Members in Wales are calling on the next Welsh government to commit to valuing nursing.
Board member Denise Llewellyn MBE FRCN, who also represents Wales on the RCN Professional Nursing Committee, says that extending safe nurse staffing legislation is a crucial part of this
In September 2020, RCN Wales launched its Vote for Nursing campaign and manifesto ahead of the 2021 Senedd election which is taking place in May.
The manifesto sets out five key policy areas that are important to members and calls on all political parties to show commitment to these to ensure nursing staff are able to deliver safe and effective care to people in all health and care settings across Wales. Alongside investment in nursing, the manifesto says the next Welsh government must extend existing safe nurse staffing legislation.
“Our surveys consistently show the top two issues affecting members are safe staffing and pay,” says Denise Lewellyn, member of the RCN Wales Board and RCN Professional Nursing Committee. “Obviously pay is important, especially for recruitment and retention. But we need to lay these issues side by side.
“Fair pay is crucial and without it there is a real risk of not having enough nurses to do the job, which means nursing staff will still leave because they don’t feel satisfied with the level and quality of care they can give.”
Clear evidence
In March 2016, following almost 10 years of campaigning by RCN members, Wales became the first country in Europe to introduce a safe nurse staffing law; the Nurse Staffing Levels (Wales) Act 2016.
The act means all health boards and NHS trusts in Wales have a legal duty to maintain and report on having sufficient nurses to care for patients using their services, and their compliance with the appropriate staffing levels in adult acute medical and surgical inpatient settings.
“Our manifesto calls for section 25B of the act to be extended to cover children’s and mental health inpatient wards, and community nursing,” says Denise. “The argument to extend this duty in the act, like the initial campaign for it, is built on evidence which makes it hard to ignore.”
Research shows that poor nurse staffing levels increase mortality rates by up to 26% compared to better-staffed areas, and that having safe and effective nurse staffing levels can reduce readmissions and errors, as well as help nursing staff to deliver compassionate care. In 2019, RCN Wales also published a report which found the act had changed NHS culture for the better and that there were extra nursing staff on every hospital ward covered by section 25B.
Denise, previously an executive nursing director, says: “I’ve seen the difference appropriate staffing levels can make. Not only can staff give the high-quality care they want to, but they can access CPD more easily, you have enough staff to release people for study leave, staff sickness reduces – all those conditions improve because there are enough people in the team.”
I've seen the difference appropriate staffing levels can make
Campaigning during COVID-19
The pandemic has meant a lot of the manifesto campaigning has had to take place online with members spreading the word on social media and attending online events to share their experiences with politicians.
“Members are speaking with huge passion about what it’s like to be on the frontline at the moment,” says Denise. “Across all settings, nursing staff are telling politicians why it’s so important that we have a level of staffing that’s conducive to high-quality care and how COVID-19 has further demonstrated this.”
Denise says that in Wales and the other countries of the UK, COVID-19 has put a spotlight on nursing: “Nursing staff are in the forefront of politicians’ minds and people can see the commitment, effort and passion that nursing staff have across the entire health and social care sector. Now is the time to highlight the professional element of nursing and how important safe staffing is for ensuring we can provide care for our communities and population need.”
Now is the time to highlight the professional element of nursing and how important safe staffing is
Denise’s role on the Professional Nursing Committee (PNC) means she’s involved in the RCN’s safe staffing work from a UK-wide perspective too, with the committee now overseeing this work. Denise says: “As a committee, we’re looking at how we can amplify the safe staffing message as it really does go hand-in-hand with pay.”
Denise adds: “What I’m really pleased about is that members of the PNC work so closely with the Trade Union Committee. As a trade union and professional body, we’re not only looking after our members, but we’re also giving them the knowledge and support they need to deliver safe and effective care, which is the reason why many people go into nursing in the first place; to look after patients.”
Health, social care and public health are devolved in Northern Ireland, Scotland and Wales, meaning governments in each country shape their own policies.
Our Vote for Nursing manifesto asks the Welsh government to:
- ensure safe and effective nursing care – with enough nurses to deliver this
- invest in nurses working in community nursing and care homes
- support the mental health and wellbeing of the nursing workforce
- improve public health and fight to end health inequalities
- value nursing - fair pay and access to continuing professional development (CPD).
Find out how members in Wales successfully campaigned for safe nurse staffing legislation.
What’s happening elsewhere?
RCN members in Scotland made a huge contribution to shaping the Health and Care (Staffing) (Scotland) Act which was given Royal Assent in June 2019. Work to implement the act has been paused, but the RCN is pressing the Scottish government to commit to implementation by the end of 2021.
RCN Scotland Board Chair Julie Lamberth said: “It was understandable that implementing the legislation was paused as staff across our health and care services threw everything into responding to the pandemic. But the need for safe staffing has been made even clearer by this ongoing crisis.
“We’re calling for implementation by the end of 2021 and for the principles of safe staffing to be applied from now. Supporting members to raise concerns is key and I would encourage all reps to make use of the RCN resources.”
The RCN is calling for staffing for safe and effective care to be enshrined in law across all health care settings in each UK country. In England, we have been calling for accountability for workforce planning and supply to be enshrined in legislation.
This year, we’re expecting the government in Westminster to put forward a new health and care bill to parliament. This bill will be used to make changes to deliver the NHS Long Term Plan and facilitate closer integration between health and care services. We think this bill is the best opportunity to secure our staffing for safe and effective care priorities and we will be campaigning to ensure these are included in the bill.
In Northern Ireland, RCN members undertook historic industrial action in December 2019 and January 2020 to demand action on unsafe staffing levels and unfair pay. As a result, pay has been restored to the same level as that in England and the number of nursing students in Northern Ireland has risen.
The RCN’s priority now is to hold the Department of Health and the Northern Ireland Executive to account for the delivery of the Health Minister's safe staffing framework, particularly in respect of the need for safe nurse staffing legislation.
While it has been difficult to move forward at the speed we would have liked, due to the pandemic, our discussions have continued. To date, we have compared the legislation that exists in Scotland and Wales with a view to developing legislation that would be suitable for Northern Ireland and have identified a timeframe for the work to be completed.
The Department of Health in Northern Ireland has approved a business case to create a bill team in order to develop the legislation and this team will be recruited as a matter of urgency to finally begin this important piece of work. When the team is in place, we will work with key stakeholders to ensure that all voices are heard and the legislation meets the needs of the population of Northern Ireland to ensure members never have to fight for safe nurse staffing again.
Read more about our campaign for staffing for safe and effective care across the UK.
