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'Crossing the bridge to safer staffing levels'


Huge congratulations to Wales on passing the Nurse Staffing Levels (Wales) Act 2016, making health boards legally responsible for ensuring there are sufficient nurses to provide safe care.

No other UK country has achieved this.

If I could make a fanfare sound as you read that, I would.

England has been fudging the issue by claiming there is no evidence base for minimum safe-staffing ratios. How can that be true in England but not in Wales?

NHS England’s claim is really just code for “we can’t afford it and even if we could, we haven’t trained enough nurses to staff wards safely”.

After the Royal College of Nursing found that chief nursing officer for Wales Jean White’s recommended average nurse-patient ratios – 1:7 in hospitals during the day and 1:11 during night shifts – were going largely unmet, the decision was taken to mandate what had previously just been guidance.

Of course, the Act also compels Wales to get its house in order for workforce planning. Minimum numbers require a good supply of registered nurses and therefore more training places. In the meantime, NHS Wales accepts that agency use will increase.

But if nurses will be working with the right number of colleagues, and feeling supported and able to do their jobs to the appropriate standard, this is likely to boost morale, reduce burn-out and increase retention.

While the legislation will initially be applied only in adult acute and surgical wards in NHS hospitals, it is likely to be extended further.

So why is there support for this in Wales but no appetite in England? While England strangles trusts with agency caps, throws the supply of students into chaos with a poorly managed plan to reform education funding and scrambles to find a new role that is, I fear, very likely to replace many registered nurses (we have too few RNs, which is why the nursing associate role is being created), Wales has mandated safe-staffing RN ratios.

If the evidence for safe staffing exists in Wales, then surely it is the same across the UK?

Or are we to believe that care is only affected by the number of registered nurses providing it once you cross the Severn Bridge from England?



Readers' comments (4)

  • michael stone

    'If the evidence for safe staffing exists in Wales, then surely it is the same across the UK?'

    Answer: yes.

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  • michael stone

    Professor David Oliver has been writing about this in BMJ - I'm not sure exactly what he said, as the article is subscription, but the title is 'Nurse staffing levels are still not safe':

    I've commented on David's the piece, pointing at Jenni's article here on NT.

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  • connormum2003

    no mention of Scotland....or Ireland....they don't have minimum numbers in Scotland either. I think we all know the reason why! Because there would never be enough staff to do this and the government like to cover up nursing shortages but if they brought this in it would then be exposed. It has been long overdue.

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  • In care homes staffing levels are even worse. In one I was the only nurse with 71 residents, 17 were classed as nursing. However those 17 were violent EMI residents.
    Incidents happen and one did, I ended up before our adversaries the NMC. Taking it to an appeal Judge Gosnell said "The unsafe working environment and the dangerous staffing made the staff position intolerable"
    Carehome owners should take that as a warning for future cases. Dangerous staffing will not be tolerated by the appeal courts even if the NMC will not accept it as a 'strong mitigating circumstance'

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