蜜桃直播

To the Chair of the Review Body on Doctors' and Dentists' Remuneration’

Re: General Practice Nursing Pay 2025-26

The 蜜桃直播 (RCN) is the world’s largest professional body and trade union for the nursing workforce. We represent over half a million nursing staff in the UK, including approximately 22,000 general practice nursing staff in England. We write to share our concerns on behalf of our general practice nursing (GPN) members, ahead of your considerations regarding the 2025-26 pay round.

Nursing staff working in general practice provide vital primary care in their local communities and are the bedrock of the services available in general practice surgeries. They manage a broad range of responsibilities, from chronic disease management and immunisations to public health interventions, women's health screening and more; all whilst playing a crucial role in reducing hospital admissions and easing pressure on GPs.

The government rightly recognises the importance of investing in prevention to promote better health outcomes among patients and alleviate pressures in acute healthcare services. Primary care is at the forefront of this ambition and must receive the proper investment it needs, including in the nursing workforce, to make this vision a reality.

However, pay disparities, difficult working conditions and staffing shortages have resulted in nursing staff leaving general practice. It is important that our members are valued by their employers and that general practices can be the employer of choice for nursing professionals in their area.

Your recommendations in respect of the year 2024-25 were accepted by the UK Government and this included a 7.4% uplift to the Global Sum, to provide sufficient funding to ensure a 6% increase to uplift “contractor income” and “other staff expenses”. The RCN believes this specifically includes GPNs. This position has subsequently been reinforced by NHS England, who stated that:

“The uplift to the Global Sum is calculated to cover all practice staff – not just GP partners and salaried GPs. This includes nurses, reception, management and other practice staff. We firmly expect GP partners to honour the intent of this uplift and award the full 6% pay rises to all their staff.”

Unfortunately, the above statement does not reflect the reality of the experience for many of our GPN members. A large volume of GPNs did not receive this pay uplift as intended; neither for the financial year 2024-25 nor for the previous financial year 2023-24.
In relation to 2023-24, we previously shared the following information with you, based on a survey of our members working in general practice, which generated almost 1,500 responses. We found that:

• Two in five respondents (44%) did not receive any pay increase in 2023-24.
• A third of respondents (33%) said they received less than 6%, with the average pay uplift being 3.2%.
• Only one in five respondents (20%) received a pay award of 6%, of these, 20% of this group did not receive back pay to April 2023
• Nearly two thirds (64%) of members who responded said that they were concerned that their employer was not being transparent about their total pay award for 2023.

Regrettably, the impact of non-payment, or only partial payment, of the 2023-24 uplift, has been compounded by what appears to be a likely repetition in 2024-25. Whilst we caveat this statement with some caution as we are aware that practices only received the uplift in September, so there may be some further room for movement in terms of passing the uplift to relevant staff, a Nursing in Practice survey of GPNs conducted in October, which generated over 500 responses, showed that 50% of respondents had not received any pay uplift for 2024-25. Of those respondents who did receive a pay uplift, the largest group of respondents only received an uplift of 2%. For almost three quarters (73.5%) of respondents who received a pay uplift, the level of their uplift was less than the 6% which, following statements from the government and NHS England, had clearly intended to be passed on to GPNs.

The lack of uplift received by GPNs has consequences for recruitment and retention within the GPN workforce: the same Nursing in Practice survey established that a quarter of respondents (28%) said they were thinking of leaving their role in general practice in the next 12 months. Two thirds of those considering leaving are doing so because they feel undervalued in their job (68%), and because they do not feel that their pay is keeping in line with the cost of living/inflation. Further, 60% of respondents who stated they were thinking of leaving also agreed that ‘pay at my practice doesn’t reflect my responsibilities and workload’.

When looking across this financial year and the patterns demonstrated in the prior to financial years, it is clear the uplift that you recommended, that was intended to include other staff expenses including GPNs, is not being applied and distributed equitably by general practices in respect of our GPN members. This is unfair and inconsistent. Whilst our GPNs spend their days delivering nursing care on behalf of the NHS, large numbers of those same staff now find themselves further away from the pay, terms and conditions of their peers who are directly employed in the NHS. This is clearly unfair and unsustainable within the context of the wider health service and is likely to lead to more GPNs leaving general practice to seek more favourable employment and better pay elsewhere.

Our position remains that where uplifts are granted to general practice, these should be passed to GPNs at the same time, including backdating those uplifts to the beginning of the financial year. This is not happening, and we ask the Doctors’ and Dentists’ Review Body to explore and consider the reasons why this is not taking place and ensure its recommendations for 2025-26 expressly and explicitly state uplifts must include wider practice staff including GPNs to avoid this occurring in the next pay year. Many thanks for your consideration on these matters. We would welcome the opportunity to discuss these issues with you further.

Yours sincerely,

Patricia Marquis

Director, RCN England