Fair pay for general practice nursing staff

GP nursing staff are usually employed directly by general practices (GPs), which are independent businesses funded by the government. This means each practice as an individual employer can set their own pay terms and conditions for their employees and employees are not subject to Agenda for Change terms and conditions. This is different from the NHS, where pay is determined nationally by recommendations of the NHS Pay Review Body or negotiations between trade unions and the governments of the UK. 

GP nursing staff play an essential role in delivering NHS services, but many of them still aren’t receiving the fair pay they deserve. We're campaigning to change that. 

6% pay rise for practice nursing staff in England

In July 2023, the UK government announced a 6% pay rise for all salaried general practice staff in England. This includes nursing staff. The government announced the pay rise after it accepted the recommendation of the Independent Review Body on Doctors’ and Dentists’ Remuneration.

How the funding is distributed

The government made funds available to practices in November and December 2023, through an increase of the Global Sum. Before this, we called on the UK government to commit to additional funding if nursing staff were left without at least 6%.

The Global Sum is based on patient numbers, and some practices have raised concerns that they don’t have enough funds to cover the pay rise.

Some practices have paid the full 6%, whereas others have paid less or nothing at all. As a result, many general practice staff are still waiting for their pay rise.

The inconsistencies in how staff have received this pay increase demonstrate how poorly the current funding model is serving general practice nursing staff. Not paying the promised pay award has left staff feeling undervalued and undermined.

Taking action

We’re calling for the government to properly fund this pay increase so that all general practice nursing staff receive the pay rise they deserve.

We’re writing to Local Medical Committees (LMC) calling on their support and working closely with the British Medical Association to collectively respond to this issue.

What our members told us 

In November 2023, we launched a survey among our members in England to get a clearer idea of how the pay award has been implemented.

• 77% of respondents said they had not received the full pay award the government promised for the 2023/2024 financial year

• 44% of respondents said they did not receive any pay award last year

• 33% of respondents said they received a pay award of less than 6%, with the average amount received around 3.2%

• Only 1 in 5 respondents (20%) received the full pay award of 6%

• 64% of respondents are concerned that their employers are not being transparent about their pay award for 2023/2024

Read our news story for more information.

The RCN believes that our members working in general practice should receive the same 6% increase in pay as salaried GPs.

However, as individual employers that contract to the NHS, general practices determine pay for their employees on a practice by practice basis. The funding for the 6% pay rise will be paid to practices via the global sum, which in some cases may not be sufficient to cover the full cost.

If your employer has not been clear with you, use our template letters to start a conversation and tell us what – if any – pay increase you have received.  

Due to the way that staff costs are funded via the Global Sum, the 6% increase in funding may not provide all Practices with sufficient additional funds to match the full 6% increase for salaried staff. Therefore, you should ask your employer to explain to you what funding they have received and what calculations they have carried out to determine how much of a pay increase you will receive. Use this template letter to raise this with your employer.

This will be at your employer’s discretion and we would encourage you to have a conversation with your employer to discuss this further.

You should ask your employer to explain to you how they have calculated your pay increase. Use this template letter to approach your employer about this.

Each GP practice employer has received additional funds to provide a pay rise. We would advise that you speak to your employer and ask how they are using the additional global sum, we believe that it should be used for salaried staff pay increase and the BMA have advised this too.

If your employer has said you will not receive a pay uplift despite new funding and they refuse to be transparent about the additional global sum they have received this should be raised with your Local Medical Committee (LMC) to advise them of this issue.

Use our template letter to write to your employer to formally ask for the pay rise. We have updated this to reflect the latest information.

This pay award was announced in July, but the funding of the promised 6% was confirmed and accepted on 29 September 2023 by the BMA GP committee England (GPCE).

The funding for the pay rise will be reflected in the November release and the back pay will be in the November release so you may get the increase and back pay in both your November and December salary.

We will support you to advocate for the pay rise you are entitled to. The first step is to raise the issue with your manager. You can use our summary of this announcement to start that conversation.

If your manager does not take this on board, you can raise the issue formally with our letter templates to guide you

The details of how and when the uplift will be provided has now been confirmed. Now we know the details of the pay award you can re-open the conversation with your employer informing them that you understand the money will be in the November Global sum payment.

We are clear that this uplift should be passed on to all nursing staff employed directly by a practice.

If you have moved employer, please contact the practice you worked at to ask them when they are going to pay you the back pay on the award for the time you worked at the practice. Share with them the exact dates you worked at the practice.

If they respond that they won’t pay you, please contact RCN Direct who will be able to get further support for you from your RCN regional office. Please make sure you have a copy of the contract of employment you had from the employer you are requesting backpay from and details of the amount that was paid to you before you left their employ. 

If you work in general practice, please make sure your MyRCN record is up to date. We use the information you on your record to keep you informed about the issues in nursing that impact you. You can check and update your details to make sure you get all the information you need.

If you want to hear more about our fight for fair pay and safe staffing in all areas of nursing, you can also become a campaign supporter to hear more about this work, across all sectors and care settings. 

Primary care workers in Northern Ireland were awarded a 4.5% pay uplift for 2022-23. Details of the 2023-24 pay award have not been announced yet.

For more information, see our 'GP nursing pay in Scotland' page.

Negotiations between the Welsh Government and the British Medical Association (BMA) regarding the General Medical Services (GMS) contracts for GPs in Wales will commence shortly.

We are in discussion with the BMA Wales about the issues of GP nursing pay.

• We’re part of the expert advisory group for the 2024/2025 GP contract alongside partners including the British Medical Association, Department of Health and Social Care, NHS Confederation, Royal College of General Practitioners and NHS England. As part of this work we are fighting to ensure the negotiations include maximising pay, terms and conditions for nursing staff employed by general practice.
• We’re responding to NHS England’s delivery plan for recovering access to primary care, making sure the needs of our members are taken into account.
• Our GP nursing forum is reviewing the RCN Workforce Standards to ensure they’re relevant and useful to nursing staff working in general practice.
• We’re developing a set of “good employment standards” for GP employers alongside the RCN Workforce Standards. These will provide GP employers with a clear guide on good employment practice, specific to GP nursing staff. The standards will also be a reference for GP nursing staff to help with discussions about working conditions and pay.
• As part of this, the GP nursing forum is leading a project looking at nursing career pathways and template job descriptions for nurses working in general practice.
• In partnership with NHS England and the National Association of Primary Care, we run a series of monthly webinars for GP nursing staff.