Debunking disinformation around nurses' pay

As a Librarian and Information Specialist, it's a part of my job to help discover and distinguish reliable and accurate sources of information, and discredit misinformation (information that is misleading, regardless of intent) and disinformation (information that is intended to mislead). With RCN members voting to strike in many NHS trusts across the UK, lets take a closer look at some misleading information that’s been circulating recently.

Nursing is a highly skilled graduate profession, not a vocation. It is risk-oriented, and patient safety focused. There’s been a lot of talk recently about nurses being paid on average £35,500 per year. That figure is indeed an average; it takes into account the most senior managers and highly specialised nurses at the top of the highest pay scales. According to NHS workforce statistics, as reported by the BBC: “The most common grade for NHS nurses is Band 5, which accounts for about 42% of nurses in England.”.

In Wales, newly qualified nurses start on band 5 at £27,055 and progress to £32,934 after 4 years, which is the highest salary they can receive, without applying for a new job at a band 6. Here’s a link to the NHS pay bands 2022-23.

It’s not just nurses that are eligible to strike, it’s also nursing staff, so that includes healthcare assistants (HCAs) and healthcare support workers (HCSWs). Typically, these are on a band 2 or 3 on the NHS Agenda for Change pay bands (£20,758-£23,177). These key workers, who provide care and support for patients, enabling nurses to undertake their highly specialised job of nursing, are essential to the wellbeing of patients.

This tweet from the Department of Health & Social Care is disinformation – The graph does not include the lowest pay point on band 6, only the top and implies that nurses progress automatically, with years of experience, from the bottom of band 5 to the top of band 5 (as they do) and conflates this with progressing to the top of band 6 – they do not.

Progressing from a band 5 to a band 6 requires applying for an entirely different job. Drawing a liner path of comparison in pay between “nurses with a few years’ experience” and “experienced nurses” is also misleading, as it gives the impression that with years of experience, the progression from a band 5 to a band 6 is automatic, when it is not the case. A band 5 nurse with 30 years of experience will always be paid less than a band 6 nurse with 10 years of experience, for example. 

Nurses do not automatically progress to a salary of £40,588, as the graph implies. If conveying misleading information were not the intention, then it should be made abundantly clear in the tweet that band 6 jobs are separate jobs and not progression points that nurses automatically reach. This is disinformation. 

So why don’t nurses get a better-paid job, or leave? This is the issue. Chronic understaffing is due to a difficulty of recruiting and retaining staff, whom evidence shows work hours beyond their paid shifts for free.

It’s not dissimilar to saying to the striking teachers in Scotland that if they want more money than they should all become headteachers. Then who is left to teach?

If a nurse applies for a band 6 job (which are fewer in number than band 5 jobs, due to the nature of the roles at those bands) and leaves their band 5 role, that vacancy still exists and still needs to be filled, as nearly half of nursing staff in England are a band 5. This is about safe staffing levels for patients to receive the care they need without nurses being stretched so thinly that they are covering vacant posts as well as their own workload.

But won’t patients be at risk? The RCN is committed to ensuring any industrial action it initiates has the preservation of patient safety at its core. A way of maintaining this and safe staffing levels is through derogations. A similar process to derogations from industrial strike action happens every year through workforce planning and preparation for bank holidays, such as Christmas Day.

It means that certain healthcare services are exempt from closure on bank holidays. For example, whilst A&E departments are still accessible on Christmas Day, your Nurse Practitioner in your local GP surgery would not be.

A derogation is an exemption provided to a member or service from taking part in industrial action, ensuring critical care, preservation of life, & patient safety is paramount even during strike action. Find more information on derogations in this RCN Magazine article.

If nurses are deemed to be too important to patient safety and care to go on strike, then then should equally be valued and paid fairly to reflect the intense level of study and responsibility required of the role, so that we have a workforce of nurses and nursing staff for our NHS in the future, and for all of us who will inevitably need the specialised care and support of nurses one day.