For the government to fulfil its stated aims on economic growth, improving and investing in the NHS must be prioritised. The nursing profession needs to be at the forefront of these investment decisions, and in particular, registered nurses need to be recognised as autonomous health care professionals in high pressure environments, paid accordingly at a band 6 level after a period of preceptorship.

We recognise that, given the current financial challenges, affordability is a consideration for nursing pay and conditions, but to date has been done in a way which is both limited and risks exacerbating inequalities.

It should not be overlooked that 81% of any additional pay for nurses is expected to be returned to the exchequer in additional tax revenue. Similarly to date, limited affordability arguments have counted against nursing given the size of the workforce which has hindered progress in reducing gender and ethnicity pay gaps.

All nursing staff pay needs to be timely, above inflation and in line with the Retail Price Index (RPI). Nursing staff in general practice need to have their pay ringfenced to ensure earning parity across the profession. Nurses make up the largest group of NHS staff and efforts to improve pay for them will progress action on gender and ethnicity pay gaps.

To support the ambitions of the Ten Year Health Plan the nursing supply pipeline and early career attrition must be addressed within the forthcoming Ten Year Workforce Plan. This should include building the government’s graduate guarantee into workforce planning and alleviating the burden of graduate debt. These principles must be extended to our internationally educated nursing staff too, ensuring the pay structure reflects their needs.

In addition, to support the implementation of the Ten Year Health Plan the shift to community must be fully funded and include an expansion of community nursing roles. A shift from acute to community provision in England requires upfront investment to ensure transformation is successful. Improving digital infrastructure must be prioritised to underpin digital advancements; and the technological innovation must be implemented with the guidance only nursing staff can bring.

Internationally educated nursing staff make an invaluable contribution to the NHS and broader health and care system; and without a robust domestic pipeline the NHS continues to rely on international recruitment. However, the recent increase to the immigration salary threshold for health and care worker visas has effectively closed international recruitment of band 3 nursing roles.

A shortfall of £63 per year in England (excluding London) and Northern Ireland means staff are unable to renew their visas. To protect the stability of the workforce internationally recruited nursing staff on Agenda for Change (AfC) band 3.1 should be paid at least an additional £63 per year to meet visa requirements and future pay awards should ensure that roles eligible for sponsorship are in line with visa requirements.

Access to continuing professional development (CPD) as part of career development is also essential for both individual nursing staff and service provision. The forthcoming Ten Year Workforce Plan must be supported by sufficient funding for CPD based on projections of future service and population needs. CPD should be factored into paid hours for nursing staff with funds to cover the shifts of those training.

The UK cannot continue to turn its back on the health needs of low- and middle-income countries and shrug its responsibilities to help address the global health workforce crisis. The UK government announced that the Official Development Assistance (ODA) to Gross National Income (GNI) target ratio would fall further from 0.5% to 0.3% by 2027 to fund increases in defence spending.

Cuts to ODA by the UK must be reversed and plans to reduce spending further must be abandoned to ensure the UK appropriately contributes to achieving United Nations’ Sustainable Development Goals.