The Royal College of Nursing has launched its latest report on the impact of the Nurse Staffing Levels (Wales) Act 2016 on patient outcomes.
It's been seven years since the law was introduced following intense RCN campaigning. It's proved to increase the number of nurses on wards covered by Section 25B, directly improving patient care, but guidance must be developed to ensure section 25A applied consistently.
These are the findings of Progress and Challenge, the RCN's third report on the effectiveness of the legislation since it came into being. Greater responsibility is placed on the Welsh government and Health Boards in Wales to ensure that safe staffing levels are maintained through better data capture and workforce planning. Nursing staff also have strengthened autonomy in using their professional judgement and lived experience to communicate staffing requirements.
However, the current legislation does not go far enough. In other clinical areas, individual nursing staff are still left struggling to care for patients in extremely difficult conditions and when standards of care fall short, they are wrongly called to account.
The RCN is campaigning for the extension of section 25B to community and inpatient mental health units and for the application of statutory guidance to section 25A. Section 25A will ensure that the Welsh government and health boards prioritise nurse staffing numbers in all areas where nursing care is provided or commissioned. Non-compliance should be met with explicit consequences.
Helen Whyley, Director, RCN Wales said:
“The groundbreaking Nurse Staffing Levels (Wales) Act 2016 was the first of its kind in Europe. I’m delighted that the RCN has played such an important role in pioneering this essential work.
“The RCN is campaigning for the Act’s full potential to be realised through statutory and operational guidance across all care settings. To truly meet the health needs of the Welsh public, it is paramount that mental health is equally important as physical health and that complex needs are cared for in a person’s own home. Some of the most vulnerable people in our society continue to be let down by depleted services, which is why we are also calling for section 25B of the Act to be extended to community and mental health inpatient services.
“Whilst we reflect on how far we have come since 2016, it is clear that this is not the silver bullet to fixing health care in Wales. Investment in nursing is the only sustainable remedy to the chronic recruitment and retention crisis in Wales. Fair pay that reflects the safety critical role of nursing and supports staff in the cost-of-living crisis is crucial in recruiting and retaining an experienced workforce for the future”.
Notes to editors:
Read the full report in Welsh and English online.
- RCN Wales successfully campaigned for the first safe staffing legislation in Europe: The Nurse Staffing Levels (Wales) Act 2016.
- 25A applies everywhere NHS Wales provides nursing services, or commissions someone else to do so. It required health boards and trusts to ‘have regard to the importance of providing sufficient nurses to allow the nurses time to care for patients sensitively’.
- 25B requires health boards to calculate and take the ‘responsible steps’ to maintain the nurse staffing level in all wards where it applies. In 2018, it applied in adult acute medical and surgical wards. It was extended to children’s wards in 2021. Patients must also be informed of the nurse staffing level on each Section 25B ward.
- A simple explanation of the Act can be found here.
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The report has a section on each health board in Wales
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Key recommendations to the Welsh Government for improvement can be found on page 5 of the report.
The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world with over half a million members in the UK, including around 29,500 members in Wales. The RCN promotes the interests of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies, and voluntary organisations.
For more information, contact the RCN Wales press office at 02920 680 769 or email mediawales@rcn.org.uk
