Dáil Éireann Debate, Tuesday - 16 June 2026
920. Deputy Pádraig O'Sullivan asked the Minister for Health the current implementation status of the Framework for Safe Nurse Staffing and Skill Mix across medical wards, surgical wards and emergency departments; the number of sites where implementation remains incomplete; and if she will make a statement on the matter. [45278/26]
Amharc ar fhreagra921. Deputy Pádraig O'Sullivan asked the Minister for Health the action which is required where a ward, emergency department or service area is assessed as not meeting staffing levels identified under the Framework for Safe Nurse Staffing and Skill Mix; the person or body responsible for escalation and remedial action; and if she will make a statement on the matter. [45279/26]
Amharc ar fhreagraI propose to take Questions Nos. 920 and 921 together.
The Framework for Safe Nurse Staffing and Skill Mix is a systematic, evidence-based approach to determine appropriate staffing levels and skill mix for Registered Nurses (RNs) and Healthcare Assistant (HCA) roles. It is determined by patient need and demonstrates impact through the measurement of a range of outcomes.
Phase 1, which focuses on Adult General and Specialist Medical and Surgical Care wards, has been national policy since 2018. Phase 2, focused on Adult Emergency Care Settings was adopted as national policy in 2022. The national implementation of these policies remains a key priority.
Since 2020, Government investment of €56.2 million has supported the implementation of Phase 1 and 2, enabling the delivery of baseline safe staffing. This investment equates to approximately 2,000 additional whole-time equivalents (WTE) RNs and HCAs. The Framework is now fully implemented in EDs and is approaching full roll-out across in-patient wards, with circa 1,900 additional RNs and HCAs in these care settings. The HSE has advised that the majority of outstanding posts are currently in a recruitment process or pending start dates. 32 Hospitals have achieved baseline Phase 1 implementation, with a further 10 hospitals continuing to progress implementation.
The framework policy requires the establishment of Local Implementation Groups (LIG) in clinical sites. These groups operate within a defined governance structure, with the Director of Nursing chairing the LIG reporting on implementation progress to the Hospital executive, the regional Director of Nursing and Midwifery, as well as to the HSE National Lead for Safe Nurse Staffing.
In addition, a national Implementation Action Group, chaired by the Nursing and Midwifery Advisor to the HSE CEO, has been established to oversee and deliver the completion of baseline implementation.
Trendcare, a supporting enabling IT system for Phase 1 of the Framework, measures patient acuity and dependency in real time. This tool supports Directors of Nursing in fulfilling their monitoring and escalation responsibilities. As of May 2026, Trendcare is fully implemented in 15 hospitals and is scheduled for full roll-out to all hospitals by the end of 2026.
