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Safe nurse staffing law in Wales: improvements made to patient care, but stricter guidance is needed

28 Nov 2023

We’ve launched our latest report on the impact of the Nurse Staffing Levels (Wales) Act 2016 on health care delivery.

Nursing staff It's been 7 years since the Nurse Staffing Levels (Wales) Act 2016 was introduced following campaigning with RCN members in Wales.

Our third annual progress and challenge report has shown that the act has increased the number of nurses on wards covered by Section 25B. This requires health boards to calculate and take ‘responsible steps’ to maintain the nurse staffing level in all wards where it applies. This requirement is directly improving patient care, but stricter operational guidance must be developed to ensure that the benefits of safe staffing levels are seen across all NHS nursing care settings.

As a result of the legislation, greater responsibility lies with the Welsh government and health boards in Wales to ensure safe staffing levels are maintained through better data capture and workforce planning. Members also have strengthened autonomy in using their professional judgement and lived experience to communicate staffing requirements.

However, the current legislation does not go far enough. In other clinical areas, members are still left struggling to care for patients in extremely difficult conditions and when standards of care fall short, they are wrongly called to account.

Read the full report in Welsh and English.

We're campaigning for the extension of section 25B to community and inpatient mental health units and for the application of statutory guidance to section 25A. In 2018, 25B applied in adult acute medical and surgical wards. It was then extended to children’s wards in 2021.

Section 25A calls for the Welsh government and health boards to prioritise nurse staffing numbers in all settings where nursing care is provided or commissioned. Non-compliance should be met with explicit consequences.

Helen Whyley, Director, RCN Wales said: 

“The groundbreaking Nurse Staffing Levels (Wales) Act 2016 was the first of its kind in Europe. I’m delighted that the RCN has played such an important role in pioneering this essential work.

“The RCN is campaigning for the act’s full potential to be realised through statutory and operational guidance across all care settings. To truly meet the health needs of the Welsh public, it is paramount that mental health is equally important as physical health and that complex needs are cared for in a person’s own home. Some of the most vulnerable people in our society continue to be let down by depleted services, which is why we are also calling for section 25B of the act to be extended to community and mental health inpatient services.

“Whilst we reflect on how far we have come since 2016, it is clear that this is not the silver bullet to fixing health care in Wales. Investment in nursing is the only sustainable remedy to the chronic recruitment and retention crisis in Wales. Fair pay that reflects the safety critical role of nursing and supports staff in the cost-of-living crisis is crucial in recruiting and retaining an experienced workforce for the future”.

Page last updated - 27/04/2024