The Welsh Levels of Care


The Welsh Levels of Care are a key component of the operational guidance developed for the Nurse Staffing Levels (Wales) Act 2016.

The Welsh Levels of Care set out descriptions of patients across five archetypal levels of care, from routine and simple to critical and unpredictable. These descriptions are broken down into typical patient needs, conditions and situations and the corresponding clinical assessments, interventions and tasks undertaken by nurses.

The purpose of the Welsh Levels of Care are to provide nursing teams with the advice, guidance and definitions required to consistently assign individual patients to a level of care. The level of care is the principle data of the national acuity audits that take place every six months, in January and June. This data is collated and analysed to provide comparative information on the range of nurse staffing levels deployed on every participating ward in Wales.

Together with information on workload, and the current deployment of staff, this data is provided in feedback to operational staff on a tool known as the visualiser.

The data on the acuity audits is then considered alongside comparative data related to the quality of care. Also considered is a professional narrative on the operational pressures that have influenced the care of patients and deployment of nursing staff during the audit period.

This evaluation, referred to as triangulation, is mandated in the Nurse Staffing Levels (Wales) Act (2016) Statutory Guidance 2021 and is the method by which Nurse Staffing Levels are to be calculated (see image below).