NHS employers in Wales must have calculated the number of nurses they need and ensured they are making efforts to maintain staffing levels by the end April, under staffing laws that came fully into effect this month.
The legislation, which was passed in 2016, applies to all NHS adult acute medical and surgical inpatient wards in the country.
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Since April 2017, under the Nurse Staffing Levels (Wales) Act 2016, health boards and NHS trusts have been required to have workforce plans in place to ensure they have enough nurses.
From this month, they are required to have calculated nurse staffing levels using a specific method set out in statutory guidance, involving professional judgement, an evidence-based workforce planning tool, and consideration of how far patients are sensitive to nursing care.
NHS employers must also ensure they have taken “all reasonable steps” to maintain the required nurse staffing levels, and are require to make this information available to patients.
The statutory guidance for calculating staffing levels was finalised in November.
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It states that a “designated person” – who must be a registered nurse or midwife – must carry out the calculation, and that frontline nurses should be able to contribute their views.
Wales is the first country in Europe to introduce a law about nurse staffing levels.
When the statutory guidance was released last year, the chief nursing officer for Wales, Jean White, described it as a “big step” towards ensuring the NHS had enough nurses.
Today, she said: “I’m really delighted that Wales has taken the lead in introducing this piece of legislation. It is a wonderful opportunity for us to get the right nurse staffing levels to meet our patients’ needs and to empower our nurses with the evidence base that will support and help inform their professional judgement.
“There is a real sense of pride in Wales within our nursing community and we regularly read about how the Welsh public share that sentiment, in letters praising the outstanding care they have received at the hands of our nursing staff,” she said. “We want to see the implementation of this act cement that feeling of pride and see it spread to every corner of our workforce.”
“We now have a system to empower and support nurses on the front line”
Welsh health secretary Vaughan Gething said: “Implementing the nurse staffing levels legislation is a real step forward for Wales.
“And we have done so because we understand there’s an evidence base that shows high quality nursing care with the right numbers and skill mix makes a real difference to patient care and patient outcomes,” he said.
He added: “We now have a system to empower and support nurses on the front line, and nurse leaders to use their professional judgement to understand and plan for the right levels of care; with the right number of nurses needed to ensure the patient gets the very best deal possible.”
Commenting on the full introduction of the law this month, Tina Donnelly, director of the Royal College of Nursing in Wales, said: “This is a fantastic achievement which will focus on ensuring patients will benefit from legislation that will protect them and ensure a safe environment of care.
“Low nurse staffing levels are directly linked to sharp rises in patient mortality - this new law demands that an appropriate number of nurses are at bedsides providing patient care and there will be an obligation for employees to ensure this happens.”
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“We acknowledge that there are currently around 3,000 vacancies for nurses in the NHS in Wales and would urge that the Welsh government’s nursing bursary continues so that the number of new nurses coming into the profession can compensate for this staffing shortfall,” she added.
She said the RCN would be working closely with the government on its future workforce plans.
Welsh Assembly member Kirsty Williams introduced what would become the Nurse Staffing Levels (Wales) Act as a private member’s bill in December 2014. With the support of Welsh government, the act received royal assent on 21 March 2016.