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Nursing role profiles are out of date, unfair and unjust: new proposals don’t go far enough

Professor Nicola Ranger 25 Jul 2024

RCN General Secretary and Chief Executive Professor Nicola Ranger responds to the new proposed NHS national nursing role profiles. 

As your new General Secretary, I’m here to ensure our profession pulls itself over the barriers and challenges that have been in our way for far too long.

Within days, we are expecting the government in Westminster to announce the next NHS pay award for England, which has consequences for Wales and Northern Ireland. Negotiations in Scotland begin imminently too.

But alongside seeking to secure fully funded and above-inflation NHS pay awards, we are working hard to ensure nursing job contracts, job descriptions, pay structures and terms and conditions are fit for purpose - matching the reality of modern nursing and the high standards we strive for. 

Earlier this year, we had the chance to tell the government how it could design a pay and career structure for nursing. Now, we’ve been able to tell the NHS formally what nursing staff expect to see from the official review of national nursing role profiles. 

Along with other NHS unions, we secured this review of profiles as part of our programme of work to get nursing staff recognised for what you really do. It is always in the interest of safe and effective patient care for the unique contribution of nursing to be accurately valued and fiercely protected.

A role profile is different to a job description and it’s important to understand the distinction and significance. This is hard, technical but crucial work and core trade unionism. Job descriptions get matched to nursing role profiles to determine the band for a job. 

The current Agenda for Change (AfC) role profiles date back to 2004 and the RCN has felt strongly for many years now that they need to be updated. In the time since AfC was introduced, nursing has transformed and our view is that the structure at present cannot provide ‘equal pay for work of equal value'.

The new proposed profiles for bands 4, 5 and 6 do not accurately capture modern nursing at each band. This has to be an opportunity to properly re-evaluate the work you’re doing, but the proposed new profiles do not yet go far enough.

Nursing deserves a pay structure that can support clear career progression with greater levels of reward to recognise skills, competence and expertise gained; and greater responsibilities assumed.

Today, three in four of our members occupy the two lowest pay bands for registered nurse professionals. There is no automatic progression and too many end their career in the same pay band they started. We strongly believe that newly registered nurses following a period of preceptorship should automatically progress to band 6. 

This change is realistic and there’s a growing consensus around it. Annex 20 of the NHS Terms and Conditions Handbook provides for automatic pay progression after a period of time, akin to preceptorship, for other professionals such as midwives and paramedics, after which they automatically progress from a band 5 to a band 6. We believe the same should apply for nursing staff - you deserve the same pay progression.

There are further issues around role substitution. I know that many of you are working beyond your pay band and our workplace representatives and job evaluation experts also tell us people on band 4 are often fulfilling band 5 duties. This creates huge issues around accountability and responsibility. It is vital nursing role profiles very clearly set out the distinction in duties and responsibilities between bands.

The RCN remains committed to designing a pay structure that more appropriately recognises the knowledge and responsibilities of the nursing profession. We know that NHS pay sets a standard for nursing staff in all settings. So, getting this right for the NHS is important for the independent health and social care sectors too. It would also significantly improve nursing retention and recruitment.

We’ve got a new government in Westminster, and I have written to the Secretary of State for Health and Social Care setting out the issues you face and with the current pay structures in particular. Nursing staff need to be properly recognised and valued through fair pay.  I know your value, and I will fight for it to be fairly rewarded.

If you believe you’re working beyond your job description, we can support you through a job evaluation process to help you seek pay justice. Find out more.  

 
Headshot of Nicola Ranger

Professor Nicola Ranger

General Secretary and Chief Executive

Professor Nicola Ranger joined the RCN in December 2022. She was previously Chief Nurse and Executive Director of Midwifery at King’s College Hospital NHS Foundation Trust in London. Before that, she held Chief Nurse posts at both Brighton and Sussex University Hospitals NHS Trust and Frimley Health NHS Foundation Trust.

She has also held a number of senior nursing roles at University College London Hospitals NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust. Earlier in her career, she worked at America’s George Washington University Hospital in Washington and at Mount Sinai Medical Centre in New York.

Page last updated - 10/10/2024