A record number of RCN members voted in England, Wales and Northern Ireland in consultations after a recommendation by the NHS Pay Review Body of a 3.6% consolidated pay uplift for all Agenda for Change (AfC) staff in the NHS/HSC. 

The RCN said: ‘We believe the votes clearly demonstrate the need for governments to deliver swift investment in nursing, including by delivering long-overdue reforms to the broken pay structure.

‘The results highlight widespread dissatisfaction among nursing staff with the way the profession is valued, beyond that which can be addressed with just an annual pay award.'

In England, the turnout in the consultation reached 56%, with more than 170,000 nursing staff voting. Nine in 10 (91%) said 3.6% was not enough to turn around a struggling profession gripped by widespread vacancies or keep patients safe amid an NHS corridor care crisis.  

The RCN said: ‘We're telling ministers in England to use the summer to reach agreement or face formal escalation to dispute and an industrial action ballot.

‘In Wales, members working in the NHS also voted overwhelmingly to say that 3.6% is not enough. We're now pushing for meaningful discussions with the Cabinet Secretary for Health and Social Care and considering next steps.'

As a pay award, staff on AfC NHS Terms and Conditions in England and Wales will receive the 3.6% consolidated uplift backdated to 1 April 2025 from August salaries.

In Northern Ireland, RCN members were consulted on the recommended award and voted to say 3.6% is not enough. However, no funding has been made available by the Northern Ireland Executive to award the uplift.  

RCN added: ‘We're working on next steps to secure this long-overdue award and make sure that nursing staff in Northern Ireland don't continue to fall behind on pay parity.

‘We're demanding long-overdue reforms to the NHS pay system, AfC, which was introduced more than two decades ago. It limits nursing staff to low starting salaries, traps tens of thousands of nursing staff on the same pay band their entire careers and prevents staff from progressing despite years of experience, skills and training.'

RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘Record numbers have delivered this verdict on a broken system that holds back nursing pay and careers, and hampers the NHS. 

‘As a safety-critical profession, keeping hold of experienced nursing staff is fundamentally a safety issue and key to the government's own vision for the NHS. Long-overdue reforms to nursing career progression and the NHS pay structure aren't just about fairness and equity but are critical for patient safety.'

In response, Rory Deighton, acute and community care director at the NHS Confederation, said: ‘NHS leaders will be disappointed to hear of the threat of further walk-outs given the dust has barely settled on the five-day resident doctor strike. Patients are always the ones who end up suffering the most during industrial action as they are left waiting longer for their vital treatments, potentially in pain, discomfort and distress.

‘But we welcome the RCN's willingness to engage on wider issues than pay given the red lines set by the government that the NHS must live within its means. We hope that the government can respond to the tight timetable for negotiations set by the RCN so there is no need for further strikes.'