RCN survey shows nursing staff feel more undervalued than ever

A decade on from the first RCN UK-wide Employment Survey, the latest results show nursing staff feel more undervalued than ever. We’re calling to “make the next 10 years better than the last”.

More than 21,000 of our members from across all health and care settings shared their experiences in our biennial survey, and while there are small signs of progress, the findings show nursing staff feel their skill and expertise are still not properly recognised, while problems include workload and being unable to provide proper care.

Respondents identify pay fairness as their single biggest concern. Two-thirds of them believe their pay does not reflect the responsibilities, skills and risks they carry every day. This isn’t just about salary – it’s about recognition and value.

The current pay framework is not fit for purpose, and no annual cost-of-living increase will deliver the fundamental change needed. The survey shows record numbers of members dissatisfied with their pay band too, reflecting frustration with the current system.

Retention remains a big issue affecting the workforce. Four in 10 nursing staff are considering or actively planning to leave their roles. The reasons are clear: feeling undervalued, low pay, excessive pressure and emotional exhaustion. This is a warning sign for workforce stability and patient care, and it demands urgent action.

Workload pressures leave staff unable to provide the level of care they want to deliver. Many nursing staff regularly work beyond their contracted hours, often unpaid, and more than eight in 10 report working when unwell. These pressures affect morale, health, and the ability to provide the level of care nursing staff aspire to deliver.

There’s also a dramatic decline in advocacy for nursing as a career. While most respondents still describe nursing as rewarding, only a third say they would recommend it – the lowest figure since the survey began a decade ago. This drop signals a serious threat to the future of the profession.

The picture painted by the survey is one of not only stress and strain at work, but at home too. Rising living costs have left some nursing staff reconsidering pension contributions and struggling to meet basic expenses.

Nursing staff are clear about what would make the biggest difference: a pay rise is overwhelmingly the top priority, followed by more annual leave and greater flexibility in working arrangements. These findings provide a clear roadmap for improving morale, retention and restoring confidence in nursing.

In the foreword to the report, Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “Ten years on from our first employment survey and the results continue to paint a worrying picture – many nursing staff are considering or actively planning to leave their roles.

“The current pay framework is broken and long overdue reform to the pay structure is needed. No annual cost of living pay increase is ever going to be enough to deliver the fundamental change we need.

“Despite these challenges, nursing is an amazing profession. Our challenge now is to make the next 10 years better than the last, for nursing as a profession but crucially for patients too.

“This means securing fair pay and recognition for all of nursing; investment for safe staffing, including mandated minimum nurse-to-patient ratios in all settings; and action from employers to make workplaces safer, with every member of the nursing workforce supported, valued and protected.

"These ambitions are not new - but they need to be realised now more than ever.”

This evidence will be provided directly to politicians and will inform the RCN’s national campaigning and policy demands.

Read the full report and see what needs to change.