Government seeks views on separate pay scale for nurses

The government has launched a call for evidence to determine the “risks and benefits” of a separate pay structure for nurses working in the NHS.

Nurses and other healthcare professionals have been urged to contribute to the online consultation, which will run for 12 weeks.

It is seeking to understand whether the Agenda for Change (AfC) contract is creating specific barriers to the career progression of nurses and to identify potential solutions to the problem.

"Nursing staff deserve a fresh place in the NHS and not more years of poor pay rises and no wider reform"

Pat Cullen

The proposed shake-up to the AfC system was first put forward by the government in 2023, as part of the 2023-24 NHS pay deal and following negotiations with the Royal College of Nursing (RCN).

At the time, the then health and social care secretary, Steve Barclay, said the government wanted to take action to address the specific challenges faced by nursing staff in terms of recruitment, retention and professional development.

The RCN has continued to push the government to commit to a separate pay spine for nurses, despite its members rejecting the idea when they voted against the NHS pay deal.

In addition, the idea of a separate pay spine was heavily opposed by most other health unions, with some warning that they would ballot their members should official proposals be put forward.

Currently, the AfC contract sets out pay scales for all NHS staff apart from doctors, dentists and the most senior managers.

Registered nurses working clinically will typically be on bands 5-7 which, under the current AfC scales, provides a pay range of £28,407 to £50,056.

Now, the call for evidence will seek to understand whether AfC is creating specific barriers to the career progression of nurses.

In addition, it will explore any solutions that could be considered if the evidence shows there are issues with the current arrangements.

Health minister Andrew Stephenson said: “We hugely value the work of nurses, who play a vital role in the NHS.

“We have listened to union concerns and are launching this call for evidence to explore the risks and benefits of a separate pay structure for nurses.

“I want stakeholders to share their expertise and help us collate feedback from across the healthcare sector, ultimately helping to make the NHS a better place to work.”

Responding to the announcement, RCN general secretary and chief executive, Pat Cullen, said: “The current pay scale turns 20 years old this year and no longer reflects the skills and expertise in nursing today.

“Despite many years of experience, the vast majority of nurses are on the lowest pay bands possible.”

Ms Cullen warned that the current system “only rewards people the further away they get from patient care” and that nurses were rarely afforded automatic pay band progression like their colleagues in other NHS professions.

She added: “Our workforce is 90% female and a new structure can remove the gender disadvantages at present and dispel completely the idea that nursing is less skilled, women’s work and worthy of low pay and poor treatment.

“Record unfilled nurse jobs in recent years are a sign of structural problems as well as underinvestment by the government.

“As the largest profession in health and care, nursing staff deserve a fresh place in the NHS and not more years of poor pay rises and no wider reform.”

Meanwhile, the acting head of health at Unison, Helga Pile, argued that the NHS needed more funding to be able to offer “decent pay to all staff”.

She said: “Pitting different groups of staff against each other for a larger slice of what’s available is the wrong approach.

“It would divert time and resources from the real problems, damage team morale and tie employers up in years of equal pay claims.”

Ms Pile noted that nurses were “rightly furious” about being underpaid and poorly recognised for the work they do.

“It would be far better to grade nurses properly, so they’re paid fairly for their skills and training, improve career progression and offer decent overtime rates for all,” she added.

In addition, GMB national secretary, Rachel Harrison, said the proposals would “completely undermine” the fact that the NHS is built on co-operation of staff.

She said: “Agenda for Change was hard fought for by GMB and other health unions.

“There must be no going back to the days of discriminatory pay awards that were inefficient at best and unlawful at worst.

“The national agreement must be protected and improved – not fragmented.”

The Royal College of Midwifery’s director of employment relations, Alice Sorby, said the government was “clearly deluded” if it thought separating out one job group was going to help tackle the workforce crisis.

“To take one staff group out of the current NHS pay structure risks seriously damaging the morale of midwives, maternity supports workers and all other NHS staff who do their best every day to provide care to mothers, babies and their families.

“Teamwork is the foundation which the NHS is built on and years of experience shows us is the best way to deliver safe high-quality care,” she said.

She added: “Over the years, where RCM members have repeatedly challenged their banding and asked for job descriptions to be updated. Too often this has been met with significant push back.

“Regular meaningful appraisals should include revisiting job descriptions to ensure that they are fit for purpose and allow midwives to be rewarded for their expertise by progressing up the pay scale,” she said.