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Nursing staff

Pay, terms and conditions in independent health and social care 

All nursing staff deserve fair pay, good terms and conditions, career development and a safe working environment, no matter where they work.

We believe all independent health and social care (IHSC) employers need to have a pay system that’s competitive with the NHS. While some IHSC pay systems are based on NHS structures, many are set independently. Pay rates are often lower, and for health care assistants, they are usually set at the national minimum wage or a few pence above it.

Other terms and conditions, such as occupational sick pay, occupational maternity pay, and annual leave are also often much lower compared with the NHS. In many cases, IHSC employers may only offer the statutory obligations of sick and/ or maternity pay and annual leave.

This isn’t good enough. It doesn’t reflect the value of your work, and it doesn’t even begin to cover the rising cost of living. 

Asking your employer for a pay rise 

We’re here to support you in asking your employer for the pay rise you deserve. Follow these seven simple steps to get the conversation started:

  1. Find out if there are any RCN reps in your workplace

    Reps can support you in getting the pay and workplace conditions you deserve. If you’re unsure whether you have one in your workplace, contact us on 0345 772 6100 and we’ll put you in touch with your local RCN office. You could even consider becoming a rep yourself.

  2. Talk to your colleagues

    A pay claim is more likely to be successful when it comes from a large number of staff. Speak to your colleagues to establish key issues and find common ground. You can use our guide to ‘discussing the cost of living with colleagues’ to help get you started.

    Gather this information to use as evidence for your pay claim, but remember to keep your colleagues anonymous when sharing their stories.

  3. Consider the real Living Wage

    Once you’ve understood how your colleagues are coping, ask them if they’re receiving (at least) the real Living Wage. See if the real Living Wage would make a difference to them, and what that difference would be. You might decide to use this as the basis of your pay claim (or you might request a higher rate). Remember to capture as much information as possible, but don’t include any individual’s personal details. 

  4. Create a survey 

    A survey is a quick and easy way to gather feedback from your colleagues. Print our short questionnaire, or create your own, and share it around your workplace. You can use the results as evidence to request a pay rise or other improvements to your terms and conditions.

  5. Think about your workplace 

    As well as gathering stories from your colleagues, think about your workplace as a business. Do you have a high turnover of staff, with a lot of people starting and leaving? What are the sickness levels like in your workplace? If turnover and sickness levels are high, why do you think this might be? Is there potential for staff to leave due to other businesses opening up nearby with better pay? Could improved pay or better terms and conditions help solve these problems?

  6. Read about our fight for fair pay in other IHSC workplaces 

    Learn how other workplaces have organised for better pay and how we have supported them. This may provide you with a useful reference point during conversations with your employer, or it may inspire your colleagues by showing them what’s possible.

  7. Write to your employer  

    Once you’ve agreed the key issues with your colleagues and spoken to your RCN rep, you’re ready to approach your employer. Writing to them as a united group of staff will have the biggest impact. It’s even better if the letter comes from a group of RCN members.

    Use our template letter to get started and remember to include all the evidence you’ve been gathering.

Tell us your story

How are staffing levels and low pay affecting you right now? How is the cost-of-living crisis and the remnants of a global pandemic impacting your work and life? Capture your lived experience with our easy-to-use tool and help tell the true story of UK nursing.

We're here for you

If you're an RCN member who needs help with any aspect of your employment, you can access online advice or contact us directly. We're here to help – wherever you work.


Our fight for fair pay in independent health and social care

We campaign for nursing staff in all settings to receive fair pay, no matter what sector they’re employed in. 
Nurses protesting fair pay at Westminster