Meetings

2.3 The Committee noted the letter.

1.1 The Committee agreed to write to the Minister for further information.

6.9a The Committee noted the letter from the Cabinet Secretary for Health, Well-being and Sport in relation to the Nurse Staffing levels (Wales) Act 2016.

NDM5956 Kirsty Williams (Brecon and Radnorshire)

To propose that the National Assembly for Wales in accordance with Standing Order 26.47:

Approves the Nurse Staffing Levels (Wales) Bill.

The item started at 17.52

NDM5956 Kirsty Williams (Brecon and Radnorshire)

To propose that the National Assembly for Wales in accordance with Standing Order 26.47:

Approves the Nurse Staffing Levels (Wales) Bill.

The motion was agreed in accordance with Standing Order 12.36.

The amendments have been grouped for the purposes of debate and the groupings will be debated as follows:

1. The description of nurse staffing levels

3, 4, 6, 7, 8, 9, 10, 12, 13, 14, 15, 16, 21, 22, 26, 32

2. Settings to which the duty would apply

45, 45A*, 46, 47A, 47, 5, 11, 40, 41, 42, 43, 44, 33, 34

3. Workforce planning

35, 17

4. Consultation

18, 19, 20

5. Reporting arrangements

36, 37, 23, 24, 25, 38, 1, 2, 39A, 39B, 39

6. Compliance with the duty

27, 28, 29, 30, 31

Supporting Documents

Nurse Staffing Levels (Wales) Bill
Revised Explanatory Memorandum
Marshalled List of Amendments
Grouping of Amendments

The item started at 16.01

The amendments have been grouped for the purposes of debate and the groupings will be debated as follows:

A vote was taken on amendment 3:

Amendment 3 was not agreed.

A vote was taken on amendment 45A:

Amendment 45A was not agreed.

Amendment 45 was agreed, in accordance with Standing Order 12.36.

Amendment 46 was agreed, in accordance with Standing Order 12.36.

A vote was taken on amendment 4:

Amendment 4 was not agreed.

A vote was taken on amendment 47A:

Amendment 47A was not agreed.

Amendment 47 was agreed, in accordance with Standing Order 12.36.

Amendment 35 was agreed, in accordance with Standing Order 12.36.

A vote was taken on amendment 5:

Amendment 5 was not agreed.

A vote was taken on amendment 6:

Amendment 6 was not agreed.

A vote was taken on amendment 7:

Amendment 7 was not agreed.

A vote was taken on amendment 8:

Amendment 8 was not agreed.

A vote was taken on amendment 9:

Amendment 9 was not agreed.

A vote was taken on amendment 10:

Amendment 10 was not agreed.

A vote was taken on amendment 11:

Amendment 11 was not agreed.

A vote was taken on amendment 40:

Amendment 40 was not agreed.

A vote was taken on amendment 41:

Amendment 41 was not agreed.

A vote was taken on amendment 42:

Amendment 42 was not agreed.

A vote was taken on amendment 43:

Amendment 43 was not agreed.

A vote was taken on amendment 44:

Amendment 44 was not agreed.

A vote was taken on amendment 12:

Amendment 12 was not agreed.

A vote was taken on amendment 13:

Amendment 13 was not agreed.

A vote was taken on amendment 14:

Amendment 14 was not agreed.

A vote was taken on amendment 15:

Amendment 15 was not agreed.

A vote was taken on amendment 16:

Amendment 16 was not agreed.

Amendment 17 was agreed, in accordance with Standing Order 12.36.

Amendment 18 was agreed, in accordance with Standing Order 12.36.

Amendment 19 was agreed, in accordance with Standing Order 12.36.

Amendment 20 was agreed, in accordance with Standing Order 12.36.

Amendment 36 was agreed, in accordance with Standing Order 12.36.

A vote was taken on amendment 21:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

A vote was taken on amendment 22:

Amendment 22 was not agreed.

Amendment 37 was agreed, in accordance with Standing Order 12.36.

A vote was taken on amendment 23:

Amendment 23 was not agreed.

A vote was taken on amendment 24:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

A vote was taken on amendment 25:

Amendment 25 was not agreed.

A vote was taken on amendment 26:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

Amendment 38 was agreed, in accordance with Standing Order 12.36.

As amendment 38 was agreed, amendments 1 and 2 fell

A vote was taken on amendment 39A:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

A vote was taken on amendment 39B:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

Amendment 39 was agreed, in accordance with Standing Order 12.36.

A vote was taken on amendment 27:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

A vote was taken on amendment 28:

Amendment 28 was not agreed.

A vote was taken on amendment 29:

Amendment 29 was not agreed.

As amendment 27 was not agreed, amendment 30 fell

As amendment 28 was not agreed, amendment 31 fell

A vote was taken on amendment 32:

As required by Standing Order 6.20 the Deputy Presiding Officer exercised his casting vote by voting against the amendment. Therefore, the amendment was not agreed.

