Nursing Workforce Standards

Nursing Workforce Standards FAQs

Here are some questions and answers that provide more detail about the Nursing Workforce Standards, and how they can be used by all nursing staff, across all settings in the UK.

If you need support with a safe staffing issue in your workplace, please contact your RCN rep, or RCND.

The Royal College of Nursing (RCN) Nursing Workforce Standards set out our expectations for safe and effective staffing across the UK.  

The first of their kind, the Nursing Workforce Standards apply across the UK, and will be used by those responsible for funding, planning, commissioning, designing, and reviewing the nursing workforce. They also set the standards which nursing staff expect to be in place to enable them to deliver safe and effective physical and mental health care, whether that is acute NHS care, community care, independent sector, care homes, prisons and other settings.  

There are 14 Standards, grouped into three themes, that can be applied to any service in which nursing staff are engaged and nursing care is delivered.  

The Nursing Workforce Standards address the lack of formal guidelines around safe staffing in most settings. The Standards have been created and agreed by registered nurses and nursing support workers to ensure safe and effective care. Many should already be upheld and delivered, but we know there are inconsistencies in leadership and support structures within workplaces.  

The Standards are vital to support the nursing workforce in delivering real change that ensures the safety of care and benefits the mental and physical wellbeing of both staff and service users.

Evidence and experience show that having the right number of staff, with the right skills, in the right place at the right time across health and social care improves health outcomes, the quality of care we deliver, and service-user safety.  

Staffing the nursing workforce to a level that feels safe for both those receiving care and those delivering it has historically been challenging. As the COVID-19 pandemic continues and services return to ‘normal’, we need to address the unintended consequences of the pandemic. The physical and mental toll on health care staff throughout the pandemic has been huge and we know many of the nursing workforce are considering leaving the profession. The nursing workforce is key to the safe and effective restoration of health care services and incorporating lessons learnt into future service planning and provision. Now more than ever, Standards for the nursing profession are vital.  

In its entirety, the pandemic has taken a significant toll on the mental and physical health of the nursing workforce, with burnout and fatigue being experienced in every single area of health and social care, not just those working with acutely unwell COVID patients.  

Within acute settings, many members of the nursing workforce have been redeployed for the waves of the pandemic and will need to return to their substantive role. Many scheduled physical and mental health services across health and social care have been delayed or cancelled, causing a significant backlog.  

Nursing across all community settings, including care homes, has faced an escalation in staff/resident ratios, a reduction in family support due to the pandemic restrictions and experienced increased pressure in both complexity and acuity in an already unstable tightly funded system.

The national vaccination programme is ongoing, and is a fantastic step forward, but it does put added pressure on the nursing workforce now delivering the programme.  

It is important that the Standards are not seen as another target to meet; they are designed to support the entire nursing workforce across health and social care as a roadmap to aid remobilisation and recovery.

We are the professional body for nursing. We speak for the nursing profession and the safe care of patients and service users across health and social care in every setting where a nursing workforce member is present. Safe staffing is an organisational priority, and we must support our members by ensuring their places of work have safe and effective staffing levels that enable them to carry out their role as effectively as possible.  

The nursing profession has proven collective leadership during the COVID-19 pandemic, and going forward, there is an opportunity to build on that.

Although legislation differs across the four countries of the UK professional commonalities and ambitions are the same.  

The Standards are a living document that will develop over time through feedback from our members, nurse leaders and those who use the Standards. A formal evaluation phase has been built in to ensure member’s experiences are captured and the Standards are useful, usable, and relevant.  

The Standards can be used in many ways, for example:  

  • at an organisational level to set, review and act on nursing workforce  
  • at an individual level to ensure delivery of safe care or continuing professional development.  

Anyone who works in a health or social care setting where a nursing workforce member or team is present can use the Standards to assure or influence the highest standards of care for service users or patients.  

Anyone developing a service that includes a nursing workforce within it can utilise the Standards to positively affect the nursing workforce and the service users.  

There are three, easy-to-follow themes: Responsibility and Accountability; Clinical Leadership and Safety, Health, Safety and Wellbeing.  

Nursing staff now have a tangible, robust and authoritative set of Nursing Workforce Standards to support their need to be safe and effective in their roles. The Standards support all members of the nursing workforce to use their nursing voice with authority, backed by the Royal College of Nursing.  

The UK population needs and expects high quality care and trusts nurses to deliver it. However, to deliver high quality care, there must be enough staff with the right skills in place. The Standards set out what we regard as necessary to meet the rising demands for care with the correct nursing workforce numbers, skill mix and training to deliver safe high-quality care.  

