Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Peers being pressed to support staffing ratios and HCA regulation


The Royal College of Nursing is lobbying the House of Lords to amend five areas of the Health Bill it believes will cause “serious and detrimental” harm to the NHS and patient care.

The bill is due to be debated by peers this week after passing through the House of Commons last month.

In a briefing paper, the RCN welcomed some of the concessions won by MPs but said many areas of concern remained. It is now attempting to secure changes to five main areas of the bill, to ensure it recognises the need to:

*Provide a service that promotes integration and collaboration

*Introduce mandatory staffing levels and the regulation of all healthcare workers

*Resist moves towards local pay bargaining

*Price services in a way that allows for high quality patient pathways

*Retain a cap on the proportion of trusts’ income that can come from private patients.

The RCN is likely to focus on securing amendments regarding staffing levels and healthcare assistant regulation, Nursing Times understands. It is talking to peers from all political parties in the hope they will agree to table amendments on its behalf.

As Nursing Times went to press, 94 peers were due to speak in Tuesday’s debate on the bill – thought to be the highest number since 1999.


The RCN’s priority areas

Staffing levels

The RCN is seeking an amendment to specify that the ratio of registered to non-registered nursing staff should not fall below 65:35 in general and surgical wards.

Under the amendment, it would be up to the NHS Commissioning Board – being established as a statutory body next October - to stipulate that providers of NHS services do not allow ratios to fall below this level.

It would also be necessary to establish a benchmark for how many patients a registered nurse should take responsibility for, the briefing states.

Healthcare assistants

The briefing calls the government’s decision not to provide statutory regulation for healthcare assistants a “mistake”.  

The RCN wants to amend the bill so that HCAs and assistant practitioners have to sign up to a mandatory register.

The document notes that this was endorsed in a health select committee report in July, which said it was the “only approach which maximises public protection”.


Readers' comments (4)

  • Hmm, I'll believe it when I see it, as the RCN has paid much lip service to this before yet done nothing to push for it.

    WHAT exactly are they doing? WHAT is their timetable? And WHAT sanctions are they using if the government do not acquiesce? I want specifics from the RCN this time.

    Furthermore as stated in other articles, this ratio does not go far enough. Even by some miracle the RCN did work hard to push it through and were successful, what would they do to ensure trusts comply? Why is it only up to the commissioning board? Why is it not being made a legal requirement.

    As I said, I suspect this is a lot more hot air from the RCN.

    Unsuitable or offensive? Report this comment

  • I would like patient dependancy to be taken into account on staffing levels.
    Dependant patients require more time and with that goes the increased paperwork. The ratio is important but you need enough staff in the first place to be able to give adequate quality care. A 65:35 ratio qualified to unqualified sounds good but to how many patients?

    Unsuitable or offensive? Report this comment

  • The RCN aren't going far enough, I believe. Whatsmore, I don't believe they will get anywhere because their noses are buried too deep in governments backsides.

    Unsuitable or offensive? Report this comment

  • Bring back SENs. They were regulated, accountable and their skills were recognised on the register. Some of the best nurses I ever worked with!

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.