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RCN publishes ‘damning’ interim findings of external review

The NHS pay deal was so complex that members found it difficult to understand. 



RCN Sign

The external report identifies several areas in which the union fell short of its members’ expectations.

Following its investigation, Electoral Reform Services has published its interim report which highlights the areas in which the Royal College of Nursing fell short during the NHS pay negotiations. You can read the full report here.

In summary, the external review found that the ‘deal was too complex’ for members to fully understand, the RCN had an ‘inexperienced trade union committee’ who ‘focused on headlines’, an ‘incomplete pay calculator’ and communication had a ‘pro-deal bias’.


The Royal College of Nursing said only last week that it has no intentions of reopening pay negotiations as staff already have ‘best available deal’.

The deal was complex.

The NHS pay deal was so complex that members found it difficult to understand.

The report states; There are inherent complexities in the pay deal that made effective interpretation and communication challenging for all stakeholders.

These inherent complexities exacerbated misunderstandings or confusion about the negotiations and deal, and its relevance to members especially in comparison to their existing pay progression arrangements.”

Trade union committee is ‘inexperienced’.

The Royal College of Nursing’s Trade Union Committee had only recently been formed, following the disbanding of its predecessor the Membership and Representation Committee (MRC). 

The report states; The Trade Union Committee was newly formed and this limited their ability to effectively fully scrutinise and evaluate the complexities of the deal.”

When interviewed by ESR the TUC described ‘nervousness’ around the ‘biggest decision to be made’ and questioned whether the committee as a group had enough time to develop and ‘bed down’, describing the pay deal decision as ‘a baptism of fire’.”

The focus was on headlines.

The Trade Union Committee did not have all the information and based some decisions on incomplete facts.

The report states; “The focus was on the headline figures of the pay deal which led to a lack of clarity and accuracy on how the deal would be implemented and affect the pay packets of individual members in the short term.”

Adding; it appears that clear and accurate information on this point was unavailable during the presentation of the deal, including to the Trade Union Committee on 7th March, and is the likely cause of misunderstanding and confusion”.

ESR noted a the RCN had a “lack of clarity and accuracy on how the pay deal would be implemented” and “apparent misinformation on details that had not yet been confirmed.”

Pay calculators were inaccurate.

The information provided to members via the Pay Calculator, which was promoted by all unions involved in the deal, was inaccurate and incomplete.

The report says; the pay calculator was not able to relay the nuances of the deal (with respect to increment dates in particular), and thus was not able to provide sufficient detail to members on how the deal would be implemented and affect pay packets in the short term.”

Communication had a ‘pro-deal’ bias.

Communication between the RCN and its members had a ‘pro-deal’ bias. It was put to members as the best deal that they were likely to get in the current climate and recommended they vote in favour.

The threats by the RCN that staff would return to a pre-deal arrangement also influenced members decisions.

The report states; Communication of the deal may have impacted on some members’ and internal RCN groups’ ability to assess the deal and thereby make an informed balanced judgement on its merits.”

ERS therefore considers whether internal groups within RCN, as well as the wider membership, were consistently informed about the finer details and impacts of the deal (both in a positive and negative sense), in a way that enabled them to make an informed and balanced judgement about it.”

No communication strategy.

The lack of communications leadership hindered the development of an effective communications strategy which was needed to clearly explain the impacts of the deal to members.

The report states; it is apparent that there was insufficient communications leadership in place to successfully present the details and impacts of the deal to the membership.”

Interviews with key personnel from the Communications Team attests to a lack of clear leadership in the communications area from their superiors.”

The Communications Team indicated that, upon drawing up five key points relating to the pay deal, their recommendations were signed off by the Chief Executive & General Secretary or appropriate members of the Pay Working Group with no corrections. This, in context, suggests a possible lack of scrutiny – from a communications perspective – may have been existent.

Extraordinary General Meeting.

A statement from RCN Council in response to the interim report said: “This initial report goes some way to detailing mistakes that were made earlier this year. We thank the Electoral Reform Services for the way in which it continues to conduct the review and await the second part.

