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Northern Ireland pay campaign background

Find out more about the main issues RCN Northern Ireland is focusing on as part of our pay campaign activity

Fair pay for Northern Ireland nurses

Members of the Royal College of Nursing in Northern Ireland expected a minimum 3% pay uplift for 2018-2019 for all staff employed by the HSC on Agenda for Change for change contracts, in order to keep pace with staff in the other countries of the UK. In partnership with the other health trade unions in Northern Ireland, this was put to the Department of Health and HSC employers in a formal proposal on 26 September 2018.

The pay award for 2018-2019 imposed by the Department of Health in December 2018 falls significantly short of this 3% minimum proposal. A significant number of nurses will receive a 1.5% pay uplift, equating to between £7.50 and £8.50 per week. Furthermore, it denies many nurses and other staff the incremental pay progression to which they are contractually entitled.

Nurses in Northern Ireland 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.

It is also clear that the 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 2,325 nursing vacancies in the HSC in Northern Ireland as at 30 September 2018. 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 inadequate 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. 


Close the Gaps

The RCN in Northern Ireland is 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 £1,419 less than a counterpart in England and Wales, and £1,875 less than in Scotland each year. An experienced band 5 staff nurse is now paid £797 less than a counterpart in England and Wales, and £1,427 less than in Scotland each year. A typical health care assistant in Northern Ireland is now paid £711 less than a counterpart in England and Wales, and £1,706 less than in Scotland each year. An experienced specialist nurse in Northern Ireland is now paid £1,156 per annum less than a counterpart in England and Wales, and £2,097 less than in Scotland each year.

We have a severe shortage of nursing staff in Northern Ireland, as the latest (September 2018) figures from the Department of Health illustrate, with 2,072 nursing vacancies in the HSC and around the same number estimated in the independent sector. Despite recent increases 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.

Safe staffing, patient safety and treating nurses fairly

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.

Page last updated - 12/02/2019