Pink tick and words safe staffing saves lives on a dark blue background

Staffing for safe and effective care in England

Staffing for safe and effective care in England

Nursing staff are the heart of our health and care services. They care for us in hospital, advocate for us in our GP surgery and support us in our own homes. But the simple truth is, there are not enough nursing staff to provide the care that patients need.

This means that essential care can be left undone - patients wait for longer for treatment and vital services remain undelivered. When a setting is short staffed, those delivering care have no option but to carry on. Our members and their colleagues do their best every day, working above and beyond. But even in a profession they love, the ongoing pressure is unsustainable.

Supporting our members to deliver safe and effective care is one of the RCN's major priorities, and we're working hard to find different ways to influence the changes the profession needs.
nurse with older lady laughing

The RCN is demanding that the government properly invests in nursing education, bases workforce assessments on need and makes them public, and puts accountability in law for the provision of staffing in England.


Internationally recruited nurses make a vital contribution to the workforce in the UK. The RCN is clear that any international recruitment must be ethical and not undermine health systems in other countries, and only take place when international recruitment is required to complement the domestic workforce, not instead of appropriate investment in education and training of domestic staff.


Where appropriate international recruitment is required, it must adhere to UK and global Codes of Practice that guide effective and ethical recruitment. We also work to influence a fair, effective and inclusive UK immigration system and appropriate testing and registration process to ensure fair and clear routes for appropriately trained international nurses to join the UK nursing workforce. We’re clear that there must be ministerial accountability for safe staffing written into law in England.


This means that the Secretary of State must have a legal duty to produce a workforce strategy based on population need, to ensure there are enough nursing staff now and in the future. 


The RCN is clear that the new Health and Care Bill must reflect the concerns of nursing staff. The Bill must set out in law the responsibilities government ministers have for delivering safe staffing levels for patients and staff and secure the sustainability of health and care services.

The RCN is demanding: 

> The Secretary of State for Health and Social Care has accountability for workforce planning and supply, as part of service and financial planning 

> The Secretary of State for Health and Social Care undertakes and publishes a detailed assessment and analysis of future workforce demand and supply requirements for all health and care services across England 

> An expansion in the number of nursing students and full financial support including grants that reflect the real cost of living (a lack of financial support for students on nursing degrees has resulted in a worrying decline in the number of people applying to study nursing in England.

The RCN also expects employers and the government to retain the current nursing workforce, through improved pay, terms and conditions. Find out more about our Fair Pay For Nursing campaign.


It's vital that nursing staff in all settings are able to work safely and with the confidence that they are supported to deliver the right care to those accessing services.

The RCN's Nursing Workforce Standards are the first national blueprint for tackling the nursing staff shortage levels across the UK. They set the standard for excellent patient care and nursing support in all settings, and all UK countries.

Developed by the RCN's Professional Nursing Committee, the Nursing Workforce Standards suggest a roadmap for designing a workforce in both the NHS and the wider health and social care sector that can offer patients the quality of care they deserve.

This is vital as health services begin to return to normal as the COVID-19 pandemic continues.

Nursing is the largest safety critical profession in healthcare and it is vital that the right staff, with the right skills are in the right place, at the right time.

You may have concerns about issues that will impact patient care or safety.

If you are worried, you can raise concerns in the first instance with your manager or employer using the model letter we have developed. Do refer to the Nursing Workforce Standards which set out the standards we expect all employers to meet, to support the delivery of excellent patient care and nursing support in all settings.

You can be reassured you are doing the right thing in raising your concerns, and the RCN will support you to take things further if needed.

We have also written a model raising concerns letter for nursing support workers. Other resources you may find useful are available here.

Get involved

As a campaign supporter you'll receive regular emails with online actions to help us campaign on the big issues facing nursing.

Help #FundOurFuture nurses

Nursing students need support to join and stay in the profession, to help grow our domestic nursing workforce. Find out more.

Fair Pay For Nursing

A fair pay increase is one way to help recruit and retain the nursing workforce. Support our campaign for Fair Pay For Nursing.