Resolution: Pay terms and conditions parity

This resolution passed.

At Congress 2018, a matter for discussion (RCN, 2018) took place on the need to re-balance RCN resources between NHS and independent sector members. Since then, there has been a global pandemic that highlighted the inequitable employment terms and conditions between those on Agenda for Change (AfC) and those who were not. Approximately 40% of RCN members do not work in the NHS, with 20% working in independent health and social care (RCN, 2022).

While those on AfC contracts voted on strike action, nurses working in other areas including general practice and adult social care have been working with little recognition that their terms and conditions are often worse than those who were eligible to vote. The public has no comprehension that general practice is not included in this action; to them and the staff who work in it, it is all part of the NHS.

In a world of integrated care systems, in England, people are voting with their feet making it increasingly difficult to recruit into organisations that do not offer NHS AfC contracts. One of the often-cited disincentives for the residential care sector to support internationally trained nurses to gain UK registration, is the risk of losing that member of staff to a local trust, where better pay and conditions are often available.

Government policy (NHS, 2019) refers to the need to move care out of hospital and into the community, however funding has gone in the opposite direction (The Health Foundation, 2020). Without adequate funding to support the workforce, services providing care in the community will struggle to keep people well, care for them at home and prevent hospital admissions. Marmot (Institute of Health Equity, 2020) cites the importance of creating fair employment and good work for all in his review of the impact of COVID-19. We need to recognise that this applies to our UK-wide workforce as much as for the people and communities we care for. 

The RCN has recently created new roles, across the UK, to address these issues but this remains a relatively small resource. Post-COVID, the increase in demand on primary care has risen exponentially, putting unsustainable pressure on its exhausted staff. The Fuller Stocktake report (NHS England, 2022) was commissioned to identify solutions and nurses need to play a central role in implementing its recommendations.

The RCN needs to support its members in taking collective action to address the imbalance of funding across health and social care services that could support the equitable recruitment and retention across the UK-wide nursing workforce.  

Reading list for this debate available at rcn.libguides.com/congress2023.

References 

The Health Foundation (2020) The bigger picture: learning from two decades of changing NHS care in England. Available at: www.health.org.uk/publications/reports/the-bigger-picture (Accessed 17 March 2023). 

Institute of Health Equity (2020) Build back fairer: The COVID-19 Marmot review. Available at: www.instituteofhealthequity.org/resources-reports/build-back-fairer-the-covid-19-marmot-review (Accessed 17 March 2023).

NHS (2019) The NHS long-term plan. Available at: www.longtermplan.nhs.uk/publication/nhs-long-term-plan (Accessed 17 March 2023). 

NHS England (2022) Next steps for integrating primary care: Fuller stocktake report. Available at: www.england.nhs.uk/publication/next-steps-for-integrating-primary-care-fuller-stocktake-report (Accessed 17 March 2023). 

Royal College of Nursing (2018) NHS/Independent sector debate. Available at: www.rcn.org.uk/congress/congress-events/nhs-and-independent-sector (Accessed 17 March 2023).

Royal College of Nursing (2022) 2021 review of the year. Available at: www.rcn.org.uk/Professional-Development/publications/annual-review-of-the-year-2021-uk-pub-010-097 (Accessed 17 March 2023).