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A fresh start for nursing pay? RCN responds to government consultation

8 Apr 2024

Evidence gathered from thousands of nursing staff could lead to the biggest overhaul of nursing pay since Agenda for Change was introduced 20 years ago. 

Nursing staff holding fair pay for nursing signs

Following campaigning by the RCN, the UK government agreed to carry out a consultation on a new pay structure for nursing staff. We’ve shared evidence from thousands of RCN members with government, showing that nursing has been continually undervalued and needs a pay overhaul to fix the workforce crisis.  

Currently, three-quarters of all registered nurses in England’s NHS are in bands 5 and 6, the lowest pay bands for registrants. Nursing has transformed in the last 20 years, with staff today working at a higher level of autonomy, specialisation and responsibility. A new pay structure, underpinned by a new nursing career framework, could ensure nursing staff are paid fairly and have clearly defined career pathways.   

Our evidence submitted to government includes results from our most recent employment survey. This revealed that 70% of nursing staff who want to leave the NHS say their primary reason is because they feel undervalued.  

Our survey also showed member dissatisfaction with their current banding. When asked whether their pay band matches the role and responsibilities they hold, nearly 66% of respondents said their banding is inappropriate or very inappropriate.   

In addition:   

  • 40% said they’d been in their band longer than they should have.  
  • 27% said they’ve been unable to obtain a role at a higher band. 
  • 87% disagree that their current pay band recognises their knowledge, skills, education and current level of responsibility. 
  • 77% don’t think the difference between bands is significant enough to recognise the increased experience and requirements between roles on different pay bands.  

With 10s of thousands of nursing vacancies across the NHS, the government needs to prioritise recruitment and retention by modernising its pay structure. We told the government that the nursing workforce crisis could become “potentially irreversible” if action isn’t taken.  

RCN General Secretary and Chief Executive Professor Pat Cullen said:   

“Nursing is not a calling. Or a vocation. Or ‘women’s work’. We are a profession. We are experts. We are leaders. There is an art and a science to what we do.   

“This work is about every nursing role. Agenda for Change has lost sight of our value. After 20 years, we are weighted to the bottom of the pay and grading structure, without a clear route through.     

“I want the career pathway for nursing to be smashed wide open. Whether you take on management roles or not, your knowledge and excellence as a nursing professional has to be recognised. Patients want the experienced nurse as well as the new joiner involved in their care and treatment.     

“We are opening the biggest public and political conversation about the value of nursing. And we will tell the sceptics why nursing is unique, why patients need us and why we deserve better. Let’s give nursing its fresh start and a new place in health care.” 

Page last updated - 08/04/2024