Enough is Enough: Fair Pay and Safe Staffing

Helen Whyley, Wales Director at the Royal College of Nursing discusses the importance of fair pay and safe staffing for the nursing workforce.

At the end of 2022, hundreds of nursing staff across NHS Wales took to the picket lines for the first time to tell the Welsh government: #EnoughIsEnough. 

I was overwhelmed to see nurses, nursing students and health care support workers standing together in solidarity. Sharing their experience to have their voices heard about how their pay affects them and how it affects safe staffing and patient care. 

A decade of pay restraint has stripped all resilience to cope with a cost-of-living crisis, made all the worse by yet another below inflation pay award. In Wales, 58% of RCN members that responded to the RCN Employment survey (2021) were the main or sole breadwinner in their families. Below inflation pay awards are having a devastating impact on not only the nursing profession but their ability to support their families. This is only increasing the NHS nursing workforce crisis as more and more nurses are turning to agency nursing due to better pay and great flexibly over their hours. 

The nursing workforce wants #FairPayForNursing because it results in safer staffing levels where they can provide high-quality compassionate care for their patients. Sadly, this is becoming extremely difficult to deliver in the current nursing workforce crisis.  

The importance of nurse staffing levels is unequivocal. When there are low nurse staffing levels patient mortality increases by up to 26%.  Safe staffing levels have also shown to reduce readmission, health care associated infection rates, medication errors, falls and pressure ulcers. The evidence is clear safe staffing levels save money and, most importantly, improve patient outcomes. 

In our 2022 ‘last shift’ survey – which formed the basis for our Nursing Under Unsustainable Pressures report – over two thirds (78%) of respondents said they did not have enough registered nurses on their shift, and less than one in five (17%) said they felt they had enough time to provide the level of care they wanted to. The pressures on the nursing workforce are indisputable. The workforce is struggling and urgent investment is needed.  

But for too long accountability for patient safety has been placed on the individual nurse. Health boards and the Welsh government need to take responsibility for the conditions the NHS is currently facing. This includes over £152m spent on agency nursing, and the 3,000 registered nurse vacancies in the NHS in Wales. It is today’s highly unsafe situation that is driving our members to say ‘enough is enough’. Patients aren’t dying because nurses are striking, nurses are striking because patients are dying. 

To ensure Wales has a workforce fit for the future and able to provide safe patient care, we need to see investment. Nursing is a fantastically rewarding career. The value of nursing needs to be recognised to ensure we can attract people into the profession and retain the ones we have. This must start with #FairPayForNursing. 

Royal College of Nursing (RCN) Wales members have made it abundantly clear to their politicians the urgent need for a fairly paid and safely staffed workforce. 

It is their tireless commitment to demonstrating how much fair pay and patient safety means to them – including through industrial action – that has led to an additional offer being made by the Welsh Government. 

The Welsh Government, through negotiations, has offered to increase the award already made for 2022/2023 by 3% (1.5% consolidated). The new offer is backdated to April 2022. It’ll now be up to eligible RCN members to decide if they want to accept the new offer.  

I  am in no doubt that RCN members will again act in the best interest of their patients and the entire NHS in Wales.