Safety critical nurse-to-patient ratios
Protecting patients and staff from avoidable harm
The evidence is clear. We need staffing levels that protect nursing staff and patient safety.
Every day, nursing staff are forced to care for too many patients by a system that undervalues and underfunds nursing.
Research shows that this puts patients at risk. More patients die when there are too few registered nurses.
We need the right number of registered nurses with the right skills and experience, in the right places. The problem of unsafe staffing persists because staffing decisions are often exposed to short-term financial pressure, workforce supply constraints, variable workforce planning, weak accountability for delivery and limited transparency.
We want enforceable staffing standards, so health and social care settings have nurse staffing levels that are safe and effective for patients and staff.
The price of unsafe staffing is simply too high. But enforceable minimum nurse-to-patient ratios could help. We're working to ensure that safe staffing becomes a reality in all settings where nursing care is delivered across the UK.
Why safe staffing matters
Hear Jane reflect on 35 years of research into the nursing workforce. She talks about the milestones along the way where policymakers have recognised the importance of safe and effective staffing levels – as well as the progress still needed to ensure patients receive the care they deserve.
The rationale
We've published a new rationale setting out why we believe enforceable minimum registered nurse-to-patient ratios are needed across the UK to protect patients and nursing staff from harm.
Minimum ratios are a failsafe, not a replacement for planning the workforce needed for safe and effective nursing care. Minimums are exactly that – a minimum – not a target. Evidence consistently shows a direct relationship between the number of registered nurses and patient outcomes, including mortality.
Learn about recommended ratios in your workplace
Our ratios resource brings together the latest guidance and evidence, where available, on safe staffing ratios across a range of health and social care settings.
We want members to use it to find out what ratios are recommended in existing guidance for different specialties and settings.
It also shows where there are gaps in the evidence and guidance, and how these vary. It will be updated regularly as new standards and guidance become available.
Our path to change
Decisions about minimum nurse-to-patient ratios should be considered carefully using evidence and expertise. This is our approach.
Raise awareness
We're highlighting the risks of unsafe staffing, using evidence from our members, as well as academic research.
Grow the evidence
We'll continue to build evidence, based on international research and successes in countries such as the US and Australia.
Build solutions
We're committed to a multi-year programme of work to improve nurse staffing through practical, long-term solutions.
The impact of staffing levels
Since California passed a mandatory minimum nurse-to-patient ratios law in 1999, there has been ongoing interest in its impact.
Our Workforce Academy commissioned the internationally leading Health Workforce and Systems Research Group at the University of Southampton to evaluate the international evidence and understand the impact of staffing levels on staff retention, burnout, cost-effectiveness and more.
Actions you can take today
Raising your concerns
Raising a concern isn't always easy, but it's the right thing to do. Our toolkit can help you understand when and how to escalate workplace issues and report concerns.
Be a standards champion
Our Nursing Workforce Standards set out what must happen within workplaces for nursing staff to deliver expert, patient-centred care. Help embed them at your workplace.
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