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History: the Safe and Effective Care Campaign in Wales

How did we get here?

Wales may have passed the first nurse staffing legislation in the UK, but it took RCN Wales members years of campaigning to get where we are now. This timeline tracks the key moments in the campaign since 2006.


At RCN Congress in 2006, members pass a resolution demanding UK-wide legislation to ensure appropriate staffing levels.

Between 2007 and 2010, the RCN Wales Get it Right campaign consolidates workforce planning in the minds of Assembly Members (AMs).


An RCN Congress resolution in 2011 urges Council to campaign for enforceable nurse staffing levels.

RCN Wales launches the Time to Care campaign later that year, demanding a statutory duty for safe care.

In 2013, Liberal Democrat Assembly Member (AM) Kirsty Williams wins a ballot enabling her to introduce a private members' bill to the National Assembly. It's the first step towards the UK's first safe staffing law.


Kirsty Williams AM formally presents the Safe Nurse Staffing Levels (Wales) Bill, as it's then known, to the National Assembly. The Bill starts its legislative journey.


RCN members campaign hard for the Safe Nurse Staffing Levels (Wales) Bill. Through petitions, social media, and postcard campaigns directed at their AMs and at Ministers, members keep nurse staffing levels at the forefront of AMs' minds.

March 2016

The Nurse Staffing Levels (Wales) Act 2016 makes history, becoming the first law of its kind in Europe. Health boards and NHS trusts in Wales must now take all reasonable steps to maintain sufficient nurse staffing levels.

Section 25B of the Act goes further, giving health boards a legal obligation to precisely calculate nurse staffing levels that reflect patient need. From 2018, it will apply in all adult acute medical and surgical wards.

April 2018

All sections of the Nurse Staffing Levels (Wales) Act 2016 are now in force.

September 2018

A short film, An Act of Compassion, charts how RCN members brought about enforceable nurse staffing levels in Wales. A companion book is also released.


RCN Wales takes a first look at health boards' efforts to implement the law, finding nurse staffing levels have risen on all wards covered by Section 25B.

Read the report, Progress and Challenge, in English or Welsh.

October 2021

Section 25B is extended to children's wards following continued RCN Wales campaigning.

February 2022

A new book, Implementing the Nurse Staffing Levels (Wales) Act 2016explores how RCN Wales members and staff helped shape the implementation of Europe's first nurse staffing legislation after it was passed.

May 2022

RCN Wales publishes an update to its 2019 report, looking at progress in implementing the Nurse Staffing Levels (Wales) Act 2016. The period covered by the report includes the onset of the COVID-19 pandemic.

Read Progress and Challenge in Delivering Safe and Effective Care 2022 in English and Welsh.

Page last updated - 14/07/2022