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NHS employers reject suggested separate pay spine for nurses

RCN’s proposed new pay scale for nurses only would threaten integrity of Agenda for Change and harm morale, employers tell government consultation
Striking nurses in Plymouth, Devon, in May 2023

RCN’s proposed new pay scale for nurses only would threaten integrity of Agenda for Change and harm morale, employers tell government consultation

Striking nurses in Plymouth, Devon, in May 2023
Striking nurses in Plymouth, Devon, in May 2023 Picture: Apex

Employers do not support the idea of a new separate nursing pay spine in the NHS, arguing that the risk to morale and patient care would be too great.

In a formal response to the government’s call for evidence on a potential pay scale for nurses only, NHS Employers says trusts ‘overwhelmingly’ do not support it.

NHS Employers’ response to government consultation

The Department of Health and Social Care (DHSC) launched a 12-week consultation in January, calling for evidence on the potential impact of a nursing pay spine, with the RCN strongly supporting the idea and suggesting a starting salary of £35,000 for newly qualified nurses.

But NHS Employers, which acts on behalf of NHS trusts in England and Wales, said it had consulted employers and they were reluctant to implement any pay structure that would ‘threaten the integrity’ of Agenda for Change (AfC), the national pay system for NHS staff.

Resources and capacity better spent on modernising the pay structure, say employers

NHS Employers said: ‘Employers were concerned that any move to pay nursing staff in a different way would threaten the equal pay principles (equal pay for work of equal value) that are the foundation of the AfC structure.’

Explaining its response to the DHSC on employers’ behalf it said: ‘We outlined the potential risks associated with moving away from this system and stated a strong belief that resources and capacity would be better spent on modernising the pay structure to benefit the whole AfC workforce.’

Employers felt such a change would affect the cohesion and focus on team working and a multidisciplinary approach to service delivery, it said. ‘Employers considered the risk to morale and consequently patient care to be too great.’

Resources would be better focused on changes to the current AfC structure, including gaps between pay bands, ‘pay step progression’ and incentives for promotion, it said.

An opportunity for a fresh start for nurses to be valued, says RCN

The issue has proved to be divisive, with trade unions such as Unison arguing that a new pay spine for nurses would be a distraction and suggesting that job role bandings should be reviewed instead.

Unison acting head of health Helga Pile has previously said the NHS needs greater funding to be able to offer decent pay for all staff. ‘That’s the way to recruit and retain the workforce that’s needed,’ 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.’

RCN general secretary Pat Cullen has called the idea of a new pay spine an opportunity for a fresh start for nurses to be valued.

The DHSC told Nursing Standard it does not yet have a time frame for publishing its findings from the consultation.


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