In an interview with the Sunday Times ahead of RCN Congress in Liverpool, Professor Nicola Ranger, RCN General Secretary and Chief Executive, outlined the RCN’s position on pay reform, workforce pressures and the future of nursing, warning that action could be taken against employers who fail to implement agreed changes fairly.
She highlighted the Westminster government’s review of band 5 NHS nursing roles in England as a critical moment for the profession. The RCN pushed the government hard to secure this review, but warned that we would challenge any attempts to undermine it at local level.
“We will not let this be scuppered by those [hospitals] that we feel haven’t done the process fairly or in the spirit in which it was intended. There are some trusts that devalue nursing and want to do it as cheaply as humanly possible.”
Nicola said many nurses remain stuck at band 5 throughout their careers despite taking on greater responsibility. She pointed to the example of a neonatal nurse with more than two decades of experience still working at the same band.
“It’s a disgrace,” she said. “There is no other profession in the NHS that [people] will start their career as a band 5 and retire as a band 5. Not one. Nurses have been completely and utterly taken advantage of.”
She added that nursing continues to be undervalued compared with other professions, with pay structures leaving it “weighted to the bottom”. “We have more band 5s than any other profession, and the least amount of 6s, 7s, 8s and above,” she said. “That wrong has to be put right.”
Nicola warned that if meaningful progress is not made, more radical options could be considered, including withdrawing from the NHS contract altogether. She added: “We always have disputes and strike action in our toolbox. We don’t want to strike, but we’re not afraid to.”
Alongside pay, she stressed the importance of strengthening the profession’s voice. She said both nursing and its leaders must be stronger advocates for their role in patient care.
“If we don’t, my real worry is that we will be reduced to having our work described as tasks. That taskification of care is already happening and it’s devastating.”
She warned that reducing nursing to a series of tasks risks undermining patient safety, as it overlooks the holistic nature of care.
The pressures facing the next generation of nurses also featured prominently. Nursing students are facing significant financial hardship, with many struggling to cover basic costs, and graduating with substantial debt, she said.
“They’re losing hope. They’ve spent three years working in organisations [as part of their degree], seeing the patient need going up. Then to be told you haven’t got a job when you know the need is there for the public and the patients, it’s shocking.”
She referenced an RCN survey, the results of which will be released next week, which found many students are cutting back on essentials. She backed proposals to forgive student loans for those committing to work in the NHS for a set period.
On the role of advanced nurse practitioners (ANPs), Nicola pushed back against recent criticism from the British Medical Association. “I was shocked and disappointed. The last thing patients need is any one profession putting doubt on the skill and the safety of another,” she said.
She emphasised the expertise required for advanced practice roles, noting the extensive experience and education involved, and added: “You don’t sort out your problems by diminishing another profession.”
RCN Congress takes place in Liverpool from Monday 18 May to Thursday 21 May. During the week, RCN members will network, hear from keynote speakers and take part in vibrant debates about the issues affecting the nursing workforce. They will also participate in an education and development programme and visit our exhibition. Find out more.
