The Royal College of Nursing will look at the possibility of including nurse-to-patient ratios in its campaign for staffing legislation but will not necessarily call for all parts of the UK to adopt the same laws, its chief executive has revealed.
In her keynote speech yesterday, RCN chief executive and general secretary Janet Davies announced that the organisation would be launching a campaign in the autumn demanding that all UK countries to introduce or extend staffing laws.
Wales became the first country in Europe to introduce nurse safe staffing legislation in 2016 and, as a result, since April 2018, NHS trusts are required to calculate – and maintain – nurse staffing levels on acute wards using a set method laid out in guidance.
In 2016, Scotland’s first minister, Nicola Sturgeon, announced that the country would follow Wales in introducing nurse staffing legislation. Ms Davies said yesterday that the draft bill was due to be presented to parliament in the coming months.
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But following her speech, the RCN leader revealed the college’s campaign would not necessarily call for all parts of the UK to adopt the same legislation used in Wales. She also highlighted that different services may require alternative approaches to legislation.
“It might not even be the same for different parts of nursing. Because there are different needs in hospitals than there are in the community, or for mental health or for learning disability nursing,” she said.
She said the RCN was working with workforce experts and nursing professors to assess the evidence base from around the world ahead of the campaign launch later this year.
“We’re looking at all the research we’ve got on what makes safe staffing – looking across the world at what other people have done,” she said.
“[The legislation the RCN campaigns for] might not even be the same for different parts of nursing”
In California and parts of Australia legal minimum nurse-to-patient ratios have been in place for a number of years.
When asked by Nursing Times whether the RCN would campaign for nurse-to-patient ratios to be included within the legislation, Ms Davies said: “We are looking at everything, we are looking at what might be best.”
In England, work to produce safe staffing guidance by the National Institute for Health and Care Excellence (NICE) was stopped by NHS England in 2015.
It later emerged that NICE, which was on the verge of publishing guidance for accident and emergency departments, was due to recommend minimum nurse-to-patient ratios.
Meanwhile, in its previously released guidance for acute inpatient wards, NICE had stated there was an increased risk of harm if a registered nurse cared for more than eight patients on a day shift.
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Nursing Times asked Ms Davies how far the potential inclusion of ratios might be a barrier to its campaign for staffing legislation across the UK.
“There’s loads of obstacles but we will be using the evidence to get to what safe staffing looks like,” she said.
“There is evidence from all over the world – and what we are doing at the moment is collecting it,” she reiterated.
When later asked how long it might take to bring in staffing laws across the UK, Ms Davies said she did not know, acknowledging that it was a “difficult” time to be proposing new legislation, due to Brexit.
“We’re starting a bit from a standing start in England and Northern Ireland. There’s real [political] will in Wales and Scotland,” she said.