Take nurse-only pay spine off the table, and focus on real issues with nursing pay

Ensuring jobs are banded correctly is key priority

A separate pay structure for nurses is not the answer to wage-grading problems in the NHS for healthcare professionals, says the UK’s largest health union UNISON today (Tuesday).

At its health conference, taking place this week in Bournemouth, nurses belonging to the union will voice concern and anger over the government’s promise to consider an “exclusive” pay spine for nurses.

Delegates will discuss UNISON’s work to monitor the way nursing roles have evolved, and call on ministers and employers to support nurses to get the right pay and banding for the jobs they do.

A detailed survey of thousands of registered nurses undertaken by the union recently has provided evidence of the increased complexity and responsibility of their roles.

It shows how the workforce is expected to develop new skills and responsibilities, but these are not acknowledged by their formal job documents or pay grades. The key survey findings include:

  • Almost nine in ten (89%) say their official job description (on which their role is graded) understates the complexity of their job.
  • Nine in ten (90%) say changes in their role over time mean they’re now required to deliver more complex care.
  • Nearly three-quarters (73%) say they have taken over more complex and risky clinical tasks that used to be done by others, such as senior nurses or doctors.
  • More than four in five (85%) say they now have greater responsibility for supervising and assessing junior staff and trainees.

Complex clinical tasks now being picked up by band 5 nurses in the survey (the lowest grade for registered nurses) included risky drug infusions, manual ventilation, advanced life support, treating clots in stroke victims, complex wound care, blood transfusions and verification of deaths.

Delegates at the health conference will argue that the NHS must pay properly for the services nurses provide. Not by taking years to set up another free-standing pay structure solely for nurses, but by delivering effective job and wage grading right now, says UNISON.

UNISON head of health Sara Gorton said: “A separate pay spine is absolutely the wrong thing to do. It risks breaking up the entire Agenda for Change pay system and would cause chaos for no good reason.

“NHS workers rightly see themselves as being part of the same team. Picking off groups of workers for special treatment is not what they want or need.

“Ministers shouldn’t be looking at unstitching the system. The way to tackle inconsistencies is for a wholesale review of grades with regular monitoring to check every job is paid properly for the work done and the skills needed.”

Notes to editors:
– Comments from the survey include:
“The lack of home and face-to-face GP visits mean GPs expect [community] nursing staff to be their eyes and ears and they rely on our assessments more and more.”
“I was put in sole charge of a 26-bed ward. Flung in with no support in the middle of a staffing crisis.”
“With some of the training I’ve had, such as administering cytotoxic drugs (used to treat cancer), I really should be paid at band 6. I submitted a job evaluation form almost two years ago. Lack of funding is the reason given for not being able to increase banding despite all the upskilling and training.”
Another said the additional workload demands without a corresponding boost to pay meant the “sparkle had gone from nursing”.
– UNISON’s annual health conference is taking place in Bournemouth and runs until tomorrow (Wednesday 19 April) lunchtime. Over the three days, health workers from all across the UK come together to take part in debates on a wide variety of topics including pay, pensions, childcare, hospital food, ambulance pressures, mental health and challenging racism. The event takes place at the Bournemouth International Centre, Exeter Road, Bournemouth BH2 5BH.
– The survey ran from 3 to 17 October 2022 and received 5,693 responses.
– UNISON is the UK’s largest union and the largest union in the NHS and in the ambulance sector, with more than 1.3 million members providing public services – in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.

Media contacts:
Anthony Barnes M: 07834 864794 E: a.barnes@unison.co.uk
Liz Chinchen M: 07778 158175 E: press@unison.co.uk