Safe staffing: guidance will pave the way for extension to law on nurse numbers in Wales

Professional judgement and patient outcomes should drive staffing decisions, says chief nurse

Professional judgement and patient outcomes should drive staffing decisions, says chief nurse

Jean White. Picture: Barney Newman

Safe nurse staffing guidance for children's inpatient services in Wales will be published later this year as a stepping stone to a change in the law.

The document will outline how many staff should be available and in what circumstances and will prepare managers of children's inpatient services for an extension to the staffing act in Wales by 2020.

Step towards broader law

Wales chief nurse Jean White told Nursing Standard: ‘The principles are being tested, and we feel ready to say if you follow them it’ll be the first step to being ready for the act when it is extended.’ 

Professor White, who was speaking at her chief nurse annual conference, expects guidance on mental health nurse staffing to be ready by the end of the year. Work continues on district nursing and health visitors staffing principles. 

The Nurse Staffing (Wales) Act 2016

The act aims to ensure adult acute surgical and medical wards have adequate nurses to care holistically for patients.

It requires a senior nurse to calculate a staffing level for their workplace using a range of criteria. The formula should allow for flexibility when circumstances change, for example sickness absence or and maternity leave.


Wales was the first part of the UK to enact a nurse staffing law and this came into force in April 2018. The Scottish parliament passed a staffing law that applies to all clinical groups in health and social care earlier this month.

Campaign on safe staffing

The RCN is calling for comprehensive safe staffing legislation to be adopted everywhere in the UK.

Professor White urged safe staffing campaigners to keep three issues in mind.

‘Professional judgement is paramount; tools must be evidence-based; and we look at needs and outcomes,’ she said.

‘Patients not beds, they’re not cubicles, they’re not numbers, they are people.’

Professor White acknowledged that a staffing law can increase costs, and said employers should be prepared for that.

A price worth paying

A report by the Wales Audit Office in January revealed spending on agency nurses to provide the numbers needed by law had contributed to a 171% increase in agency spending from 2010-11 to 2017-18.

However, the chief nurse added that increased spending was the lesser price to pay.

‘There is a cost to this but if you don’t get your staffing right, the cost is borne by patients, who may stay in hospital longer or who may come to harm,’ she said.

‘If you don’t get your staffing right patients suffer.’

Related material

All Wales Nurse Staffing Programme

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