Department of Health

Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015 

Key messages

  • On 10 November 2020, the Victorian Parliament passed the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Amendment Bill 2020.
  • The new Amendment Act outlines a second phase of improvements to ratios and complements the first phase of ratio changes that commenced 1 March 2019.
  • The Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015 provides for safe patient care in hospitals by establishing requirements for a minimum number of nurses or midwives per number of patients in specified wards or beds, recognising that nursing workloads impact on the quality of patient care. 

Safe Patient Care Act 2015

The Government believes a strong nursing and midwifery workforce is crucial to deliver the best care for Victorians.

Nurse and midwife to patient ratios have assisted in maintaining the safety of Victorian patients since they were introduced in 2000 and contribute to better outcomes for Victorians and safer workplaces for nurses and midwives.

The Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Bill 2015 was introduced to Parliament on 1 September 2015 and the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Act 2015 (the Act) took effect from 23 December 2015.

This landmark patient safety legislation is arguably the most comprehensive nursing and midwifery staffing Act anywhere in the world.

It delivered on the Government’s commitment to enshrine in law minimum numbers of nurses and midwives to care for patients.

Nurse and midwife to patient ratios are the key means of determining nurse and midwife staffing levels in Victoria, and were previously outlined in the Nurses and Midwives (Victorian Public Sector) (Single Interest Employers) Enterprise Agreement 2012–2016.

Services that are impacted by the legislation are those covered by the Enterprise Agreement. Services not covered by the Enterprise Agreement, including private and not-for-profit hospitals, private and not-for-profit residential aged care services and private and not-for-profit day procedure centres, are not impacted by the legislation.

Amendments to the Safe Patient Care Act - more Nurses and Midwives to care for Victorians

The government has committed to support a range of improvements to ratios within the Safe Patient Care Act.

On 21 February 2019, the Amendment Act 2019 successfully passed through the Legislative Council and came into effect on 1 March 2019. Changes to the Safe Patient Care (Nurse to Patient and Midwife to Patient Ratios) Regulations 2015 commenced on 6 March 2019.

The Amendment Act 2019 will continue to be implemented in a staged approach until 2023. It includes improvements to existing ratios, the creation of new ratios in a range of clinical settings and the introduction of other operational enhancements in the Act that will have a significant and lasting impact on the provision of safe and high-quality healthcare within Victorian public hospitals.

On 10 November 2020, the Amendment Act 2020 was successfully passed by the Victorian Parliament to deliver on the government’s commitment for a second phase of improvements to the Safe Patient Care Act. This complements the changes introduced in 2019.

The Amendment Act 2020 includes application of the new rounding methodology to shifts and wards not included in the first phase, establishment of in-charge arrangements in a range of settings, new after hours coordinator requirements for level four hospitals and the reclassification of Warrnambool hospital to a level 2 hospital. The first of these amendments commence 1 March 2021 and will be introduced in a staged approach to 2023.

Further information is available in the Phase two - Improvements to ratios FAQ and the updated Guide to Implementation, inclusive of Phase one and Phase two amendments available in the downloads section below.

Reviewed 27 June 2018

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