeployed to areas they’re not familiar with and asked to do tasks they’re not trained for. This risks their professional registration and can pose a risk to patients.

It’s critical that the right nursing staff with the right skills are in the right place, at the right time. But our members consistently tell us this doesn’t happen in their workplace. For the delivery of care to be safe and effective, nursing staff must be adequately trained in the clinical specialty they work within.

There’s a staffing crisis in nursing across the world. But in some countries, governments are stepping up. They’ve introduced mandatory nurse-to-patient ratios to protect nursing staff and patient safety.

We're the largest professional nursing body and union in the world. By working with our members and nursing leaders, we’ll make safety critical nurse-to-patient ratios a reality in every UK health care setting.

Our path to change

We made a commitment to our members at RCN Congress 2023 that we'll campaign for safe nurse-to-patient ratios. We'll achieve this in 3 phases. 

Raise awareness

We're highlighting the risks of unsafe staffing, using evidence from our members.

Set ratios

We'll set safety-critical ratios for every UK health and social care setting.

Secure commitment

We'll campaign so that health leaders and politicians fully commit to safety-critical ratios.

Headshot of Nicola Ranger

We must set a safety critical red line when it comes to how many patients nursing staff are expected to care for. We know 1 nurse can be left caring for 10, 15 or more patients at a time. It's not safe. It's not effective. And it's not acceptable.

Read more

Professor Nicola Ranger RCN Chief Nurse

Hear more at RCN Congress 2024

Be the first to hear about our plans to set safe nurse-to-patient ratios at RCN Congress in June. Book your free place now. Or catch up online after. 

Pat speaking at RCN Congress 2023

Actions you can take today

Become a standards champion

Our Nursing Workforce Standards set out what must happen within workplaces for nursing staff to deliver expert, patient-centred care. Help embed them at your workplace. 

Learn more

Sign up for campaign news

Get the latest updates on our work to set safe nurse-to-patient ratios in every health care setting in every part of the UK – sent straight to your inbox.

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See the evidence

Watch the videos below to hear more about the global evidence for ratios. 

'The international evidence base for establishing minimum safe hospital nurse staffing standards'

Professor Linda Aiken

Professor of Nursing and Sociology
Founding Director, Center for Health Outcomes and Policy Research, University of Pennsylvania

'Nurse staffing research evidence and NHS policy'

Professor Jane Ball

School of Health Sciences, University of Southampton

'Learning from ratios in Australia'

Professor James Buchan

Queen Margaret University, Edinburgh

'Our nurses, our future: An overview of the global nursing workforce'

Howard Catton

Chief Executive Officer, International Council of Nurses

'Why safe nurse-patient ratios? Because it's our job!'

Linda Silas

President, Canadian Federation of Nurses Unions