“We urge members to read these early findings before voting in the Extraordinary General Meeting. They show that, in places, the RCN’s understanding and communication of the NHS pay deal in England was not of the standard that members should expect – for that we apologise again today. 

“This report will inform the EGM called for by members and the second document with clear recommendations will come later this autumn.”


Safe staffing and equality have been an issue since the start

Parliament passed the Nurses Registration Act in 1919.



State registered nurse

A new exhibition charts the history of nursing from the Nurses Registration Act to modern-day.

In the centenary year of nurse registration, a new exhibition charts the history of the journey from the Nurses Registration Act in 1919 through to the modern-day.

Called ‘Wake up Slackers! The great nursing registration controversy’ the exhibition looks at the heated arguments around the official registration of nurses through the first registration of men, overseas nurses and one of the first nurses to be struck off.


The Royal College of Nursing (RCN) was just three years old when registration first happened and securing this had been part of its founding ambitions.

The exhibition shows how many of the discussions and controversies of the past, including safe staffing, continue today and influence many of the discussions around modern nursing.

The Nurses Registration Act.

The exhibit contains artefacts from the RCN archive including invites to member meetings to discuss the College’s proposals for state registration, House of Commons Parliamentary debates during the year the Nurses Registration Act was passed in 1919, as well as drafts of legislation.

Opening during Black History Month, the exhibition also showcases the story of Eva Lowe, one of the first known black nurses on the register. Research shows how, despite being well qualified she was rejected many times before finding employment. It shows how she received vague and unsatisfactory excuses for her rejection, some based on false concern for her welfare.

As well as letters and documents from the RCN’s own archive, the exhibition will also feature items loaned from other collections such as that of the regulator the Nursing and Midwifery Council.

Are nurses born or made?

Frances Reed, Events and Exhibitions Co-ordinator at the Royal College of Nursing said: “It is incredible today to think that 100 years ago there were arguments about whether or not nurses should be registered.

“Today it seems unthinkable for somebody with such responsibility for the welfare of patients not to be registered and yet there were strident clashes over it, despite other health professions securing regulation well before nursing.

“The story of the first black nurse on the register, Eva Lowe is important to highlight too. There is little known about black nurses whose names are on the very early 1920s registers.  It is essential we recognise that their contribution to health care existed well before Windrush.

“It’s also particularly striking to see how hard Eva Lowe had to fight to become the first black nurse on the register, and how 100 years later racial inequalities still exist in the health and care system.

The exhibition runs at RCN HQ in Cavendish Square, London 17 October – 20 March 2020

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One in six nursing associates drop out before qualifying, finds report

Despite this trainees showed “high levels of enthusiasm and commitment to the programme”.



Group of nurses in meeting

Only 65% of trainee nursing associates said they planned to work as a nursing associate once qualified.

An independent evaluation of the nursing associate role commissioned by Health Education England (HEE) has found that while there are “high levels of enthusiasm and commitment to the programme”, one in six nursing associates are dropping out before completing the course.

Attrition rates for trainee nursing associates fell slightly below that of student nurses, with 18% leaving before completing the course.


While ill health and personal issues were some of the most common reasons for leaving the programme, nearly a quarter (23%) withdrew because they failed to meet the academic requirements of the programme – with numeracy skills cited as a key issue.

One trainee said they found the “attitudes towards the role and the negative feedback about Nursing Associates” challenging.

Only 65% of trainees said they intend to continue working as a nursing associate once qualified as the programme is often seen as a stepping stone to becoming a registered nursing.

Highlighting challenges.

Mark Radford, Chief Nursing Officer, Health Education England said the report “highlights some challenges that we must address to ensure that students such as ensuring the quality and oversight of placements, attrition and numeracy support.”

“We also recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the MDT. I am pleased to be able to report that we are in the process of identifying candidates to be considered as NA ambassadors across England.

Commenting on the report, Andrea Sutcliffe, Chief Executive and Registrar for the Nursing and Midwifery Council (NMC), said; “Having had the pleasure of meeting many nursing associates across the country, I am continually inspired by their enthusiasm and dedication for providing care and they should be very proud of the difference they make for the people they support.”

“I look forward to seeing how nursing associates continue to develop and be supported in their work, long into the future.”

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