Fixing the nursing workforce crisis in Wales

Safe staffing saves lives.

When you're in hospital, you are vulnerable.

And research shows that the numbers and skill level of the nurses and nursing staff caring for you directly impact your chances of survival or coming to harm—from a fall or medication error, for example.

In other words, registered nurses are safety-critical.

Section 25B protects some patients.

In 2016, Wales passed a revolutionary new law to protect people from the dangers of staff shortages.

Section 25B of the Nurse Staffing Levels (Wales) Act 2016 defines what an "appropriate" number of nurses is—and makes health board leaders responsible for disclosing that number and making sure it is met.

Section 25B only applies in NHS Wales adult acute medical and surgical wards, and children's wards.

It should protect all patients.

RCN Wales believes that the protections in Section 25B should extend to every area where nursing care is provided across Wales. 

Once we know that patients are more likely to be harmed in certain situations, we have a moral duty to prevent those situations.

Patients are safer when nursing staff have the time to care. Section 25B ensures they do.

Watch the Welsh Parliament debate extending Section 25B

10,572 people signed our petition to make this debate happen.

It's a law that protects nurse staffing levels in Wales - the first of its kind anywhere in Europe. The result of a years-long campaign by RCN Wales members, it makes health boards and NHS trusts legally responsible for providing enough nursing staff in their nursing services and those they commission.

Section 25A of the Nurse Staffing Levels (Wales) Act 2016 applies everywhere patients receive care from an NHS Wales nurse.

It says:

...Local Health Board[s] must have regard to the importance of providing sufficient nurses to allow the nurses time to care for patients sensitively.

(Nurse Staffing Levels (Wales) Act 2016, section 25A(2))

Section 25B has applied to adult medical and surgical wards since coming into force in 2018, and the Welsh Government extended it to children's wards in 2021. The power to extend Section 25B is built into the law, but this is the only time a Welsh Government has used it.

Section 25B says that, wherever it applies, health boards and NHS trusts must:

(a) designate a person or a description of person to calculate the number of nurses appropriate to provide care to patients that meets all reasonable requirements in that situation (the “nurse staffing level”),

(b)take all reasonable steps to maintain the nurse staffing level, and

(c)make arrangements for the purpose of informing patients of the nurse staffing level. 

Sections 25C, D, and E set out how staffing levels are calculated and require health boards to report regularly on whether they've met those staffing levels, and what actions they've taken if not.

Effective care maximises what goes right.

Safe care minimises what goes wrong.

By protecting nurse staffing levels, we can ensure everyone receives the safe and effective care they need and deserve.

If you have a concern about someone's care and need advice on how to report it, we can help.

Click here for advice on what to do if you see poor care, or if you feel you are being prevented from providing safe, compassionate care.

Sign in to the RCN Reps Hub to find our Representatives' Toolkit. Designed by our Employment Relations team, it provides tips and resources to help reps and members escalate concerns around the implementation of the Nurse Staffing Levels (Wales) Act 2016 in their organisations.

Our latest publications

We regularly publish our research on nursing in Wales. Browse through our most recent publications or click for more.

Explore and get involved