A vote was taken on amendment 33:

Amendment 33 was not agreed.

A vote was taken on amendment 34:

Amendment 34 was not agreed.

All sections and schedules of the Bill were deemed agreed, concluding Stage 3 proceedings.

In accordance with Standing Order 26.21 the Committee will dispose of amendments to the Bill in the following order:

Sections 2 to 5; Section 1; Long title.

Supporting documents:

Safe Nurse Staffing Levels (Wales) Bill

Marshalled list of amendments

Groupings of amendments

In attendance:

Kirsty Williams AM, Member in charge of the Safe Nurse Staffing Levels (Wales) Bill

Lisa Salkeld, Legal Services, National Assembly for Wales Commission

Philippa Watkins, Research Service, National Assembly for Wales Commission

Mark Drakeford AM, Minister for Health and Social Services

Helen Whyley, Nursing Officer, Welsh Government

Rhian Williams, Lawyer, Welsh Government

2.1 Lynne Neagle declared the following relevant interest under Standing Order 17.24A:

•        She has a close family member currently living on a mental health inpatient ward

2.2 In accordance with Standing Order 26.21, the Committee disposed of the following amendments to the Bill:

Amendment 28 (Mark Drakeford)

Amendment 29A (Darren Millar)

Amendment 29B (Darren Millar)

Amendment 29C (Darren Millar)

Amendment 29D (Darren Millar)

Amendments 29E, 29F, 29G, 29H and 29I (Darren Millar) were disposed of en bloc.

Amendment 29J (Darren Millar)

Amendment 29Z (Elin Jones)

Amendment 29AA (Elin Jones)

Amendment 29AB (Elin Jones)

Amendment 29AC (Elin Jones)

Amendment 29AD (Elin Jones)

Amendments 29K, 29L, 29M, 29N and 29O (Darren Millar) were disposed of en bloc.

Amendment 29P (Darren Millar)

Amendment 29Q (Darren Millar) was agreed in accordance with Standing Order 17.34(i).

Amendment 29R (Darren Millar)

Amendment 29S (Darren Millar)

Amendment 29T (Darren Millar)

Amendment 29U (Darren Millar)

Amendment 29V (Darren Millar)

Amendment 29W (Darren Millar)

Amendment 29X (Darren Millar)

Amendment 29Y (Darren Millar)

Amendment 29AE (Elin Jones) was not moved.

Amendment 29 (Mark Drakeford)

As amendment 29 (Mark Drakeford) was agreed, amendment 1 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 20 (Elin Jones) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 2 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 21 (Elin Jones) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 3 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 4 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 22 (Elin Jones) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 23 (Elin Jones) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 24 (Elin Jones) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 5 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 6 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 7 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 8 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 9 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 10 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 11 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 12 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 25 (Elin Jones) fell.

As amendment 29W (Darren Millar) was not agreed, amendment 30A (Darren Millar) fell.

As amendment 29X (Darren Millar) was not agreed, amendment 30B (Darren Millar) fell.

Amendment 30 (Mark Drakeford) was agreed in accordance with Standing Order 17.34(i).

As amendment 29 (Mark Drakeford) was agreed, amendment 13 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 14 (Darren Millar) fell.

Amendment 31A (Darren Millar)

Amendment 31 (Mark Drakeford) was agreed in accordance with Standing Order 17.34(i).

As amendment 29 (Mark Drakeford) was agreed, amendment 15 (Darren Millar) fell.

As amendment 29 (Mark Drakeford) was agreed, amendment 16 (Darren Millar) fell.

Amendment 36 (Darren Millar)

Amendment 37 (Darren Millar)

Amendment 32 (Mark Drakeford)

As amendment 32 (Mark Drakeford) was agreed, amendments 17 and 18 (Darren Millar) fell. 

Amendment 19 (Darren Millar) was not moved.

Amendment 33 (Mark Drakeford) was agreed in accordance with Standing Order 17.34(i).

Amendment 34 (Mark Drakeford) was agreed in accordance with Standing Order 17.34(i).

Amendment 35 (Mark Drakeford)

Amendment 27 (Mark Drakeford)

Amendment 38 (Mark Drakeford) was agreed in accordance with Standing Order 17.34(i).

As amendment 38 (Mark Drakeford) was agreed, amendment 39 (Elin Jones) fell.

2.3 All sections of the Bill were deemed agreed by the Committee.

5.1 The Committee agreed the order of consideration for Stage 2 proceedings of the Safe Nurse Staffing Levels (Wales) Bill.

NDM5858 Jane Hutt (Vale of Glamorgan)

To propose that the National Assembly for Wales, for the purposes of any provisions resulting from the Safe Nurse Staffing Levels (Wales) Bill, agrees to any increase in expenditure of a kind referred to in Standing Order 26.69, arising in consequence of the Bill.

