Northern Ireland pay campaign background

Nurses in England, Scotland and Wales received the 1% pay increase for 2017-2018 from April 2017. Although the Northern Ireland Department of Health finally announced in December 2017 the implementation of this award, it was only paid at the end of February. For most of 2017-2018, Northern Ireland was therefore isolated as the only UK country in which no pay award had been received for the current financial year. 

This follows several years of pay restraint for nurses, including two years of a pay freeze and the 2014-2015 non-consolidated award, which meant that many nurses in Northern Ireland yet again received no cost of living pay increase. 

Nurses in Northern Ireland are now at least 14% worse off in real terms than in 2010. They are seeing their standard of living fall, with no sign of light at the end of the tunnel. According to the most recent RCN Employment Survey, 40% of nurses in Northern Ireland say that they struggle to pay gas and electricity bills (compared with 34% in Wales, 29% in England and 27% in Scotland). 24% of Northern Ireland nurses struggle with childcare costs (compared with 12% in England and Wales and 11% in Scotland. Around one in five nurses has been forced to take a second job just to make ends meet. We are also hearing reports of nurses in Northern Ireland, and across the UK, accessing food banks. The delay in implementing an award for 2017-2018 has intensified the hardship felt by hard-working nursing staff and adding to the perception that the care they provide to the people of Northern Ireland is not valued.

It is also clear that the 14%+ real terms fall in nurses’ pay is having a negative impact upon recruitment and retention and, therefore, on staffing levels and patient care. The Northern Ireland Department of Health confirmed that there were around 1,800 nursing vacancies in the HSC in Northern Ireland as at 30 June 2017. The current figure is likely to be higher. The RCN estimates that there could be an equivalent number of vacancies in the independent (nursing home) sector. A recent RCN member survey in Northern Ireland confirmed that the two most significant priorities for nurses here are [1] safe staffing and [2] pay. Nurses believe that the cap on nursing pay is putting patient care at risk. It devalues nurses and nursing, means people are not joining the profession and many people are leaving. And because there are not enough nurses, patients often cannot get the care they need. 

The RCN in Northern Ireland is now running a campaign to highlight and close the gaps between nurses’ pay here and that in the rest of the UK.

A newly-qualified band 5 staff nurse in Northern Ireland is now paid £218 less than a counterpart in England each year and £530 per year less than in Scotland. An experienced band 5 staff nurse is now paid £284 less than a counterpart in England each year and £572 less than in Scotland.

 A typical health care assistant in Northern Ireland is now paid £382 less than a counterpart in England each year and £1128 less than in Scotland. A specialist nurse in Northern Ireland is now paid £413 per annum less than a counterpart in England and £831 less than in Scotland.

We have a severe shortage of nursing staff in Northern Ireland, as the latest (July 2017) figures from the Department of Health illustrate, with 1,828 nursing vacancies in the HSC and around the same number estimated in the independent sector. Despite the recent welcome increase in pre-registration student nurse places, we are not training enough nurses and increasing numbers are going elsewhere to find employment with better terms and conditions. The Department of Health estimates that some 21% of newly-qualified nurses here plan to leave Northern Ireland to work elsewhere. The impact of this upon patient care in Northern Ireland is devastating.

Notwithstanding the current political situation in Northern Ireland and the difficulties this poses, the RCN will continue to highlight the need to close the gaps in nurses' pay with the rest of the UK, as well as implement a fair pay deal for Northern Ireland nurses.

The negative impact of this treatment upon health and social care in Northern Ireland is readily apparent, with the high levels of vacancies across the HSC and the independent (nursing home) sector, and demand for nursing staff outstripping the supply. We have a significant over-reliance on the supply of nurses on an ad hoc basis through the nurse bank and nursing agencies. There are alarmingly high sickness absence rates amongst nursing staff that are largely attributable to stress and mental ill health. 

Nurses in Northern Ireland are more likely than nurses in England, Scotland or Wales to cite increases in workload, unfilled vacancies and recruitment freezes in their workplace. We need to invest in safe staffing across all areas of nursing practice. Mortality rates increase by up to 46% in hospitals with a 1:8 nurse-patient ratio compared with a 1:4 nurse-patient ratio. Every patient added to a nurse’s workload is associated with a 7% increase in deaths after general surgery. Higher patient satisfaction is recorded in hospitals with fewer patient per nurse workload and good nursing work environments.

We need proper workforce planning that is based on health needs and strategic priorities, not financial considerations. Three-quarters of all nurses in Northern Ireland currently work beyond their contracted hours each month because they are concerned about patient care. More than 50% of those that do so work unpaid for these extra hours. Nurses in Northern Ireland (84%) are more likely to work unsocial hours than nurses in Wales (79%), England (78%) or Scotland (77%). Nurses in Northern Ireland (68%) are less likely to be paid enhanced rates for working unsocial hours than those in Scotland (66%) and England (53%). Nurses in Northern Ireland are more likely to work additional hours than nurses in England, Scotland or Wales and are less likely than nurses in any country except Wales to be paid for these additional hours.

We need to make sure that health and social care transformation is delivered and this requires investment in community nurses such as district nurses, school nurses, and health visitors. However, we learned recently of significant cuts in the Northern Ireland training budget for these areas of practice.

The RCN is committed to securing fair pay for Northern Ireland nurses. We will continue to keep you informed of how the pay campaign is progressing.