Building on a historic year for nursing

The nursing year started with an unprecedented amount of anger and optimism. We were on picket lines across the country either side of last Christmas and we’d never been louder as a profession – pushed there because nobody was listening but very firmly believing something positive would come out of it all.

How did the year go? Politicians only granted us modest progress – enough to save their own skins but not the revolution that nursing needs and patients deserve. Would we do it over again? Yes, by your actions you forced ministers to announce a top-up on the previous year’s pay settlement and give more than they had wanted to for the current year. Me and other RCN negotiators got every penny they were ever going to give – and that was real money in your banks when it’s really been needed most – but their desire to fix nursing was simply not as strong as ours.

What’s your appetite to campaign for more? Not just a pay rise but a big commitment to improve staffing levels and patient safety. 2024 is a general election year and every party will be challenged by the RCN to demonstrate clear vision and hard cash for nursing, the NHS and social care. Please continue to share your views with the College and let’s make sure we again push ministers further than they want to go.

Looking more internally, this year my focus has been on transforming the RCN through actions in response to our culture and governance reviews. We’re at the start of a long journey in changing behaviours and improving processes to create a more supportive and transparent environment for all, but we’ve made significant progress in addressing issues to become the truly representative and trusted College our members deserve.

We also launched an ambitious five-year strategy, which aims to inspire, champion and support the nursing community to deliver the best possible care. This includes strengthening the RCN’s position as the home for learning, education, and development with our bespoke online platform RCN Learn offering state-of-the-art resources which you can tailor to your personal needs and goals.

In addition, work progresses towards the establishment of the RCN Institute and the pioneering academies it will create. This will see the RCN become a centre for excellence, allowing us to advocate with authority for every aspect of the profession we represent. 

It has been a truly momentous year for the RCN and our members. Following our historic strike action, our professional body and trade union is at record size and there is much we can do as the indisputable Voice of Nursing. Speaking to thousands of passionate RCN members on picket lines this year was one of the proudest, and most humbling moments of my nursing career. The brave actions of our members started a wave, the momentum of which will continue long into next year.

Growth in the nursing workforce was outstripped by a four times greater increase in waiting lists. As nursing staff, you knew the many pressure spots across all health and care settings and what it means for safety – longer waits, poorer care quality and too often a loss of even basic dignity. The public know this too. Nursing staff are stretched dangerously thin, caring for 10, 15 or more patients at a time. The public supports us but they know it shouldn’t be like this.

In recent YouGov polling conducted on our behalf, 73% said there are too few nurses to provide safe care, 65% said they thought one nurse should be caring for just six patients or less on non-critical care hospital wards, 41% said they’re confident that a loved one will receive good care in an NHS hospital. The public understands the value of nursing, but governments seem woefully ignorant by comparison.

In England, we remain in dispute with the UK government over NHS pay and we’re already consulting these members about what they may be prepared to do in the new year. Last week the health secretary finally instructed the NHS Pay Review Body to start work on gathering evidence for the pay award for 2024/25, but they are very late. 

In Wales, we’re holding the Welsh government and NHS employers to account on their commitment to implement the non-pay elements of the pay award by 31 March 2024.

In Scotland, implementation of the shorter working week, protected time for learning and the review of band five nursing roles are still to be agreed by the cabinet secretary, despite our continued pressure, and the recent budget shed no light on Scottish government plans to address the nursing workforce crisis. We will continue to press Scottish government to fulfil their promises to nursing staff.

In Northern Ireland, the absence of the Executive and Assembly is having a devastating impact on the health and social care system. Nursing staff there have been left behind and denied a pay award for 2023/24. We’re asking RCN members and the public to write to their MLAs to demand fair pay and for them to demonstrate political leadership and accountability by getting back into government.

Wherever you live, whatever you do, we must continue to fight to be heard and have our work recognised. We must make the case that fair pay is inextricably linked to being able to recruit and retain a nursing workforce able to meet patient demands.

Our country is falling behind on the global stage. Recent data from the Organisation for Economic Co-operation and Development (OECD) shows that in most OECD countries, nurses can expect to earn 20% more than the national average wage – in the UK, nurses earn 10% LESS. 

This continued undervaluing of our profession is matched by a lack of investment in health care overall. The UK sits near the bottom of the list of 43 countries for the number of hospital beds, CT scanners, MRI units and PET scanners.

We must never forget that things don’t have to be this way. The UK is a comparatively wealthy country and the sustained underinvestment in health and social care is a political choice.

We must stand up and speak out for our profession.

We must tell governments we’ll not accept this anymore. 

Our polling showed 72% of the public say they’d support nurses taking further strike action over staffing levels, and 66% said they’d support staff striking over pay. 

Perhaps this is why the UK government is trying so hard to limit your freedom to strike. Despite promises earlier this year that the new Strikes (Minium Service Levels) Act would not target nursing staff, we’re now faced with proposals for hospital workers that could see them forced to work during strikes or face the sack. 
What happens when our politicians turn their backs on us? When governments refuse to hear our concerns about patient safety, pay and safe staffing? We’re forced to strike.

Making the decision to strike was the hardest choice many of us have faced in our careers. It’s not something that myself, the College or any of our members did lightly. This is why my personal plea to each of you is to write to your MP and urge them to protect your right to strike.

In 2024, politicians of every party across the UK must rise to the public’s expectations on safe health and care services. Failure to do so will cost them votes and maybe jobs. To save their own skins in the new year, their answer will have to be better than what’s gone before.

Ours is a proud profession with reason to be hopeful – the voice of nursing is a political one and we intend to use it.