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Safe and Effective Care in Wales

Implementing and extending the Nurse Staffing Levels (Wales) Act 2016

By protecting nurse staffing levels, we can protect patients.

Nursing is a safety-critical profession. A shortage of registered nurses can increase mortality by up to 26%. On the other hand, with every 10% rise in the number of degree educated nurses, patients are 7% less likely to die.

Having more nursing staff around also reduces all kinds of other risks including falls and medication errors. It allows nursing staff time to care for people in a way that is compassionate and sensitive to their needs.

What is RCN Wales campaigning for now?

Under Welsh law, in certain kinds of ward health boards have to use a specific method to calculate the number of nurses they need. They then have to tell people what that number is, and try to provide that many nurses. RCN Wales members made this happen.

We believe these requirements, known as Section 25B, should apply everywhere nursing care is delivered in Wales.

Watch the Welsh Parliament debate extending Section 25B

10,572 people signed our petition to make this debate happen.

It's a law that protects nurse staffing levels in Wales.

It's the first law of its kind in the UK, and the result of a years-long campaign by RCN Wales members. It makes health boards and NHS trusts legally responsible for providing enough nursing staff in their nursing services and those they commission.

The law says health boards and NHS trusts in Wales must "have regard to the importance of providing sufficient nurses to allow the nurses time to care for patients sensitively". Health boards also have to publish a report on how successful they've been at complying and take action if failings occur. In some types of ward, the requirements go further - see "What is Section 25B?" below. 

Section 25B says that in certain kinds of ward, health boards have to:

  1. calculate the number of nurses appropriate to provide care to patients in a specified way,
  2. inform patients of this number, and
  3. take all reasonable steps to maintain it.

Just two kinds of ward came under Section 25B when it came into force in 2018, but a clause in the law allows politicians to extend it.

This could allow new areas like children's wards, community nursing and mental health wards to benefit. Five years later, it has been extended once - to children's wards.

We have a moral obligation to protect patients from avoidable harm. Section 25B worksRCN Wales believes Section 25B should apply everywhere nursing care is delivered in Wales.

Effective care maximises what goes right. Safe care minimises what goes wrong. By protecting nurse staffing levels, we can ensure everyone receive the safe and effective care they need and deserve.

Find out what to do if you see poor care or feel you are being prevented from providing safe, compassionate care here.

If you are an RCN activist, please login to the Reps Hub to find our Representatives Toolkit. Designed by our Employment Relations Team, it provides tips and resources to help reps and members escalate concerns around the implementation of the Nurse Staffing Levels (Wales) Act 2016 in their organisations.

Get up to speed

The petition might be over, but this introduction is as relevant as ever.

Our latest publications

We regularly publish our research on nursing in Wales. Browse through our most recent publications or click for more.

Nursing in Numbers 2023

The latest in a yearly series, our flagship statistical report finds NHS registered nurse vacancies now sit at 2,717, up from 1,719 in 2021. Read in Welsh or English.

June 2023: Caring for older people

Two-thirds of RCN Wales work in the community, many in care homes. Discover how we can make sure people in care homes continue to get the safe and effective care they need. Read the executive summary in Welsh or click here for the full report.

Progress and Challenge in Delivering Safe and Effective Care 2022

How have health boards implemented the Nurse Staffing Levels (Wales) Act 2016? This major new report updates the 2019 edition.

All our publications on nursing in Wales

We regularly publish new research on the nursing profession in Wales. To browse through our publications, click the title of this box or click here.

Explore and get involved

Discover the timeline

Explore the timeline of the safe and effective care campaign in Wales.

Spread the word

We've got a wealth of resources for you to use online.

In our members' words

Staff shortages affect everyone. RCN members explain why.

Last Shift Survey Report

Last year's survey reveals the extent of the UK staffing crisis in nursing, with 8 in 10 shifts lacking enough staff to keep patients safe. Read more today.

Follow RCN Wales

Find us on
Facebook, Twitter and Instagram
for all the latest news, events and consultations.

Campaigning for safe staffing across the UK

Take a look at what is happening in England, Scotland and Northern Ireland here.

Page last updated - 06/10/2023