Nurses have entered a crucial pay review process with “good grace” but remain “not afraid to strike” in the future, the head of their professional body has warned.

Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing (RCN), indicated that targeted industrial action could be launched against NHS trusts that fail to fairly uplift the pay of Band 5 nurses.

Professor Ranger described the government’s commitment to review every Band 5 nursing role in England as the “best opportunity to elevate nursing in decades”.

A Band 5 nurse represents an entry-level position for newly qualified registered nurses under the NHS Agenda for Change pay system. However, the RCN contends that many staff remain at this level for years, even decades, despite performing duties that demand higher skills and greater responsibility.

The review, announced in February, means all Band 5 nurses are eligible for reassessment, potentially leading to a pay increase, with the government providing funding to employers to cover these salary uplifts. The RCN is currently awaiting the “final plan” for the scheme’s rollout, which is expected in the coming weeks, with implementation hoped to begin “this summer”.

“We will be pushing this to be done well, but in a systematic way, and we will be part of the overall scrutiny as to how each employer is doing with the process,” Professor Ranger told the Press Association.

Professor Ranger says government commitment to the review is ‘best opportunity to elevate nursing in decades’open image in gallery
Professor Ranger says government commitment to the review is ‘best opportunity to elevate nursing in decades’ (PA)

She stressed that nursing forms the “absolute backbone of this country” amidst challenges like the cost of living crisis and global issues such as the war in Iran, insisting the scheme “is going to have to continue to stay on track.”

Professor Ranger reiterated assurances that the initiative was “not about affordability, but about recognising what was right,” given clear evidence that nurses are “weighted to the bottom of the pay scale.” She added: “Whilst I recognise that finances are more challenging, we do not expect in any way for this scheme to be undermined by those challenges.”

The RCN leader vowed to be “absolutely clear and unapologetic” in holding employers to account. The union’s ambition is for the staff nurse role to sit at a Band 6, citing the precedent in Scotland where 80 per cent of Band 5 nurses undergoing a similar process were elevated to Band 6.

“Therefore, we have in our minds what that conversion rate should be,” she stated. Should some trusts achieve a 75-80 per cent conversion rate while others manage only 5 per cent, the RCN will identify these “outliers” and take action.

This opportunity is particularly significant because the funding for pay increases will come directly from the government, not from individual trust budgets.

“This is the first time that we can start to elevate nursing, and it’s not for the trust to worry where the money comes from, that’s for the Government to agree and sort out, and it’s for the trust to be fair to their nurses, simple as that,” Professor Ranger asserted, promising the RCN would be “very bold and strong on that, and if they don’t, we will take action against them.”

There could also be targeted action at NHS trusts who do not uplift band five nurses fairly, Professor Nicola Ranger saidopen image in gallery
There could also be targeted action at NHS trusts who do not uplift band five nurses fairly, Professor Nicola Ranger said (PA)

While there is no immediate appetite for a ballot on industrial action, as the RCN wishes to enter the scheme “with good grace” and give it a chance, the threat of strikes remains.

“In fairness to the previous health secretary, this is a scheme that he has personally supported, and the part of this was to stop us going on the picket lines,” she explained. “But we need to be really, really clear, we are deciding and agreeing to do that, but that does not mean that we are afraid to strike.”

Professor Ranger also issued a warning to the new Health Secretary, James Murray, stating he faces a “tough challenge” and “will fail” if he does not adequately value nursing.

A Department of Health and Social Care spokesperson commented: “Nurses are the backbone of our NHS and deserve to be properly recognised for the vital work they do.

A nurse entering the profession today receives 18.6 per cent more in basic pay than 4 years ago, and this government has introduced a package of measures to transform the nursing profession and make sure nurses get the pay and support they deserve.”

This package includes boosting access to jobs for graduates, prioritising increased graduate pay, reviewing Band 5 roles, and establishing a national preceptorship framework for newly qualified nurses.

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