Safe nurse staffing law has improved outcomes, but it’s stalling
Nurses’ leader credits new law with improving staff well-being but tells Welsh parliament moves to extend it to mental health, district nursing and health visiting services have stalled
Ministers must widen the law on safe nurse staffing to include inpatient and community mental health settings, a nurses’ leader told a group of Welsh parliament members.
RCN Wales director Helen Whyley expressed concern to the Senedd’s cross-party health and social care committee that work to extend the reach of the act had lost momentum.
Ms Whyley was giving evidence to the committee about the impact of the Nursing Staffing Levels (2016) Act. The legislation, which came into effect in 2021, places a legal duty on NHS health boards in Wales to calculate for and provide adequate nursing staff for safe and sensitive care on certain categories of ward, including adult medical, surgical, and children’s. The committee is holding an inquiry to evaluate the effectiveness of the act two years on.
Safe staffing legal mandate for mental health and community nursing
Ms Whyley told the committee hearing on 19 October: ‘Our concerns are that while we have got those principles ready to roll, we’re not doing that work of making sure they are being implemented by the NHS. And that was certainly the plan.
‘When the staff levels programme was set up, it’s very clear from HEIW [Health Education Improvement Wales], from their website and public documents that works were in preparation for the extension of the act in mental health inpatient settings and some community settings, including district nursing and health visitors.
‘It would be a good next step for the legislation as it would support workforce planning those areas.’
Nurse Staffing Levels Act ‘brought a cultural shift in the NHS in Wales’
Ms Whyley and RCN Wales board chair Jackie Davies told the Senedd hearing the act had improved staffing transparency, accountability of employers, the well-being of nurses at work, and patient outcomes.
Ms Davies said the act had achieved a cultural shift in the NHS, where nursing recruitment and retention was being discussed at the highest level, and with patient safety in mind.
‘Many industries have a legal framework supporting their approach to public safety, but for historical reasons it is fascinating that the national health service in the UK didn’t have that,’ she said. ‘There was no obligation or framework. We are very proud to have started this in Wales, and it has very much changed corporate behaviour.’
She added: ‘The research is clear: there is a direct link between nurse staffing levels and patient safety. Legislating on safety-critical roles needs to be a standard process in healthcare as in any other industry.’
A Welsh Government spokesperson said: ‘The Nurse Staffing Levels (Wales) Act 2016 is clear about what would be required to extend its second duty to other settings. Without robust, tested, evidence-based workforce planning tools – and the necessary infrastructure by which to implement them – any plan of further extension is premature.’
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