If an area of health and social care is short staffed, service user needs cannot be met, or anyone’s safety guaranteed. The Standards set out what we expect to see in place to support our nursing workforce to deliver the best care, in the safest way in a challenging economic and health climate.  

If any member of the nursing workforce is concerned about staffing levels, it is their duty to raise it. This is the right thing to do to safeguard and protect staff and service users, as well as learning from a situation and making improvements.  

Our Raising and Escalating Concerns guidance supports members to raise concerns wherever they work. It includes a decision-making flowchart to help decide whether and when to escalate.  

The Standards are deliberately set at a high and aspirational level. This is to ensure they can work alongside each nation’s legislation and any setting-specific guidance, and in every area of health and social care with a nursing workforce whilst still being adaptable to local nuances.  

They should be used by local, regional, and national organisations to implement positive change for the nursing workforce and by the regulators of health and care services and the profession.  

The Standards do not define specific models or tools of nursing workforce planning as they are high level and need to be applicable across all UK-wide settings. Where there are established practices or setting-specific guidance, these should be followed, and are to be used alongside them. The Nursing Workforce Standards web page will also signpost out to other relevant guidance, standards and information.  

We believe the Standards will be as well-known and well used as the NMC (Nursing and Midwifery Council) Code.  

Our vision is that the Standards will be cited by students, referenced by academics, and used by every member of the nursing workforce in myriad ways to support and develop themselves and their team.  

The Standards will be extensively used by organisations to guide their nursing workforce planning and assess whether there are adequate nursing staff to safely deliver the services needed.

With evaluation and feedback from our members we can continue to develop the Standards to ensure they are robust, useful, and used.  

Many regulators have committed to taking more contextual information into account when assessing the quality of services or investigating incidents. Standards help inform best practice staffing decisions, which in turn aid regulators as part of their information gathering. Health and care services use best practice guidance, such as these Standards, to inform their decisions, even if there is no legal or regulatory requirement for them to do so.  

One barrier which may affect the implementation of the Standards is a lack of funding for staffing. However, these Standards will help decision makers find gaps which are likely to affect patient safety or outcomes, which are elements assessed by regulators.  

The Standards are needed by the nursing workforce to enable robust decision making about the workforce and staffing levels.

If anyone is concerned about staffing levels, it is their duty to raise it. This is the right thing to do to safeguard and protect staff and service users, as well as learning from a situation and making improvements.  

Our guidance Raising and Escalating Concerns supports members to raise concerns wherever they work. It includes a decision-making flowchart to help decide whether and when to escalate a concern.  

The Standards have been co-created with our Professional Nursing Committee who are the decision-making body of the RCN on professional issues and provides leadership on our work in this area.

Liaison with all four countries of the UK, England regions, nursing experts in their fields within and external to the College, Employee Relations, Policy and Public Affairs and health care stakeholders have provided extensive feedback and collectively and collaboratively shaped the Standards into the final copy now available.  

A formal evaluation stage has been built into the project surrounding the Standards. We know that they may not be perfect first time and alongside the formal evaluation we welcome engagement and feedback to inform us where the Standards are not being met and to shape them further year-on-year to ensure they are robust, relevant and meet the needs of our wide membership.  

These Standards are about the safe delivery of effective physical and mental health care by the nursing workforce. Nursing workforce planning, commissioning and patient safety should be wholly influenced by nurses, but the burden of responsibility for poor policy decisions should not be shouldered by or rest with frontline nurses and nurse managers.  

These Standards set out what we expect to see in place as the professional body for nursing. Trade unions exist to maintain and improve conditions of employment and the quality of public services; both of which are inherent in these Standards.  

These Standards will help all unions in better understanding nursing workforce aspirations and challenges in health and social care and the standards expected for them to work safely.  

These Standards are designed to be useful for every member of the nursing workforce or those leading or designing a service in health and social care with a nursing workforce.  

They should be used whether you are a director of nursing, a commissioner designing a new service needing a nursing workforce, a nurse who is managed by another health care professional as part of a multi-disciplinary team, a registered nursing associate (England) or health care support worker working collaboratively with registered nurse colleagues.  

Not all Standards will apply to everyone, but they define what we expect to see from every organisation with a nursing workforce as well as helping teams and individuals to facilitate a safer, more effective place of work where staff have access to training in a healthy and safe environment.  

The Standards will also enable individuals to raise and escalate a concern when care does not feel safe by referring to nursing workforce specific Standards which should be in place.