We believe that enforceable minimum registered nurse-to-patient ratios are essential to making sure staffing levels don’t fall to dangerously low levels, patients receive safe care and nursing staff are protected from avoidable harm. We’re working on evidence-based resources to support the nursing workforce and those involved in workforce planning to reduce patient safety risks, improve nurse wellbeing, enhance nurse recruitment and retention and improve the cost efficiency of health and social care service delivery.

Here’s some of the work we’re doing in this area: 

• Establishing our policy position
• Evaluating the evidence
• Modelling the use of ratios in specific settings
• Reviewing current guidance and tools in community nursing settings
• Developing a ratios resource of evidence, legislation and guidance 

You can find more information and up to date evidence here: Safe nurse-to-patient ratios in every health care setting

A registered nurse must never be substituted with any other health care professionals, including nursing support workers (which includes registered nursing associates). Evidence shows that substitution can have a negative impact on the quality and safety of the nursing care being delivered. 

That’s why we’ve set out our position clearly among health care providers: a registered nurse must never be substituted with any other health care professionals, including nursing support workers. We'll continue to review and update this position, based on research.

We’ve developed guidance to help employers avoid this blurring of roles and the consequent safety risks – and help you identify when this is happening where you work.  

This is part of our value of safe nurse staffing work.

See our position

Get the blueprint for safe, effective nursing. 

Our Nursing Workforce Standards set the benchmark for a safe and effective nursing workforce. 

They can be used in all settings, in all UK countries.

Make positive changes in your workplace by becoming a Nursing Workforce Standards Champion.