The item started at 16.59

NDM5858 Jane Hutt (Vale of Glamorgan)

To propose that the National Assembly for Wales, for the purposes of any provisions resulting from the Safe Nurse Staffing Levels (Wales) Bill, agrees to any increase in expenditure of a kind referred to in Standing Order 26.69, arising in consequence of the Bill.

The motion was agreed in accordance with Standing Order 12.36.

8.5a The Committee noted the correspondence.

Correspondence from the Minister for Health and Social Services

Correspondence from Kirsty Williams AM, the Member in charge

3.3a The Committee noted the correspondence and agreed to return to the subject at its next discussion of the Committee’s forward work programme.

NDM5772 Kirsty Williams (Brecon and Radnorshire)

To propose that the National Assembly for Wales in accordance with Standing Order 26.11:

Agrees to the general principles of the Safe Nurse Staffing Levels (Wales) Bill.

The Safe Nurse Staffing Levels (Wales) Bill and Explanatory Memorandum were laid before the Assembly on 1 December 2014.

The report of the Health and Social Care Committee on the Safe Nurse Staffing Levels (Wales) Bill was laid before the Assembly on 8 May 2015.

The report of the Constitutional and Legislative Affairs Committee on the Safe Nurse Staffing Levels (Wales) Bill was laid before the Assembly on 6 May 2015.

The item started at 16.18

NDM5772 Kirsty Williams (Brecon and Radnorshire)

To propose that the National Assembly for Wales in accordance with Standing Order 26.11:

Agrees to the general principles of the Safe Nurse Staffing Levels (Wales) Bill.

The motion was agreed in accordance with Standing Order 12.36.

Note: Stage 2 proceedings on this Bill will only go ahead if the General Principles are agreed to on 3 June 2015.

1.1 The Committee agreed, in principle, the order of consideration for Stage 2 proceedings of the Safe Nurse Staffing Levels (Wales) Bill.

CLA(4)-11-15 – Paper 14 – Draft Report

1.1 The Committee considered and agreed, subject to minor changes, the Stage 1 draft report on the Safe Nurse Staffing Levels (Wales) Bill.

CLA(4)-10-15 – Paper 10 – Draft report

1.1 The Committee considered the key issues that have arisen during its consideration of the general principles of the Safe Nurse Staffing Levels (Wales) Bill.

Melanie Minty, Care Forum Wales

Anne Thomas, Linc Cymru and representing Care Forum Wales

Michele Millard, Spire Cardiff Hospital and representing Welsh Independent Healthcare Association

Simon Rogers, Welsh Independent Healthcare Association

4.1 The witnesses responded to questions from Members.

Kirsty Williams AM, Member in charge of the Safe Nurse Staffing Levels (Wales) Bill

Lisa Salkeld, Legal Services, National Assembly for Wales Commission

Philippa Watkins, Research Service, National Assembly for Wales Commission

Safe Nurse Staffing Levels (Wales) Bill

Explanatory Memorandum

2.1 Kirsty Williams, the Member in charge of the Bill, responded to questions from Members.

6.1 The Committee considered the evidence received.

6.2 The Committee agreed to write to the Minister for Health and Social Services to request clarification about whether the Acuity Tool Governance Framework (when validated) will include fixed staffing ratios that apply to all medical and surgical adult in-patient wards.

Mark Drakeford AM, Minister for Health and Social Services

Dr Jean White, Chief Nursing Officer

Fiona Davies, Lawyer

3.1 The witnesses responded to questions from Members.

3.2 The Minister agreed to provide the Committee with a note on his powers of direction under Section 12 of the National Health Service (Wales) Act 2006.

5.1 The Committee considered the evidence received.

5.2 The Committee agreed to seek additional information from local health boards about the arrangements they have in place to manage care they commission from the independent sector and/or from other administrations (e.g. NHS England), particularly:

·         whether standard contracts are used for such arrangements;

·         how health boards monitor compliance with the contracts/agreements that are in place for the delivery of care they have commissioned.

5.3 The Committee agreed to seek additional information from the Welsh Independent Healthcare Association about:

·         its comment in written evidence that “it is important that should the Bill be extended that it will include all of the Independent Sector not just NHS funded care within the Sector”; and

·         whether the industry adheres to any staffing ratios at the moment and, if so, what those ratios are, to what extent compliance is monitored and by whom, and what the rates of compliance are.

Dr Jean White, Chief Nursing Officer

Fiona Davies, Lawyer

Helen Whyley, Nursing Officer

2.1 The witnesses responded to questions from Members.

10.1a The Committee noted the correspondence.

10.2a The Committee noted the summary of evidence.

