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Consultation on a new nursing pay spine

The UK government has launched a consultation to explore the creation of a separate pay spine for nursing staff working for the NHS in England.

It’s calling for evidence to consider the benefits and challenges of a separate nursing pay spine and to explore other potential approaches to support the career progression and professional development of nursing staff. 

The government committed to doing this during pay negotiations with the RCN in 2023 after we raised concerns about how the Agenda for Change (AfC) pay structure has failed to keep pace with the evolution and complexity of nursing roles.

In early 2024, we asked for your feedback to help shape our response to the consultation. We are currently analysing your responses, and will provide an update on this soon.

‘Nursing needs a fresh start’

“The government has asked for your views on how to value and reward you – let’s grab the moment.

"In this election year, let’s open the biggest public and political conversation about the value of nursing. And tell the sceptics why nursing is unique, why patients need us and why we deserve better.”

Image of Pat Cullen at RCN HQ, London

FAQs

It is unacceptable that despite years of experience, many nursing staff are still employed at the band they started their career on.

Today 42% of registered nurses working for the NHS in England are on band 5 salaries.

The current system mostly rewards staff the further away they get from providing hands-on patient care. This approach is poor for patients and works against career progression for nursing staff. Routine pay progression from band 5 to 6 is afforded to some occupational groups but not nurses – that is unfair and unsustainable.

During pay negotiations with the UK government in March 2023 the subject of how the NHS Agenda for Change (AfC) pay and grading structure affects career progression and professional development of nursing staff was discussed.

The RCN believes that limited career progression in nursing has a direct impact on recruitment and retention within the profession and has contributed to the staffing crisis in the NHS.

The RCN proposed the option of a separate pay spine for nursing staff, and the government has now opened a consultation on this matter.

In our consultation response we will consider what a nursing pay spine would mean for all nursing roles, between bands 2 to 9. From the newest health care assistant to chief nurses, we are one profession.

Discussion of any potential nursing pay spine is ongoing, and the UK government’s consultation will gather evidence and opinions from many organisations and individuals to understand the problem and possible solutions.

Yes. Absolutely. The RCN is committed to consulting with members on issues such as this.

Discussions of any potential nursing pay spine are ongoing, and the government’s consultation will gather evidence and opinions from many organisations and individuals to understand the problem and possible solutions.  

The government has said that if a separate pay spine for NHS nursing staff was taken forward, there are two options to consider:

  1. a separate pay spine within the existing NHS AfC structure
  2. a new pay structure for NHS nursing staff outside Agenda for Change.