Letter to the new Prime Minister, Sir Keir Starmer

Dear Prime Minister,

On behalf of the Royal College of Nursing (RCN), I extend our congratulations on your election success and appointment as Prime Minister. As the world’s largest professional college and trade union for nursing, representing over 500,000 members, we advocate for the interests and welfare of nursing staff, who are essential to the health and wellbeing of our nation. We look forward to establishing the RCN as a partner with your new government to find solutions that can tackle the significant challenges ahead.

The RCN's substantial expertise can make a vital contribution to health and social care policy. We look forward to a reset in relations with government and a conscious move towards productive collaboration as the largest union in the NHS in England and a key part of the NHS Staff Council; the voice of nursing must be heard at the heart of government.

My profession is facing an unprecedented crisis, characterised by tens of thousands of vacancies and many nursing staff considering leaving. They work in overcrowded hospitals, with more than a third of nursing staff reporting they were delivering care in inappropriate settings, such as corridors, during their last shift. This often forces them to provide care without access to appropriate supplies and equipment. In June, I labelled this a national emergency with the support of the professionals I represent.

As a starting point, stringent reporting requirements on ‘corridor care’ are essential to understanding the scale and nature of the issue and the move towards the removal of the practice. The RCN can provide valuable insights and support in developing and implementing reporting systems, ensuring all patients receive safe and dignified care.

Fair pay and reward is an important factor in retaining staff and ensuring patient safety within the health and care sectors. The RCN remains in formal dispute over NHS pay, and resolving this is crucial. One of the first acts this month must be to announce the 2024/25 NHS pay award – our members have waited three months into the year already.

The commitment to rapid discussions with the junior doctors is commendable and we would welcome a similar strategy with all unions, regardless of industrial action mandates. Revoking the anti-strike legislation, including the law on minimum service levels, is entirely proper. A formal undertaking that the legislation will not be used in the period before repealing the Acts would be valuable to resetting the industrial relations landscape.

We welcome the ambitions set out in the ‘New Deal for Working People’ and appreciate the commitment to wide consultation. Policy discussions on issues such as maternity rights and sexual harassment at work would be significantly enhanced by including the voices of the largest clinical workforce in the NHS. The perspectives of our predominantly female profession are crucial in discussions on matters of employment policy.

The RCN is dedicated to advocating for practical solutions to address the ongoing crisis in our health and care services and working in partnership with your Ministerial team to achieve this. For example, we are calling for legally enforceable safety-critical nurse-to-patient ratios, inspired in part by the successful model introduced by the Australian Labor Party. I would welcome the opportunity to discuss the robust evidence supporting this approach and why legislative changes are essential for ensuring patient safety.

We are concerned about the recent reports on the financial instability within the higher education sector in England. This situation jeopardises the positions of our nurse educator members and poses a significant threat to the nursing workforce supply. We urge you to seek investigation of these issues and provide the necessary financial support to protect nursing degree courses from closure or reductions in available places.

Your party has recommitted to the Long-term NHS Workforce plan in your manifesto – that plan is officially heading backwards after its first year and even greater action is now needed. The future of our health and care services depends on a well-educated and continuously developing workforce. Government-funded nursing degrees with a job guarantee for graduates, alongside sufficient funding for continuing professional development, will ensure that nursing staff are equipped to meet evolving demands.

The exploitation of migrant care workers is a great concern and thousands of our members have written to you on the subject, highlighting this critical issue for nursing and seeking a sector-wide investigation into social care abuses. We are grateful for your commitment on this and ask that this takes place as soon as possible. The RCN supports the creation of the new Single Enforcement Body and seeks a permanent seat on it to lead the work.

Two weeks ago, I had a fruitful first discussion with one of your team and submitted an outline of a series of practical policy proposals to your office, which were designed to improve patient care standards, improve the treatment of NHS staff, lift morale and introduce policies that have broad political, professional and trade union backing.

Congratulations once again, and we look forward to a productive partnership under your leadership. I would welcome the opportunity to meet you to discuss the priorities for nursing at your earliest convenience.

Yours sincerely,

Professor Nicola Ranger

Acting General Secretary and Chief Executive