Introduce legally enforceable safe nurse-to-patient staffing ratios in the NHS
10,439 people signed this petition to the UK Parliament after it opened on 25 September 2025; it closed on 25 March 2026. The Government responded on 17 March 2026.
The petition
The petition's creator is not named in the Petitions site's published record. Quoted in full from the UK Parliament petitions site.
Introduce legally enforceable safe nurse-to-patient staffing ratios in the NHS
Make minimum staffing levels a legal requirement by introducing national nurse-to-patient ratios that can help guarantee patient safety and protect staff wellbeing.
We believe recent government cuts have worsened understaffing issues, pushing services to a tipping point. Patients can be left waiting, care can be rushed, and harm can occur. There are reports of nurses burning out and leaving in record numbers. We feel unsafe care has become normal and is endangering both patients and staff. We think action is urgently needed to protect lives and sustain the NHS.
The Government's response
The Government published its response on 17 March 2026; the petitions site lists the Department of Health and Social Care as responsible. Its summary:
There are no plans to make nurse-to-patient ratios a legal requirement in England. Staffing levels are determined locally, supported by national guidance and regulated by the Care Quality Commission.
The opening 400 words of the 695-word response:
Fixed nurse-to-patient ratios are not enforced in England. The responsibility for staffing levels remains with clinical and other leaders at a local level, responding to local needs, supported by guidelines set by national and professional bodies and overseen and regulated by the Care Quality Commission (CQC).
This is particularly important in community nursing settings, where a simple numeric ratio does not adequately capture the complexity of safe staffing. Unlike inpatient environments, community nurses work across dispersed caseloads, often as lone workers, with significant variation in patient acuity, geography, care complexity and travel time. A flexible, evidence-informed approach to caseload weighting and workforce planning is therefore essential to reflect the realities of community care delivery.
Providers must systematically determine and review staffing and skills to meet service users’ needs and ensure patient safety, following legislation and available guidance.
Reaching the right staff numbers and mix should depend on an evidence-based approach and the exercise of real-time, risk-assessed, professional judgements by day-to-day leadership and a multi-professional approach.
The CQC checks for compliance with regulations that require regulated providers to have enough suitably qualified staff, and can take enforcement action where incorrect staffing levels are having an impact on patient outcomes.
National Quality Board (NQB)
Guidance from the NQB entitled Safe, sustainable and productive staffing (2016, available online at https://www.england.nhs.uk/wp-content/uploads/2013/04/nqb-guidance.pdf) and Developing Workforce Safeguard (2018, available online at https://www.england.nhs.uk/wp-content/uploads/2021/04/Developing-workforce-safeguards.pdf) is designed to ensure a consistent, scientific and evidence-based approach to staffing levels and to improve governance and board accountability relating to staffing decisions.
The approach combines evidence-based tools, professional judgement, and outcomes to ensure appropriate staffing and minimise patient safety risks.
It is important to note that NQB guidance primarily addresses acute inpatient care. For community nursing, NHS England supports specific staffing tools to assess caseloads, and ensuring their widespread use is a priority.
While England’s approach to safe staffing is through a combination of locally led decisions, evidence-based tools, professional judgement, regulatory oversight, and national guidance instead of fixed ratios, the Government will continue to monitor international evidence for workforce planning.
The 10 Year Health Plan and staff
This Government is committed to publishing a 10 Year Workforce Plan to set out action to create a workforce ready to deliver the transformed service set out in the 10 Year Health Plan. The 10 Year Workforce Plan will ensure the NHS has the right staff, with the right skills, in the right places.
Read the full response on the petitions site.
Source and receipt
- https://petition.parliament.uk/petitions.json?state=with_response&page=6UK Parliament Petitions API · read 2026-10-15 · SHA-256
729632b6104f13d0… - The petition on petition.parliament.uk
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