Northwest Nurse

Okay so some of you may remember last year when I was posting about how nurses have suffered years of pay freezes and due to rising cost of living, inflation etc, the average nurse was thousands worse off, with some leaving the profession or taking extra jobs to make up for the deficit in their wages. At present, nurses are 14% worse off than they were in 2010,  and is predicted to drop a further 2.6k by 2020 against inflation 

We were eventually ‘rewarded’ a 1% pay rise which meant nothing because in the same year inflation increased by 2.6% and our national insurance contribution increased which effectively meant we had received a pay cut… yet again. This pay increase was recommended by the NHS Pay review body in their 30th report, 2017 (see 1), however because of the government imposed pay cap we could not get higher than 1%, and the review body explicitly stated that this could not go on. 

A nurse currently starts on 22.5kish and can work their way up to 28kish. This is a band 5 registered nurse , and this pay is across the board via Agenda For Change, a national pay system for NHS staff regulated . Only private companies can pay equivalent nurses more. We cannot just ask for pay rises, we have to lobby the government. To get any higher than this 28k, one must become a band 6+ nurse and this means becoming a specialist, or into a more managerial role. It means that thousands of experienced nurses with decades in the NHS won’t receive more than 28k a year.

Alongside this Nursing is rightfully a graduate profession needing a Bachelors Degree to register, however training bursaries have been scrapped which means student nurses now have to pay to train to be a nurse (it used to be free). I’m sure my US friends will think this normal, BUT student nurses have to work 37.5hrs per week for the NHS for free to be able to pass their degree. So they are paying to work. This has led to a 23% drop in nursing university applications 

All this means we are struggling to recruit and retain nurses. There are now more nurses leaving the nursing register than there are joining . 1 in 3 nurses are coming up to retirement age, so this means we are going to lose many more. We are also losing thousands of European nurses because of Brexit .Currently we are short of 41,000 nurses (see 2.) and this will only increase. 

One thing Health Education England has decided to do is invent a new role called the Nursing Associate which was supposed to ‘bridge the gap’ between health care assistants and registered nurses. Instead of funding nurses money was put into training these who were supposed to support RNs. They will do a foundation degree one day a week for 2 years alongside working in the NhS. However as some of us predicted, some trusts are  converting nurse vacancies into nursing associate posts  and have cut RN places to make way for this support role, ignoring the evidence that graduate RN reduce mortality rates. This creates a huge safety concern and also threatens the RN job security because some chief nurses have said it makes sense for the NA to take over RN tasks to 'free up RN for advanced practice and supervision’ aka being the paperwork pushers and assessors whilst NA do the jobs we became nurses to do. The Nursing Associate will be paid less than an RN, but will be allowed to do the majority of tasks that an RN does - which begs the question, if we - for example - need three years of medicines management to safely administer meds, why are they allowed to after doing only 1 day a week at uni (cramming in all sorts of subjects) for two years? Unfortunately with the amount of underfunding and shortage going on, hospital trusts are just going to see people who can do a job for cheaper, rather than looking at it more broadly and seeing that anyone can be trained to complete an action, but it needs education to complete it to the same standard and with the same reduced mortality and good outcomes an RN has be proven to produce. It also really isnt fair on these Trainee Nursing Associates as they came to bridge the gap, not replace the RN for far less pay. 

So all this, along with the deliberate underfunding of the NHS has created a perfect storm. This summer was a 'summer of protest’ in which nurses protest for fair pay. Last month it was announced that our pay cap was to be scrapped however no pay restoration or rise was given. Our challenge then said that if we are to be given a pay rise we must be more productive, ignoring the fact nurses already are looking after too many patients (the ratio on my acute med-surg ward is 8-10:1 and 13:1 at night) are not getting breaks, are working extra hours for no pay, are at their wits end and routinely suffering mental and physical health problems due to the role. Today was the UK government’s autumn Budget statement and we expected a pay rise to be announced. This was not the case. Instead we got told that our Agenda For Change pay structure is being subjected to ‘reform negotiations’ by our Health Secretary Jeremy Hunt (who no-one likes, sorry but not sorry) and if these reforms bear fruit, only then would there be money released from the budget for our pay rises/restoration.

So basically it seems like the Agenda For Change pay structure, which you can read more about here, will be changed and only then will we receive a pay rise. But what changes? We all know these changes cannot possibly be for our benefit if only when they are changed will we receive extra money. Many of us believe our unsociable hours enhancements will be targeted and removed - at the minute we are paid extra for nights, weekends etc. This is something that has been attempted in the past and something they’d love to get their hands on. It’ll be a case of robbing Peter to pay Paul, either way we win nothing.

In the long run the patients suffer. They’re the ones who need nurses. Nurses we are currently struggling to not only recruit but retain.

So yeah, thats it in a nutshell in my words and with the factual stuff cited. The next few years are going to be… interesting to say the least.

1. NHS Pay Review Body - Thirtieth Report (2017)