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Welsh nurses asked for views on safe staffing law proposals


Nurses in Wales are being asked for their views on draft legislation that could see the country become the first part of the UK to enshrine safe staffing levels in law.

The ground-breaking bill, drawn up by Welsh Liberal Democrats leader Kirsty Williams, would impose a legal duty on NHS organisations to maintain minimum nurse-to-patient ratios on adult inpatient wards in acute hospitals.

“The bill will require ministers to issue guidance to health service bodies with the duties on safe staffing”

Kirsty Williams

The draft Safe Nursing Staff Levels (Wales) Bill itself does not specify recommended ratios. These would need to be set out later in new government guidance.

However, the bill makes it clear that leadership roles, such as ward managers and senior midwives, should be supernumerary and staffing plans must factor in time for induction, professional development, mentoring and supervision, and also planned and unplanned leave.

In addition, the draft document would require hospitals to stick to minimum skill mix ratios for nurses and healthcare assistants.

A formal consultation on the draft document is due to run until 12 September and Ms Williams will be touring Welsh hospitals to find out what nurses think of the proposed law.

Kirsty Williams

Kirsty Williams

She said she recognised the need to preserve flexibility, because of concerns that set ratios would be too rigid and take away nurses’ ability to use their own judgement.

“The need to preserve flexibility in order to respond to patient need and local circumstance was a key theme in consultation responses,” she said.

“The bill will therefore require ministers to issue guidance to health service bodies with the duties on safe staffing, which recognises the important role of acuity and dependency workforce planning tools, the exercise of professional judgement, and the need for an appropriate skill mix.”

If passed, the new law would mean every NHS body in Wales would have to publish an annual compliance report , including the number of times the safe staffing duty had been breached and action taken to prevent it happening again.

The legislation is due to be introduced to the assembly by the end of the year. It would only apply to acute hospitals at first, but ministers would have the power to extend it to other healthcare settings in the future.

More than 3,000 people have already signed a petition or written to their Welsh Assembly member urging them to back the bill.

Kirsty Williams

Kirsty Williams visiting Brecon Hospital where she talked to nurses and patients about her proposed bill on safe staffing in acute hospitals


Readers' comments (3)

  • California is the only state in the United States that has lawfully restricted the number of patients a hospital can assign to one nurse, and has mandated strict nurse-patient ratio guidelines. Here are some of the enforced guidelines:

    Medical/surgical: 1 to 5
    ICU/CCU : 1 to 2 (1 to 1 is preferred)
    ER : 1 to 4
    L&D : 1 to 2 (active labor), 1 to 4 not active labor)
    Tele : 1 to 4
    Psych : 1 to 6

    The rest of the country lack these parameters. Med/surg is commonly staffed 1 nurse to 7-10 patients; ICU is commonly staffed with 1 nurse caring for 2-3 patients, and the ER---the nurse will be assigned as many as beds are available---usually 7 to 8 patients--simultaneously. LTC facilities: an RN will be assigned 27 patients at one time (1 to 13 is considered safe)--more is common (and the RN is mandated to over-see all their medications, perform their treatments and chart assessments on each and every one---per shift.) I'm not sure about how other parts of the world regard safe nurse-to-patient care but here in the U.S. the current attitude and practices are nearing catastrophic proportions. Patients are dying needlessly at an alarming rate from neglect and errors due to over-worked, stressed out, exhausted nurses--nurses given too many patients at one time. I'm sure the U.S. record on the number of pressure ulcer cases has skyrocketed because of this as well. The nurse staffing guidelines that most all hospitals (except for CA) follow are over 25 years old---and were inadequate even then! I hope the Welsh nursing community gets heard and their demands get met. Advise: Get specific and get the ratios in writing---make them law!

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  • Maybe I`m missing something here, but all I`m seeing is this bill is to be introduced within the NHS. Don`t nurses in the private sector matter then?? Also it talks about managers and senior nurse leaders not being factored into ward numbers. To be honest when was the last time you saw a manager or a senior nurse leader working the shop floor, and knowing what is really going on ion their own areas?? Better still, how many managers have enough clinical knowledge or experience to know what is going on ion their areas....Just a thought...

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  • @mervyn let's not let the best be the enemy of the good! This could make a huge difference to us nurses here in Wales. We have the fewest nurses per patient of anywhere in the UK!

    I hope it happens. The Labour party (including disappointingly my AM) have been pretty cold on the idea so far.

    I hope lots of nurses respond to the consultation!

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