Invest in UK nurses or risk more strikes, union boss warns ministers

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Reforms to the UK’s fiscal rules should be used to invest in nurses, the head of the Royal College of Nursing has said, warning the sector could be forced to take further strike action.

In an interview with the Financial Times, Professor Nicola Ranger called on the government to see nursing as an investment in critical infrastructure, adding that the RCN’s rejection of a pay offer last month signalled that nurses were “no longer going to be passive”.

Chancellor Rachel Reeves has confirmed she will change the government’s debt rules in her Budget on Wednesday in a bid to fund about £20bn a year of extra investment with increased borrowing.

“The chancellor is changing the fiscal rules to invest in infrastructure. And that’s how I want her to think of us,” Ranger said. “My profession is both safety critical and key to economic prosperity. There is no justification for leaving us depleted.”

“Investment in us is as vital as investment in any major project,” she added.

The government’s three priorities for improving the state of the NHS include providing better primary care in communities, shifting from treatment of sickness to prevention, and moving from analogue to digital systems.

“We want to see a genuine understanding from the government that nursing is key to this reforming and infrastructure agenda,” Ranger said. “Nurses are absolutely key to community care and ill-health prevention.”

Last month, RCN members in England voted by a two-thirds majority to reject the government’s offer of a 5.5 per cent pay rise for 2024-25 to NHS nurses, which is set to be reflected in salaries from October.

The RCN consultative vote did not affect the implementation of the 5.5 per cent uplift, which was signed off earlier this year, but it could pave the way for a separate statutory ballot on strike action.

“We are not strike hungry but there is only a limited time that our members will be willing to wait to see that this government is serious about valuing nursing,” Ranger said.

“The vote signalled that nurses are no longer going to be passive. They have had enough,” she added. “They can see patients are suffering under the current state of nursing.”

In 2022 nurses in Britain went on strike for the first time in the 74-year history of the national health service, seeking higher pay.

With more than 32,000, or one in 10, unfilled nursing vacancies in NHS trusts in England, Ranger said the sector was “depleted”.

The Department of Health and Social Care said the NHS had faced chronic workforce shortages for years and that hiring the necessary staff “will take time”, but it was “committed to delivering the biggest expansion of NHS staff in history”.

Ranger said nurses should move to a band six pay level following graduation and the completion of their preceptorship, a time-limited structured support to transition from newly registered nurse to a nursing professional. The NHS pay scale runs from the lowest band one up to nine.

The starting salary for a band six employee is £37,338. “We no longer believe nursing is a band five profession, we want to see an increase in line with what we have seen for paramedics and midwives,” she said.

Analysis conducted by London Economics, a consultancy firm, on behalf of the union, showed the current pay of every type of nursing professional was significantly down in real-terms on the year 2010-11.

The union has drawn a contrast between the 5.5 per cent pay offer and the uplift of 22.3 per cent junior doctors are set to receive over two years.

It said that 145,000 of its members working for the NHS in England had voted in the ballot last month, with 64 per cent saying they did not accept the award.