Would Any Increase in Pay Be Enough On Its Own To Address Nursing Staff Shortages?

“I think the worst thing for any of us as Nurses is working when we've not got safe staffing levels”

Dr Denise Chaffer explained to a Health and Social Care Select Committee in May 2022 that retention constituted a “huge problem” in nursing.

Dr Chaffer cited recent NMC analysis showing that for the first time in recent years the total of those leaving had increased year-on-year, with over 25,000 Nurses quitting the register in 2021-22.

When asked what could be done to improve retention, Dr Chaffer said pay was crucial to ensuring Nurses felt “valued and supported”.

She said: “We have Nurses who are unable to pay their rent, afford their petrol to get to work, and they're unable to get a mortgage…Clearly pay is absolutely critical and we can't move away from that.”

Do you agree? Is pay critical to retaining Nurses in the workforce, or are issues around workload and burnout of greater importance?

Dr Chaffer also told the committee that because of its connection to retention, pay was a patient safety issue.

“I think the worst thing for any of us as Nurses is working when we've not got safe staffing levels,” she explained.

“And we're in a circular problem, because we need to pay Nurses to keep them to have safe staffing levels to keep the patients safe…We can't afford not to address this,” she emphasised.

RCN General Secretary Pat Cullen,  “Years of pay cuts from ministers should not be capped off with yet another real-terms fall in salaries…There are tens of thousands of vacant nurse jobs and this treatment pushes more [nurses] out of the profession”

Also in May of this year, the union Unison wrote to the then Health Secretary Sajid Javid demanding a pay deal for 2022-23 that would help alleviate the spiralling cost of living and prevent further staff losses.

The letter was signed by more than 35,000 health workers and members of the public.

“What every NHS employee needs – from nurses and paramedics to porters and healthcare assistants – is a decent wage rise and genuine measures to convince them to stay,” the letter urged.

Unison head of health, Sara Gorton, said at the time: “This is a desperate situation with NHS staff already quitting in their droves…It’s patients who will suffer when there are too few staff to provide proper care. Ministers must ensure workers are encouraged to stay with an above-inflation wage rise and an end to poverty pay”.

If the case can be made for nursing pay directly impacting on patient safety, should that give the pay review body more leverage with the Department of Health and Social Care and the Treasury when recommending pay rises for Nurses?

In July 2022 the government did announce a pay-rise for NHS Nurses, retrospective to cover the period from April 2022 onwards.

Full-time salaries will increase by at least 4% for most Nurses (but not all).

This figure is less than the demands from nursing and other unions and will not be applied evenly across all pay bands, meaning not everyone will receive the same percentage increase in their pay.

Do you think the offered pay increase will make any tangible difference to turnover or retention rates? And if not, is there a realistic level of pay increase which would start to improve the staffing situation within nursing?

When announcing the pay increase in July, current health and social care secretary Steve Barclay claimed that offering high pay increases driven by inflation “would have a worse impact on pay packets in the long run”.

He said: “This government hugely values and appreciates the dedication and contribution of NHS staff which is why we will give over one million NHS workers a pay rise of £1,400 this year, on top of the 3% they received last year when pay rises were temporarily paused in the wider public sector.”

The RCN disagreed, saying the government had misjudged the mood of nursing staff with its poor offer, with many Nurses already struggling with rising living costs and now facing another real terms pay cut.

If the Government is unable or unwilling to raise their pay offer for Nurses, do you think that the numbers of Nurses leaving the profession will increase? And if so, could addressing other issues that are causing Nurses to leave make a positive difference to staff retention rates?

In an email to members about a ballot for possible industrial action, RCN general secretary Pat Cullen and council chair Carol Popplestone wrote to their members:

'This pay award does not help you with the rising cost of living – inflation is rising much higher. It will do nothing to help to recruit or retain more nursing staff where you work. It does not recognise the skill and responsibility of the job you do. Sadly, it will not keep patients safe’.

If RCN members vote to take industrial action, would you support it? And would such industrial action result in an improved pay offer for Nurses and other healthcare staff?

Responding to reports that the NHS would have to find funds internally to bridge the gap between the 3% pay increase the Treasury initially budgeted for and what is now being offered, NHS England chief financial officer Julian Kelly cautioned that cancer and primary care budgets, amongst others, would be affected.

The chief executive of NHS Employers Danny Mortimer also expressed concern about the lack of additional funding for the pay award:

‘NHS employers have only been allocated enough money to award staff a 3% rise, so unless the extra increase is funded by the Treasury, very worryingly, this will have to be drawn from existing budgets and will mean an estimated unplanned £1.8 billion shortfall.’

Should the government, given the huge backlogs caused by COVID policy, combined with the ongoing attrition on the nursing workforce, increase their pay offer to Nurses and ensure that any extra funding required is not extracted from existing health budgets?

Please let us know what you think in the comments.

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