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Safe and effective care campaign background


Safe and effective care campaign

The RCN is continuing to campaign for safe staffing and  fair pay for Northern Ireland nurses. This campaign focuses upon highlighting the growing pay inequality between Northern Ireland and the rest of the UK, together with the impact of this upon recruitment and retention. You can find out more about these issues below.

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.

As from April 2019, 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 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 (30 June 2019) figures from the Department of Health illustrate, with 2,936 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 safe staffing and fair pay for Northern Ireland nurses. We will continue to keep you informed of how the campaign is progressing.


Page last updated - 03/09/2019