Today’s discussion (6 June) at RCN Congress on the campaign for safe and effective care has me in a reflective mood.
Caring for patients safely and effectively lies at the heart of what nursing is for. There’s nothing more fundamental. What it means in practice is a workforce of tens of thousands of highly skilled and educated people, all free to practice their profession to give patients the best possible care.
And when I think of all we’ve achieved in Wales, I can scarcely believe it’s just seven years since I started a petition asking Welsh politicians to back the Safe Nurse Staffing Levels (Wales) Bill.
We RCN Wales members campaigned with all our might, and we made history. In 2016 Wales became the first nation in the UK to legislate on nurse staffing levels.
The real meat of the 2016 law is the part known as Section 25B, which requires that in some wards, health boards must precisely calculate the level of “sufficient nursing staff” that reflects patient need, maintain it, and report on whether they achieve it.
As an RCN member, I feel incredibly proud of that.
Less known, but still significantly, RCN Wales later joined forces with 16 other organisations to amend another law, the Quality and Engagement Act. Now, health boards now must produce a report each year on how they’ve improved quality of care in terms of workforce numbers, skills, and planning.
And after continued RCN Wales campaigning, October 2020 saw the Welsh Government finally announced it would extend Section 25B to include paediatric wards by the following October.
What difference does it make?
We’re already seeing the impact.
By 2019, nurse staffing levels had risen in every ward covered by Section 25B.
By 2021, some health boards were reporting entire years without one patient fall linked to low staffing levels that led to serious harm or death – down from double figures just a few years earlier.
But in some ways, this was the most significant thing of all: fears health boards wouldn’t be able to comply have proved completely unfounded.
Far from setting them up for failure, announcing Section 25B’s extension to paediatric wards spurred a flurry of activity. By October 2021, every single health board had had the conversations, made the preparations, and secured the resources they needed.
The lesson is clear: make safe staffing a legal requirement, and organisations will do what is necessary to comply. If that’s not impact, I don’t know what is.
Safe staffing touches on every aspect of nursing care and every problem facing the profession. Low staffing levels put patients at unnecessary risk and make it harder to deliver the highest quality care. That drains staff morale. Low pay rubs salt in the wound. People are driven to quit ever earlier in their careers. And so, the cycle continues.
That’s why we’re campaigning to extend Section 25B to nursing care everywhere, starting with community nursing and mental health wards. Without it, the pressure on staff isn’t sustainable. As I like to say, we can’t afford not to.
I’m fiercely proud of the RCN’s record on safe staffing in Wales. All nations in the UK should follow in Wales’s footsteps and heed the RCN’s call for safe care everywhere.
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