Staffing for Safe and Effective Care

  What is the Nurse Staffing Levels (Wales) Act 2016?

• The Nurse Staffing Levels (Wales) Act 2016 became law on 21st March 2016.
• Health Boards now have a legal duty to have regard to the importance of providing appropriate numbers of nurses in all settings.
• In adult acute medical and surgical settings and, as of October 2021, in children's wards, nurse staffing levels must be calculated according to a specified methodology - and maintained at that level.
• Health boards have a duty to report on compliance with staffing requirements and to take action if failings occur.
• The Welsh Government has issued guidance on how to determine appropriate staffing levels.

  Why is this so important?

• This law protects patients. Research shows poor nurse staffing levels increased mortality by up to 26% compared to better staffed wards.
• This historic Welsh law is the first of its kind in the UK. International precedents have been successful in reducing patient mortality.
• It empowers the ward sister/charge nurse and the Nurse Director equally to ensure that there are safe nurse staffing levels.
• Safe staffing reduces readmissions, health care-associated infections, medication errors, falls and pressure ulcers as well as allowing nursing staff time to deliver compassionate, sensitive care.

This new report examines how health boards have implemented the Nurse Staffing Levels (Wales) Act 2016, and in particular Section 25B. Based on publicly available documents, after taking a look at national themes and indicating the challenges ahead, the report looks in depth in each health board.

• The Nurse Staffing Levels (Wales) Act 2016 has improved patient care and increased the number of nursing staff on wards covered by Section 25B.
• Patient acuity has increased, meaning Wales needs more registered nurses and health care support workers to care for patients.
• All health boards were prepared for the extension of Section 25B of the Nurse Staffing Levels Act to paediatric inpatient wards on 1 October 2021.
• The biggest challenge is that there are far more nurses leaving the NHS than can be matched by newly qualified nurses or internationally recruited nurses.

It follows RCN Wales’ 2019 report, Progress and Challenge: The Implementation of the Nurse Staffing Levels (Wales) Act 2016.

We're excited to launch our new report and short film on ward managers in Wales: the issues they currently face, but also the impact great leadership brings in improving patient care and reducing adverse incidents.

Often responsible for around 30 patients and teams of around 40, ward managers need protected time when they aren't required to care directly for patients and can focus on managing and leading their teams. This is called being supernumerary, and it benefits both staff and patients.

RCN members made this possible. Over 100 ward managers from across NHS Wales participated in three focus groups, interviews and an online survey. Their views and experiences and views formed the basis of our recommendations. Read the report.