Government appears to want to address practice nurse pay concerns, says RCN lead

The government appears to want to address concerns around the pay, terms and conditions of general practice nurses (GPNs), according to the Royal College of Nursing’s director for England.

In an interview with Nursing in Practice, Patricia Marquis said ministers were talking to the union about general practice nursing in a way that ‘hasn’t always happened before’.

However, she said the union remained frustrated that it was excluded from negotiations on the GP contract and that GPN pay was not a core part of the contracts that GPs must adhere to.

In the summer, the government exclusively told Nursing in Practice that a new GP Contract promised by 2028 ‘could address’ practice nurse pay and conditions.

It came after ongoing concerns about GPNs missing out on annual pay rises and being given only statutory maternity and sickness leave pay.

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Ms Marquis said pay, terms and conditions for GPNs was ‘still a really significant issue’ for the union.

While she recognised that money for GP practices was ‘increasingly tight’, she said there were examples where GPNs were not being valued ‘as much as they should’ be by their employers.

Ms Marquis pointed to feedback from members who said they were getting paid at the equivalent of an NHS Agenda for Change Band 5 while carrying out the work and role of a Band 7 position.

‘There is real variation,’ she told Nursing in Practice.

‘[There are] some really good employers who do their utmost to give the best pay, the best maternity leave and the best sickness benefits that they can. And then there are  others where practice nurses are on the bare minimum and given nothing beyond statutory benefits.’

The RCN has been calling for GPN pay, terms and conditions to be, as a minimum, in line with those on Agenda for Change, and for practices to be given ringfenced funding to support this through the GP Contract.

Ms Marquis said it was the ongoing ambition of the RCN to be at the table for negotiations on the GP Contract but that she felt in recent years ‘we’re having more of an influence’.

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She pointed to the fact that the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) – which makes recommendations on GP pay – had made reference to general practice nursing in recent years, including its mention of exclusive Nursing in Practice survey findings.

‘We can see in the conversations that we’ve had with a variety of ministers that they want to talk to us about general practice nursing in a way that probably hasn’t always happened before,’ she said.

Ministers were ‘interested’ in the idea of GPN pay needing to be spelt out in the GP contract, and that they recognised the ‘current contracting system doesn’t work’, Ms Maquis suggested.

‘I genuinely think that the government wants to try to address general practice nurse pay, but obviously it’s tied up in the way the whole current contract model works and we’re not involved in those negotiations around the contract – so, that’s a really big frustration for us,’ she added.

In April, a General practice nurse pay: A salary survey of the profession 2025 report, produced with our sister title Management in Practice, revealed that the average salary of a full-time (or full-time equivalent) GPN working in the UK is only £35,057 and lags behind those working in NHS hospitals on Agenda for Change. 

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The report, based on a survey of more than 500 GP nursing staff, suggested very few were given maternity pay beyond statutory (5%) and less than a third (32%) say they are given occupational sick pay above statutory levels.

In its submission to pay bodies this year, the government has said it can only afford a pay rise of 2.5% for nurses working in general practice and the NHS for 2026/27.

While in recent years funding has been made available to GP practices to pass on an annual pay rise to GPNs as recommended by the DDRB, many practice nurses have gone without or have not received the full amount.