The shortages of registered nursing staff, an appropriate skill mix and overall staffing levels to perform the fundamental and skilled elements of safe and effective nursing care across the UK remain at crisis level. This crisis is further exacerbated by the impact COVID-19 is creating in the UK. Despite the recent mandated use of workforce and workload planning to establish the nursing workforce, nurse staffing remains poor throughout the UK. A report published in 2020 discussing the 2019 state of nurse staffing levels across the UK revealed that there are still challenges in achieving safe nurse staffing (Royal College of Nursing, 2020). Longstanding concerns over staffing levels will not abate until there are long-term solutions identified to address recruitment and retention of staff. COVID-19 has lifted the lid on the appalling state of nurse staffing levels.
Nurses often work without the proper time and resources to provide care that meets the needs of patients. There are serious issues associated with nurses having to cope with the impact of staffing shortages on care provision and, at the same time, dealing with the worry of trying to balance a responsibility to the employer with ensuring that the tenets enshrined in our Code and professional accountability required by the Nursing and Midwifery Council (2018) are adhered to. It should also be noted that the employer has a duty of care to staff, which is a legal obligation and just as important as all other rights at work.
The 14 healthcare unions across the UK consulted with their members and came together to call for a 12.5% pay increase for all healthcare staff who are covered by the Agenda for Change (AfC) arrangement in the UK. This, they are saying, must be applied equally to all bands. The AfC deal is not due for review until April 2021, when the current 3-year deal comes to an end. Unions have been calling for a pay deal that would equate to at least £2000 per person to be implemented as soon as possible but, despite the pressure from the unions and protests from frontline staff (UNISON, 2020), the government is not budging on its timeline. The proposed pay rise has to be fully funded and must not be subsidised by squeezing budgets that are used for other essential health services.
Throughout the Year of the Nurse, nations have observed nurses and nursing as a profession that is highly skilled and deserving of fair pay. The pay rise will bring nurses' wages in line with the rising cost of living as well as recognising the skill, accountability and expertise of a safety-critical profession. The call for fair pay is about more than the nursing response to COVID-19. It is about recognising and respecting the complexity of skill, responsibility and experience that all members of the profession demonstrate, day in, day out. It is about ensuring safe staffing levels and addressing the tens of thousands of unfilled nursing roles. It is about an honest recognition that the salaries of far too many nursing professionals have failed to keep pace with increases in living costs over the years. Finally, this pay claim is about providing safe and effective care for all.
After years of neglect and inadequate support for the largest health and care workforce in the UK, the political response to the claim will clearly indicate what all the UK governments truly believe nurses are worth. Their rhetoric about how nurses and nursing have been the backbone of the COVID-19 response, stepping up to the plate in the face of adversity, needs to be supported with the 12.5% pay increase. It is now time to pay nursing staff fairly and it is the job of the 14 trade unions to come together and exert pressure on the government to make the right response. As the pandemic is still a long way from disappearing, the widespread nursing shortages across the NHS have the very real potential to lead to staff burnout, bringing with it risks to patient safety.