RCN Wales calls on new Welsh Government to grow nursing workforce as survey warns of “high risk” of harm

Nursing staff in Wales say staffing levels are not matching the complexity of care patients now need, with too many shifts operating without enough registered nurses to deliver safe and effective care, the Royal College of Nursing says.
The findings are from the RCN’s “Last Shift” survey, which received more than 13,000 responses across the UK between 2 March and 7 April 2026.
A quarter of nursing staff said registered nurse numbers were so far below what was required that there was now a “high risk” of harm on shift.
Patients in Flintshire receive most NHS hospital care through Betsi Cadwaladr University Health Board, which is the NHS body responsible for health services across north Wales.
Across the UK survey, 79% of nursing staff said clinical complexity had increased over the last two years.
Only one in ten said staffing was at the right level for all patient needs to be met.
More than two thirds, 69%, said the situation was forcing them to make difficult decisions about prioritising care.
More than three in four, 76%, said they felt emotionally exhausted on their last shift, with reports of exhaustion highest among those who said their shift was understaffed.
A nurse working on an older people’s ward in the NHS in Wales told the survey: “[We] need to increase the agreed establishment; nurse to patient ratio due to increasing acuity, dependency and complexity of patients’ condition and presentation.”
The nurse said: “More and more patients are now presenting with worsening cognitive function and often display challenging behaviour.”
A health care support worker from an inpatient mental health unit in Wales said: “Our ward has been bombarded with high acuity for around a year now and staffing levels have barely seen an increase.”
RCN Wales executive director Nicola Williams said: “Nursing staff across Wales are telling us clearly that staffing levels are not matching the complexity and intensity of care patients now need.”
Ms Williams said: “Too many shifts are operating without enough registered nurses to deliver safe and effective care.”
She said: “When more than a quarter of nursing staff describe staffing levels as unsafe and nearly half report compromised care, we need to listen and take action to address it.”
Ms Williams said: “Our members are going above and beyond every day for their patients, are demoralised, going without breaks and having their much needed training time cancelled, they cannot continue carrying the burden of workforce shortages indefinitely.”
She said: “Emotional exhaustion is becoming normalised across the profession and that is dangerous for staff, patients and the future sustainability of services.”
Ms Williams said: “The newly elected Welsh government must urgently invest in growing and retaining the nursing workforce, ensure they have the training they require, alongside delivering safe staffing levels that are properly planned and enforced.”
She said: “Without action, patient safety risks will continue to grow.”
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