Comparing The NHS & The Spanish Health System (Nursing Perspective)

Drawing from her own experience, Band 7 Bed Manager, Laura, compares the NHS with the Spanish Health System, and outlines why she chose to take a job in the UK.

Topics covered in this article

Introduction

Comparing Contracts

How Nursing Specialities Differ Between The UK & Spain

Bandings & Promotions

Training & Development

How Nursing Pay Differs Between The UK & Spain

The Nurse To Patient Ratio

Nursing Experience Between Countries

Introduction

Hi guys. My name is Laura.

Today, I will be talking about the main difference between the NHS and the Spanish health system, from a nursing perspective.

I graduated in Spain six years ago and I started working there for about a year before I moved here to the UK.

But why did I make such a life changing move?

Well, let me start with you the main reasons why I believe the UK system appealed a lot more to me.

Comparing Contracts

First, I would like to mention the difference between contracts.

Once you graduate in Spain, if you want to work in a public hospital, you have to join a public list where you are just a number.

The more experience, courses, masters or publications you have, the higher you are on that list.

That is the list they use when there's a lack of permanent Nurses, they use the Nurses on that list to offer short contracts.

When you finish university, obviously you don't have any experience, which means that you will be on the last part of the list.

So you will be offered not great contracts.

The way to obtain a permanent contract is doing an exam.

For example, if there are 200 permanent posts available, the best 200 marks, will get contracts, the mark you get will be half of your experience and half the note of your exam.

In the UK, in my case, I was offered a permanent job while I was still in Spain.

I had to pass some interviews that in Spain don't exist, but I was offered a permanent contract straight away.

This was the first main reason why I decided to move to the UK.

As at the beginning of my career, I just managed to work with contracts that went from one week to two months, maximum length.

How Nursing Specialities Differ Between The UK & Spain

In Spain, as I mentioned before, if you are not on the top of the list, your chance to get a decent contract is low.

The system works with phone calls.

They call you and they offer you, for example, three contracts and you choose one.

But, if you refuse to work, because maybe you didn't like the contracts available or well, if there's not a good reason, you might get a penalty and you might not be able to work for two weeks.

So if you are not on the top of the list, it's very hard to choose where to work.

But if you have more points, and your position is higher, there is a meeting where the long contracts are offered and you can choose easier where to work.

But, as I said, you must have experience or maybe a master to join that meeting.

In England, I first started with a contract in elderly care, but it wasn't hard at all to change the specialty.

It was as easy as applying for an interview.

In my case, I moved to my favourite field, which is Haematology.

That's where I wanted to work from the beginning, but I just couldn't.

So, after six months starting in the NHS, I had the chance to change.

In that aspect, I think the NHS has a smoother process than in Spain.

Bandings & Promotions

The third difference is about the promotions.

There are no bands in Spain, you are just a Nurse.

And depending on your experience working in the same place, you will get pluses, as extra money.

Of course, on the wards, everyone knows who has been working there for a very long time and has a higher level of expertise.

But yeah, that just only works in practice.

As that Nurse will not get a promotion, Also is the ward managers, and it's a similar role as in the UK. In the UK, we know exists band five, band six, up to band 9.

There are so many levels of Nurses.

And I liked the fact that you can promote, not only for your experience, also for your expertise and your knowledge.

Training & Development

In Spain, you can educate yourself as much as you want, but all will be paid for you.

There's a possibility in some cases to apply for some scholarship, but that is up to each Nurse.

Usually the hospital will not pay for any information for the Nurses.

Normally it's due to economical reasons, but actually, that doesn't stop the Spanish Nurses to keep learning.

But in England, there are many opportunities to develop yourself inside of the hospital and outside.

Frequently, the hospital will help financially or will offer some study days.

In my case, all of my courses have been funded by the hospital.

I started from infection control courses at the hospital, and I finished doing specialised Haematology courses at the university.

And I am so glad for this, as it was what helped me to get promoted.

How Nursing Pay Differs Between The UK & Spain

Now let's talk about money.

In Spain, and England, the salary for a Nurse goes hand-in-hand with the cost of living of each country.

They are similar. But the holidays?

No way. In Spain, of course depends on the length of your contract.

If you have a year contract, you will get 22 labor days, which means more or less a month.

But if you have a two months contract, you will just enjoy five days of holiday, that means 2.5 days per month.

But here, the staff can expect up to 35 days off per year, including the bank holidays.

And that's a huge difference.

The Nurse To Patient Ratio

My last point is a very important difference for the Nurses.

I'm talking about the Nurse-patient ratio.

This is the minimum number of Nurses in charge of a certain number of patients.

We could also name it as nursing workload.

A high ratio means that in a normal work, let's say arena, where the basis are not extremely acute, a Nurse looks after 10 patients each, whereas a low ratio, could be on the same ward, looking after six patients.

Like when we're short of staff on the wards, the Nurse-patient ratio increase.

Obviously both country depends on the acuity of the patient and this doesn't include intensive care, or A and E.

Spain has the highest Nurse patient ratio with 12.5.

But the UK has an average rate of 8.8.

Nursing Experience Between Countries

To finish with this topic, I would like to mention that the experience for the Spanish Nurses that work in the UK up to 2021, was accountable in Spain.

What I mean with this, is that in the mentioned list, if you work two years in the UK, meant as if you worked in Spain for two years, that experience helped you to go higher on the list.

But after Brexit, as the UK is not part of Europe anymore, this situation changed.

There's no official communication confirming this yet, but the theory is that the experience is just accountable in Spain for Nurses that work in other European countries.

These might pose to some Spanish Nurses, if they want to keep working much longer in the UK, if they don't want to stay forever in the UK.

So as you can see the work conditions for Nurses in the UK are overall much better than in Spain.

Obviously every hospital is different and there will be many exceptions to my points, but I think this is a general picture for you guys to understand the main difference between the NHS and the Spanish health system.