Most nurses believe the pay band they are on undersells what they actually do in practice, a survey has revealed.
The survey of more than 5,500 registered nurses, carried out by the union Unison, showed the extent to which nurses’ roles were evolving but that this was not being recognised in their job descriptions and pay.
“Lack of funding is the reason given for not being able to increase banding despite all the upskilling and training”
Nurse in survey
Nine in 10 (90%) respondents to the survey, conducted in October, said they were now required to deliver more complex care than they would have previously.
A further three-quarters (73%) said they had taken over tasks that were previously done by senior nurses or doctors, and 85% had greater responsibility for supervising and assessing junior colleagues.
However, the survey showed nurses were not being paid for the service they were providing.
Overall, nine in 10 (89%) nurses who took part in the survey said their official job description, on which their role is graded, understated the complexity of their job.
One band 5 nurse said: “With some of the training I’ve had, such as administering cytotoxic drugs [used to treat cancer], I really should be paid at band 6.
“I submitted a job evaluation form almost two years ago. Lack of funding is the reason given for not being able to increase banding despite all the upskilling and training.”
A community nurse added: “The lack of home and face-to-face GP visits mean GPs expect [community] nursing staff to be their eyes and ears and they rely on our assessments more and more.”
Unison said the results showed that “the workforce is expected to develop new skills and responsibilities, but these are not acknowledged by their formal job documents or pay grades”.
However, the union said separating nurses out of the current Agenda for Change (AfC) system was not the answer to addressing the banding issues.
The government recently made a commitment to the Royal College of Nursing (RCN) as part of pay negotiations to explore the idea of introducing a pay spine exclusively for nursing staff.
The idea is opposed by other unions including Unison, which is instead calling for a review of AfC for the benefit of all professional groups covered by it.
Unison head of health Sara Gorton said: “Ministers shouldn’t be looking at unstitching the system.
“The way to tackle inconsistencies is for a wholesale review of grades with regular monitoring to check every job is paid properly for the work done and the skills needed.”
The nurse pay spine proposal was discussed at Unison’s annual health conference this week where members backed their union’s position.
Lorraine Drum, a Unison rep from the Northern Irish branch, said: “I’m a healthcare assistant, and I don’t want to support separation of our nurse members from our one NHS team.
“We’re all interconnected and want to keep it this way. Agenda for Change provides a ladder, and it helps our members to make real pay improvements.
“We can make changes within this system, but we need to make sure this stays in place.”
Steve Jones, a mental health nurse from Stoke-on-Trent, added: “We have an agreed mechanism for pay.
“Yes, we want more pay, but the concept should be doing that within what we currently have.”
“The profiles against which our jobs are measured, they are way, way out of date”
Anne Cherry, a community nurse from the North of England, said instead of separating nurses out of the current structures, she wanted to see all nursing profiles reviewed.
She said: “Splitting anything off is never a good idea, we need to work together. I’m a nurse in the community, we’re all the same family.
“What we need to do is look at job descriptions for nursing, they were written 20 years ago when we did AfC.
“The profiles against which our jobs are measured, they are way, way out of date.
“They tell you nothing about the complexity and skills and experience needed.”
The pay spine proposal, while not part of the official NHS pay offer from the government in England, was included by the RCN in its ballot with its members on the deal, which they rejected.
The RCN is now seeking a better pay offer from the government, and it told Nursing Times that it wanted the nurse pay spine work to remain on the table.
An RCN spokesperson said: “After voting for historic strike action, our members deserve a historic pay rise.
“The RCN is clear that the government should add to the deal on the table, not remove elements that have already been negotiated, including the pay spine.”