How we achieved safe staffing legislation in Wales

 Tina Donnelly 7 Mar 2018 Safe staffing

RCN Wales director Tina Donnelly reflects on the hard-fought campaign, which started in 2007.

Welsh Assembly
In 2016, Wales became the first country in Europe to introduce safe staffing laws for nursing. It was an historic step which caught the attention of policy makers across the UK.
In simple terms, the Nurse Staffing Levels (Wales) Act is a new law which places a legal duty on Health Boards and NHS Trusts in Wales to ensure they employ enough nurses to provide sensitive patient care in all settings and specifically an appropriate number of nurses are on shift in adult care settings.
The law also requires Health Boards to report on how Trusts are performing and take action if failings occur.
At the turn of the decade - before the campaign for safe staffing had begun - we knew that staffing levels was the number one concern for our members.
The evidence for introducing legislation was overwhelming, too.
Reports found that poor nurse staffing levels increased mortality by up to 26 per cent, compared to better staffed wards. And studies into similar legislation in California found safe staffing legislation has reduced 30-day mortality rates by between 10 and 13 per cent.
The campaign to pass legislation through the Welsh Parliament was long and hard-fought, and only possible thanks to the tireless efforts of both RCN staff and members.
For almost a decade, we kept the issue on the political agenda, in the media, at RCN events and in meetings with politicians and other health care organisations.
Through all of these activities, we made the case for legislation and reiterated that the new law would protect patients. 
The Nurse Staffing Levels (Wales) Act received Royal Assent on 21 March 2016, but our efforts soon focussed on effective implementation of the Act. This meant ensuring that statutory guidance, produced by the Welsh Government for Health Boards, was as robust as possible.
The final guidance was published on 2 November with a number of key changes, which we campaigned for, including recognition of the supernumerary role of the ward sister or charge nurse, and explicit reference to nurse-patient ratios.
Since the legislation has come into force, the Welsh Government has invested heavily in nurse training and education, thanks, in no small part, to our campaign which put patient care at the heart of government.
In the coming years, we’ll continue to monitor how the Act is implemented and work with the Welsh Government to extend the legislation into other areas including mental health, community and children’s and neonatal care.
And we look forward to working with colleagues in England, Scotland and Northern Ireland, to achieve safe staffing levels across the UK.

Tina Donnelly

Tina Donnelly

Director, RCN Wales


Tina Donnelly has been the Director of RCN Wales since 2004.  She has previously held senior management posts in the NHS in England and Northern Ireland and senior academic posts in higher education in England and Wales. 

Page last updated - 05/09/2018