Kirsty Williams AM writes… An important step towards minimum nurse staffing levels in Wales

Today, the National Assembly for Wales voted to give me permission to bring forward a Private Members Bill to set minimum nurse staffing levels in law.

I believe this is necessary in Wales because we currently have the highest number of patients per nurse in the UK, which means that all too often our nurses are unable to give the time to perform their role to their highest caring ability.

Evidence is increasing from across the world on the positive impact that nurse staffing levels have on patient care and the recruitment and retention of staff. Nurses who have fewer patients to tend are able to spend a greater amount of time with each patient and as a result can provide better care. If they are more easily able to identify potential problems with a patient’s care, then they are able to play a preventative, rather than a simply reactive, role and consequently reduce the level of treatment needed and the cost of this care to the NHS. It also means better support for staff which leads to more manageable workloads, increased job satisfaction and reduced levels of stress or burnout.

In 2013 the Francis Review highlighted that the prioritisation of financial performance over adequate staffing levels was a significant factor in the poor care delivered at Stafford. The Keogh Review (2013) found that an over reliance on unregistered support staff and temporary staff had subsequent implications for workforce efficiency and cost-effectiveness. A major study in 2007 by Rafferty et al revealed that patients in hospitals with the highest patient-to-nurse ratios had 26% higher mortality rates; nurses were twice as likely to be dissatisfied in their jobs; to show high burnout levels; and to report low or deteriorating quality of care.

Some places already have mandatory staffing levels, such as California, which introduced a law in 1999 requiring acute care hospitals to maintain minimum nurse-to-patient staffing ratios. This has resulted in increased staffing levels, more reasonable workloads for nurses, leading to fewer patient deaths, higher levels of job satisfaction and no reduction in skill mix.

Spending on safe staffing levels should be seen as an investment not as a cost, helping to reduce expenditure such as the £132m spent in Wales over the last three years on agency staff or overtime, or reducing the £117m cost of compensation claims. Better care will mean that patients spend less time in hospital and there are fewer return visits.

All the evidence both internationally and here at home shows that more nurses means better, safer hospitals with vastly improved outcomes for patients. I am ambitious for Wales and for the Welsh NHS and I hope that we will lead the way the UK in giving nurses time to care through mandatory nurse staffing levels.

If you would like to get involved or would like more information please visit my dedicated website, More Nurses for Wales.

* Kirsty Williams AM is Cabinet Secretary for Education in the Welsh Government

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This entry was posted in Op-eds.


  • Gareth Phillips 5th Mar '14 - 9:21pm

    Fantastic news Kirsty, setting the standard for the rest of the UK and showing what the LibDems are capable of.

  • Fantastic, well done!

  • Taking the challenge forward. Nurses want to deliver the best care they can. With more dedicated staff and time to care for the patients. The result will surely be a better outcome for the patient. Improved job satisfaction for nurses and a reduction in sickness levels and burn out. Nurses applaud you Kirsty!

  • 1 to 8 patient ratio, what if they are ALL CARE ? Is that ratio realistic? Obviously you are very much out of touch of current nursing issues that nurses deal with on A DAY TO DAY BASIS?

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