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Report reveals RCN leaders did not ‘fully understand’ the NHS pay deal despite recommending it to members

The report identifies 12 key findings and provides a set of recommendations for the college.



Office paperwork

An independent external review has concluded that key members of the RCN did not fully understand the ‘complex’ pay deal despite recommending it to members.

The Council of the RCN has published the final part of the independent review by Electoral Reform Services (ERS) of the College’s understanding and communication of the 2018 pay deal for staff in the NHS in England.

An external review was commissioned following complaints from members that they did not receive the deal that was advertised during the consultation period.


The full 13-page report published today reveals significant failings within internal processes at the RCN which led to key decision makers being unable to fully understand and therefore be able to provide an “informed balanced judgement” about the proposed deal.

Earlier this month, a preliminary report 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’.


Included within the report are several internal emails which emphasise the confusion within the college about the proposed pay deal. An email from the RCN’s Chief Negotiator to RCN staff clearly states “Members employed by the NHS in England can expect to receive their 3% uplift in July’s pay packet” – despite this not being the case

ESR highlights that there was a significant ‘pro-deal bias’, alternative options to simply recommending members accepted the pay deal were not adequately explored and the deal was presented in a way many could not understand.

The report identifies 12 key findings and provides a set of recommendations for the college.

The report warns that the RCN needs to “carefully consider how to proceed with future negotiation involving pay rise and pay structure reform”.

‘Not fully informed’.

Responding to the publication of the report, RCN Council said: “The report concludes that the Executive Team, Council, Trade Union Committee, and the membership were not fully informed about the details and impacts of the deal in a way that enabled them to make an informed balanced judgement.

“This conclusion does not absolve the College of fault, and indicates that the processes around the pay deal and its communication were not sufficiently robust.

“RCN Council agrees with the findings of the review, and has committed to addressing the recommendations in full. Work has already commenced to ensure that the College is stronger for our members.”

An Extraordinary General Meeting is being held later today, following a petition signed by more than 1,000 RCN members calling for a vote of no confidence in the unions senior officials.


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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