Pay justice now: government must enhance nursing salaries to combat NHS staffing crisis

The government should pay nursing staff a significant recruitment and retention supplement in addition to their basic salary in order to tackle the “ever-worsening” workforce crisis in the NHS, the RCN says today as it calls on the UK government to deliver pay justice for the profession.

The supplement must be at least “several thousand” and be paid in addition to a “substantial” above-inflation pay rise to encourage nursing staff to join and stay in the service.

These are the demands in our formal submission of evidence to the NHS Pay Review Body (PRB), which makes recommendations to the government on wage rises each year.  

It comes as a new RCN survey of thousands of frontline nursing staff reveals almost half of those working in the NHS are actively planning or considering leaving their job. Without the pay enhancement, we’re warning that scores more staff could leave, further limiting the ability of nursing staff to provide safe and effective care. 

Professor Pat Cullen, RCN General Secretary and Chief Executive, said: “The crisis in the nursing workforce deepens each day as thousands of experienced staff decide to leave the NHS, fed up with being undervalued and underpaid. When nursing professionals with the greatest clinical experience leave the profession, patient care ultimately suffers. 

“A pay enhancement worth several thousand pounds is recognition of the crisis gripping the nursing workforce. It is a quick and effective measure that can alleviate some of the dissatisfaction with pay, terms and conditions felt by staff after years of neglect. The policy is a no-brainer for ministers.

“The lesson for the government and politicians everywhere is that failing to deliver the pay justice nursing staff deserve has consequences. Only decisive action can now help stem the loss of staff and protect patients.” 

Our evidence highlights that nursing staff have suffered years of below-inflation pay awards, and that this is at the root of the current NHS crisis. The PRB must act on the evidence and make recommendations that would begin to restore nursing pay. 

Despite being a highly skilled, degree-educated, safety-critical profession, the outdated Agenda for Change (AfC) pay structure means a large proportion of nurses are stuck at Band 5, the lowest pay band for a registered nurse on which they start and end their nursing careers.  

We call on the PRB to recommend measures such as automatic progression from band 5 to band 6 that’s already available to other NHS workers, to create better long-term career prospects for the nursing workforce. 

The NHS is wasting billions of pounds per year on agency fees and increasingly looking overseas to fill the gaps created by the government’s failure to retain staff. 

Evidence shows that nursing staff are more likely to stay in the profession when they’re paid fairly, offered career progression, and are working in fully staffed teams where they’re able to deliver care safely. Pay justice, improved career progression, and safe staffing measures are the only things that can address the NHS crisis. 

The RCN didn’t participate in the PRB process last year, as we sought direct negotiations with the government as a result of the industrial action taken by members. This year, although we’re participating, we’re also highlighting the flaws of the PRB process and making clear to them and to the government that future participation is not guaranteed. The process is only fit for purpose if it is truly independent and makes pay recommendations based on evidence, not the will of politicians.