Attempts by NHS trusts in the North West of England to pay nurses less for working extra shifts have been condemned by nursing leaders as “unacceptable and unsustainable”.
The Royal College of Nursing’s (RCN) North West branch has called out trusts in the region for reducing rates of pay for nurses filling shifts via the staff bank and NHS Professionals.
“It’s an erosion of pay, an insult to professionalism, and a betrayal of trust”
Simon Browes
It claimed that nurses were being denied the opportunity to earn overtime pay for working beyond their contracted hours.
Instead, nurses looking to work additional hours were being expected to pick up shifts through the staff bank or NHS Professionals.
In addition, staff in the North West region have reported to the RCN that their pay for working staff bank or NHS Professionals shifts has recently been cut.
They have reported earning less for working extra shifts than their substantive wage set by their Agenda for Change pay band.
This means that nurses could be being paid less than their regular wage for working extra shifts on their own ward, the RCN has said.
The RCN has estimated that a staff nurse on a typical ward could be £40 worse off for a 12.5-hour shift, while intensive care nurses and those in other highly specialised settings stand to lose even more.
Nurses in Stockport, covered by the Greater Manchester Integrated Care Partnership, have told the RCN they experienced cuts. Staff at the top of band 5 were being offered extra shifts for rates at the bottom of the band.
And nurses in Liverpool have also reported cuts to staff bank payments. One nurse in Liverpool who is on band 6 told the RCN they were being paid the equivalent of a mid-point band 5 nurse for doing their usual band 6 job on their own ward.
In real terms, this means nurses are being paid less for taking on the most demanding and high-risk work, often while covering safety-critical staff shortages, according to the RCN.
Regional director for RCN North West. Simon Browes. said: “It’s an erosion of pay, an insult to professionalism, and a betrayal of trust.
“Nurses already give more unpaid overtime than any other profession, because we care deeply about our patients. But to be paid less for doing the same job, often under pressure and short notice, is completely unacceptable.”
“Let’s be clear, nurses are highly skilled professionals. They carry enormous clinical responsibility. They deserve to be recognised and paid fairly for the work they do, regardless of whether it’s a rostered shift, a bank shift, or an emergency request,” Mr Browes said.
He added: “If a nurse works extra hours in their usual setting, they should be paid overtime. If they work bank shifts or through NHS Professionals, they should be paid at a rate that reflects their skill, experience, and responsibility.”
A spokesperson for NHS Cheshire and Merseyside said: “The Cheshire and Merseyside health and care system faces a really significant challenge to deliver its financial plan in 2025-26.”
They added: “Switching to a standardised bank rate will help ensure that NHS resources are used as effectively and efficiently as possible and that the local NHS workforce is fairly and consistently remunerated.”
However, Mr Browes warned that these moves to cut pay nurse pay for extra shifts were worsening morale, and would increase the workforce crisis.
“Nurses are leaving the profession at an alarming rate, many within just a few years of qualifying,” Mr Browes said.
“This is a dangerous and growing crisis that will undermine any attempts to reduce waiting lists or improve patient care,” he warned.
Cuts to staff bank and NHS professionals pay have previously been introduced in other parts of England.
In March this year, Nursing Times reported that cuts to bank shift pay were being planned by the Black Country Provider Collaborative.
It includes Walsall Healthcare NHS Trust, The Royal Wolverhampton NHS Trust, The Dudley Group NHS Foundation Trust and Sandwell and West Birmingham Hospitals NHS Trust.
These cuts were set to be implemented by some trusts from April this year and in September by the others. Under the plans, staff will only receive pay in line with the lowest point in their banding for bank shifts.
An RCN survey carried out in March of more than 1,000 staff at the trusts said they would stop taking extra shifts if the lower pay rates were imposed. This led the college to warn that the cuts would end up a false economy.
Speaking in March, RCN West Midlands regional director Lindsay Meeks said that the trusts and the government needed to understand that “if hundreds of nursing staff stop doing thousands of hours of bank shifts, it will end up costing more money to plug the staffing gaps with agency workers”.
She said: “It’s a false economy, and that’s before you factor in the cost of damaging their relationship with their nursing staff, no fewer than 1,300 of whom spelt out their disapproval and sense of feeling utterly devalued in our survey.”
This argument was recognised by health and social care secretary Wes Streeting in a letter on the importance to the NHS of reducing agency spending, which was sent on 2 June to all NHS provider executive teams and ICB executive teams.
Mr Streeting wrote: “We all know that bank work offers the best benefits to our staff through flexibility and the ability to work in familiar settings. We want to ensure that working through a staff bank is staff’s first choice when they want to take on an extra shift,” he said.
He added that it was “imperative” that bank rates of pay were competitive.