Almost half of general practice nursing staff in England did not receive a pay rise last year, a survey by the Royal College of Nursing (RCN) has revealed.
But the nursing union did not blame GP practices for the lack of a pay rise, calling instead on the Government to provide sufficient funding to enable the promised increase.
RCN has today issued a fresh call to the Government to find ‘urgent’ funds to provide the full 6% pay rise general practice staff were promised last summer.
The survey of almost 1,500 nursing staff employed by GP practices found more than three-quarters (77%) did not receive the full 6% and almost half (44%) received no pay rise at all for 2023/24.
Just one in five (20%) of respondents received a pay award of 6% and among those who did, 19% were not given back pay to April 2023.
In addition, almost two-thirds (64%) of general practice nursing staff said they were concerned their employers were not being transparent about their pay award for 2023/24.
The RCN has now written to the Government to ‘demand action’ on the issue and has submitted evidence to the spring budget.
It said it was ‘seeking a change’ to the funding model used to uplift the pay of employed general practice staff.
It was confirmed in October that the global sum given to GP practices had been increased to help fund the 6% pay rise, and that it would be distributed by November.
However, because the global sum allocates funding per patients, based on various factors including demographics, it became clear that some practices would not receive enough additional funding to cover the rise, while others could get more than they need.
In light of this, concerns over the discrepancies between the pay, terms and conditions of general practice nurses compared to that of those working in the NHS have ramped up in recent months, with nurses describing the situation as ‘inherently unfair’ and ‘disappointing’.
The RCN and the British Medical Association (BMA) also recently pledged to work together to ensure ‘fully funded fairer terms’ for nurses working in general practice amid concerns many nurses would miss out on their promised pay rise because of the complex funding formula currently used.
Dr Paul Evans, a GP in Gateshead, said: ‘Unfortunately, the 6% rise promised was funded only for salaried GPs, and it is a shame that NHSE were not clear about this. Further, many practices found that the 6% rise for salaried GPs was not adequately funded even for this group, and partners therefore had to fund this at personal expense.
‘It is regrettable that, once again, NHSE have failed to recognise the value of general practice and all its workforce, and continue to over-promise to the public and other bodies whilst starving general practice of the means to deliver.’
it comes as Pulse has revealed that the Government’s initial offer for a GP contractual funding uplift for 2024/25 is just 1.9%.
Dr Laura Mount, a GP in Warrington, said: ‘I think it’s sad that we have a system that cannot reward hard working primary care staff adequately and in line with our hospital colleagues. The 6% figure was to include employer costs which are nearly 30% for most staff so in reality around 4% was left for staff uplift that they received in their pay.
‘Many practices took funds from another area of the practice if they did award the full 6%. Also the contract correction was confusing and inaccurate for any practices meaning some could not afford to award much, it didn’t actually reflect the staff you have and their pay levels.
‘Practices have to balance the sustainability of the practice with rising costs of running a practice which was not reflected in the general practice GMS core contract payment last year. It’s a difficult time for many practices who will face a tough decision regarding their future over the next 12 months if an adequate uplift to cover rising costs is not given this year.’
Today, the RCN once again urged the Government to ‘step in and ensure every practice has enough funds to deliver the pay rise’ to all general practice nursing staff.
It warned that the failure to ensure nurses were given their pay uplift had left staff feeling ‘undervalued, with some saying they’re considering leaving the profession’.
Patricia Marquis, RCN England director, said: ‘The Government should be valuing the role nursing staff in primary care play, instead of leaving them short-changed.
‘They keep communities healthy, detecting disease early, reducing hospital admissions, and preventing more patients from ending up at A&E.’
She added: ‘If the Government was serious about addressing waiting lists, it would immediately provide ring-fenced money to fund the full 6% pay increase it promised general practice nursing staff.’
The news follows the announcement that general practice nurses (GPNs) are set to be included within the Additional Roles Reimbursement Scheme (ARRS) – which allows primary care networks (PCNs) to reimburse the salaries of some staff – within next year’s GP contract.
The move had been called for among the profession, amid fears the GPN role could otherwise be lost and concerns that nurses are increasingly being substituted by nursing associates, who are currently covered by the scheme.
Ms Marquis said earlier this week that adding GPNs to ARRS must see nursing pay ringfenced and equal to NHS terms and conditions ‘as a minimum’.
She also stressed ‘safeguards’ must be put in place to avoid further pay ‘inequity’ for GPNs.
Dr David Wrigley, deputy chair of BMA’s GP committee for England, said: ‘Nurses are the backbone of general practice and hugely valued by GPs and their patients. But just like GPs, nurses have been let down and undermined by a lack of government financial support for their roles and this new data paints a worrying picture about how the government is addressing the current situation.
‘General practitioners and nursing staff want to serve the needs of their patients both more effectively and efficiently, but practices simply do not have the funds to help bring about change, and that comes down to a lack of government financial support. Ultimately, if the Government wants to get serious about improving patient care, they need to get serious about investing properly in general practice, and that starts with valuing staff for the work they do.’
The RCN surveyed members working in general practices in England between 23 November 2023 and 15 January 2024.
Nursing in Practice has asked the Government to provide a comment.
A version of this article was first published by Pulse’s sister title Nursing in Practice.
It’s complicated as practices don’t wait for intermittent government one off actions to timetable annual pay review. If the government hasn’t recommended a rise in a particular year and a practice has given a rise anyway, or if it has given very large rises in the past to match the market demand, it might not be appropriate to give a further out of calendar rise.
Practice staff are on rates negotiated with the practice, not national rates, and these are often better than hospital rates. As such the government intervention can at times only confuse matters and sow discord where cumulative pay rises might have outstripped inflation for some year before.
Practice nurses should be given their 6% pay rise. GP contractor employers have a Moral (sic) duty to do so, no convoluted excuses. It’ll just seem two-faced.
NHSE didn’t fund the full 6% as they don’t know and are not willing to find out what 6% is in real terms to each practice. The 6% was the total amount – remove on-costs and the increase is 4.31%.
After much chagrin (about the process/policy) we gave 6% real increase to all. We were royally screwed-over on this one, I have no doubt it was deliberate. We think our staff are wonderful and deserved it, but it left us out of pocket. As intended.