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Significant investment in nursing is needed across health and care

Professor Nicola Ranger 13 Sep 2024

RCN General Secretary and Chief Executive Professor Nicola Ranger reflects on the publication of Lord Darzi's report on the state of the National Health Service in England and the nursing staff she has met during our NHS pay consultations. 

This week saw the publication of Lord Darzi’s independent investigation into the NHS in England. I was part of the Expert Reference Group that informed the Darzi investigation and attended two sessions as part of that work. We also submitted written evidence focusing on the concerns of our members including safety-critical nurse-to-patient ratios, nursing student numbers, mental health support, raising concerns and corridor care.  

I’m sure that you will recognise many of , not least how sustained austerity, cuts to public health and failure to invest in community services have impacted NHS performance and patient care.  

The modest increases in the size of the nursing workforce have been significantly outstripped by the demand piled on the NHS in recent years. Nursing staff are now too commonly caring for patients in corridors, or in other inappropriate areas, which I know leaves you unable to give the quality of care that you would want to give.  

On the eve of the report’s launch, we called for the Prime Minister to back-up his ‘mission’ to repair the NHS with new investment to boost recruitment into nursing. Urgent investment in the nursing workforce couldn’t be more necessary if the government wants to reduce health inequalities. 

To turn around health and care after years of neglect, the government must start to significantly invest in the nursing workforce to make any reforms or shifts viable. This is also the message that I’ve heard from nursing staff during my visits to NHS trusts during the last few weeks.  

Our pay consultations in England and Scotland are nearing their end, and I’ve said many times during this consultation period that for the RCN to truly be the voice of nursing and represent our half a million nursing staff, we need to listen to you. So, I have been meeting members to understand what you think about pay, staffing and working conditions. 

While chatting to one ward leader, she told me that we had to keep fighting on pay, particularly for the nursing staff at the lower pay bands. She herself had given money from her own pocket to her staff to make sure they can afford the bus home from work. That situation is completely wrong. It is always nurses who end up doing more – more hours, unpaid overtime, giving from their own pocket. It can’t go on.  

Something that comes up again and again in my conversations with nursing staff is how pay and safe staffing go hand in hand. They are two sides of the same coin. How can we hope to recruit and retain nursing staff if we aren’t properly rewarded and valued for the safety-critical work we do?  

This week the Welsh government also announced a 5.5% pay award for NHS Wales staff on Agenda for Change terms and conditions, accepting the independent pay review body recommendations in full. The RCN Wales board and the Trade Union Committee are now considering the award in detail and will decide on next steps for members. We will update members on those next steps soon.  

We know that 5.5% won’t resolve all the issues that our members face. But the only way we can begin to address those issues is through having a strong and engaged membership, so those in power know that our members are ready and willing to speak up for what is right.  

There is still time to have your say in England and in Scotland, so please use your vote.  
Headshot of Nicola Ranger

Professor Nicola Ranger

General Secretary and Chief Executive

Professor Nicola Ranger joined the RCN in December 2022. She was previously Chief Nurse and Executive Director of Midwifery at King’s College Hospital NHS Foundation Trust in London. Before that, she held Chief Nurse posts at both Brighton and Sussex University Hospitals NHS Trust and Frimley Health NHS Foundation Trust.

She has also held a number of senior nursing roles at University College London Hospitals NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust. Earlier in her career, she worked at America’s George Washington University Hospital in Washington and at Mount Sinai Medical Centre in New York.

Page last updated - 10/10/2024