Professor Gillian Leng, the National Institute for Health and Care Excellence (NICE)

2.1 The witness responded to questions from Members.

2.2 Professor Leng agreed to supply the Committee with:

• an outline of NICE’s work programme for developing guidance for safe staffing for nursing in settings beyond adult inpatient wards in acute hospitals; and  
• NICE’s report on its assessment of the cost impact of its Safe staffing for nursing in adult inpatient wards in acute hospitals guidance.

5.1 The Committee considered the evidence received.

5.2 In light of the need to re-arrange the evidence session with the Chief Nursing Officer, and in order to ensure sufficient time to consider the evidence received on the general principles of the Bill, the Committee agreed to write to the Business Committee to seek an extension to the deadline for its Stage 1 report.

7.2a The Committee noted the correspondence.

Dawn Bowden, Unison Wales

Tanya Bull, Unison Wales

5.1 The witnesses responded to questions from Members.

Kate Chamberlain, Healthcare Inspectorate Wales

Alun Jones, Healthcare Inspectorate Wales

4.1 The witnesses responded to questions from Members.

Peter Meredith Smith, Board of Community Health Councils in Wales

3.1 The witnesses responded to questions from Members.

7.1a The Committee noted the consultation responses.

Representing Health board executives

Paul Roberts, Abertawe Bro Morgannwg University Health Board

Anne Phillimore, Aneurin Bevan University Health Board

6.1 The witnesses responded to questions from Members.

Professor Dame June Clark

Professor Peter Griffiths

Professor Anne Marie Rafferty

2.1 The witnesses responded to questions from Members.

9.1 The Committee considered the evidence received.

6.5a The Committee noted the correspondence.

(Indicative time 1.30 – 2.15pm)

Mark Drakeford AM, Minister for Health and Social Services

(Indicative time 2.15 – 3.00pm)

Kirsty Williams AM, Member in Charge of the Safe Nurse Staffing Levels (Wales) Bill

CLA(4)-04-15 – Research Service Briefing

CLA(4)-04-15 – Legal Advice Note

The Committee received evidence from the Mark Drakeford AM, Minister for Health and Social Care.

The Committee also received evidence from Kirsty Williams AM, Member in charge of the Bill.

Dr Sally Gosling, Chartered Society of Physiotherapy

Philippa Ford, Chartered Society of Physiotherapy

Dr Alison Stroud, Royal College of Speech and Language Therapists

5.1 The witnesses responded to questions from Members.

Dr Phil Banfield, BMA Cymru Wales

Dr Victoria Wheatley, BMA Cymru Wales

Dr Rhid Dowdle, Royal College of Physicians (Wales)

4.1 The witnesses responded to questions from Members.

Representing NHS Wales Health Boards and Trust Nurse Directors:

Rory Farrelly, Abertawe Bro Morgannwg University Health Board

Ruth Walker, Cardiff and Vale University Health Board

3.1 The witnesses responded to questions from Members.

3.2 Rory Farrelly agreed to supply the Committee with additional information regarding Abertawe Bro Morgannwg University Health Board’s recent recruitment plan to fill the 140 nursing vacancies reported within the Health Board. Rory Farrelly also agreed to clarify the relevant closing dates for applications and the number of applications received.

Tina Donnelly, Royal College of Nursing Wales

Lisa Turnbull, Royal College of Nursing Wales

2.1 The witnesses responded to questions from Members.

7.1 The Committee considered the evidence received.

7.2 The Committee agreed to seek additional information about the arrangements in place in Scotland to mandate safe nurse staffing levels without legislation.

Research Brief

Safe Nurse Staffing Levels (Wales) Bill

Explanatory Memorandum

9.1     The Committee considered the financial implications of the Safe Nurse Staffing Levels (Wales) Bill.

Kirsty Williams AM, Member in Charge

Lisa Salkeld, Legal Services, National Assembly for Wales Commission

Philippa Watkins, Research Service, National Assembly for Wales Commission

Safe Nurse Staffing Levels (Wales) Bill

Explanatory Memorandum

7.1 The Member in Charge of the Bill (Kirsty Williams) responded to questions from Members.

7.2 The Member in Charge agreed to supply the Committee with an outline of which of the safe nursing indicators outlined in section 3(5) of the Safe Nurse Staffing Levels (Wales) Bill were derived from the CNO’s guidelines, the NICE guidelines and which were included as a result of the responses to her consultations on the Bill.

10.1 The Committee considered the evidence received.

7.1 The Chair welcomed Peter Black who will be substituting for Kirsty Williams for business relating to the Committee’s Stage 1 scrutiny of the Safe Nurse Staffing Levels (Wales) Bill.

7.2 The Committee considered and agreed its approach to Stage 1 scrutiny of the Bill.

Supporting Documents

Safe Nurse Staffing Levels (Wales) Bill

Explanatory Memorandum

The item started at 14.30