Staff who opt to do extra shifts to ensure staffing levels are safe for patients book these through an in-house staffing bank because their employers are reluctant to grant them overtime at the NHS’s standard higher rate of 1.5 times their pay.

Now the staff face a further knockback because four hospital and community trusts in a partnership known as the Black Country Provider Collaborative are inflicting a harsh cut in bank pay rates to the lowest point of their pay band – citing financial pressures for the decision, which follows input from external consultants.

It will leave a band 5 staff nurse on a higher pay point up to £40 worse off for working a 12.5-hour bank shift compared to a regular shift.

RCN West Midlands regional director Lindsay Meeks has written to the trusts urging them to abandon the cuts, condemning them as a race to the bottom.

She said: “It’s heartless for employers to short-change the goodwill and loyalty shown by their nursing staff whose extra shifts cover gaps in the rota and help keep services running and safe for patients.

'Glaringly unfair'

“It’s glaringly unfair that a nurse who does an extra shift, who goes the extra mile, will now be paid less than their basic hourly rate for that shift. In no other line of work would this be normal or acceptable.

“If a nurse is paid at the upper point of their pay band on a regular shift, it’s because this is no less than they deserve. Their knowledge, skills and experience should be recognised in their pay for a bank shift, too.

“As we approach the fifth anniversary of the start of the Covid pandemic, I’m sure the public who showed their support and appreciation for NHS workers on those Thursday evenings in 2020 will be surprised and dismayed to learn this is how they’re now being treated.”  

Almost 1,000 RCN members employed by The Royal Wolverhampton NHS Trust, Walsall Healthcare NHS Trust, The Dudley Group NHS Foundation Trust and Sandwell and West Birmingham Hospitals NHS Trust have said in a survey they will stop working in-house bank shifts if lower pay rates are imposed. More than 650 staff said they would seek temporary work outside of nursing instead.

'False economy'

Ms Meeks added: "We know NHS finances are under pressure but this group of trusts and the government need to understand that if hundreds of nursing staff stop doing thousands of hours of bank shifts, it will end up costing more money to plug the staffing gaps with agency workers. Either that or capacity will become even more depleted, putting patient safety at further risk as care is compromised and vital diagnostic tests and treatment are delayed."

“It’s a false economy, and that’s before you factor in the cost of damaging their relationship with their nursing staff, no fewer than 1,300 of whom spelt out their disapproval and sense of feeling utterly devalued in our survey.”

Sandwell and West Birmingham Hospitals has postponed reducing its bank pay rates until September at the earliest to support work to reduce agency spending but the three other trusts are understood to be imposing the cuts in April.

Pay rate comparisons

The following table shows NHS Agenda for Change gross pay point rates for the current 2024/25 financial year and, for further comparison, associated overtime rates for full-time staff. The greyed-out column highlights the reduced rates for bank pay due to be imposed by the four Black Country NHS provider trusts.

A small sample of the 1,300 written responses to our member survey

“It’s an insult to our experience and skills. It will have a huge impact on patient care.”

“Wards are struggling as it is, and yet the hospitals are doing everything they can to make sure nurses don't do bank. Yes, those desperate for money will still bank but if I'm currently on mid-point of band 5 and bank is at the lowest rate, minus NI, tax, pension and everything else, is it really worth the stress?”

“I will not be willing to work any bank hours due to the cut. In my opinion our pay does not reflect the work we do already so it definitely doesn't with the cut. I feel many people feel this way and will not be willing to do as many bank shifts, meaning being short staffed and patient care being impacted by this.”

“Nurses rely on bank shifts to accommodate flexibility to allow better work-life balance and to support local trusts with adequate nursing levels to ensure patient safety is a must. Would reconsider total change of career or work in a private sector of nursing.”

“I think as a trust it should be disgusted and ashamed of this decision, other areas need to be reviewed in order to support staff and give us the fair pay we deserve. It cannot claim to be a supportive trust for mental health and wellbeing, yet turn their heads at staff worries and concerns when salary is mentioned. It is disgusting.”

“No other profession in the country works overtime for LESS than their base rate, and often overtime pays time + 1/3. Completely blind decision.”

“I understand the financial pressures that the trust faces and the rationale for the decrease. However, families like myself are struggling financially to provide basic needs at home, whilst working additional hours, short staffed and risking burnout.”

“It is dismissive and disrespectful to people who have worked hard to gain a wealth of knowledge and experience over the years. If we do a bank at the lower rate we will still be expected to use this experience. As a result, these bank shifts will be filled by very junior staff who still require a lot of support which we will still be expected to provide. Either that or we will go back to the days where units are dangerously understaffed which means that our workload will be increased and patient care quality will plummet because we are only human and can only do so much. Whichever way it goes our workload will be increased, likely to dangerous levels and the patients will inevitably suffer.”