‘The RCN is the organisation to negotiate on practice nurse pay’

Royal College of Nursing (RCN) director for England Patricia Marquis sets out why the college must be given an official space to negotiate general practice nurse (GPN) pay and conditions, and how supporting this part of the workforce is a key priority for the organisation.

Patricia Marquis sits down with Nursing in Practice to discuss the RCN’s response to concerns raised by Edward Morello, Liberal Democrat MP for West Dorset, about the need for ‘stronger advocacy’ for nurses in general practice, particularly in terms of pay.

Addressing issues around the pay, terms and conditions of GPNs continues to be a ‘major’ piece of work for the RCN, she says.

Notably, she says the RCN has written to primary care minister Stephen Kinnock about the need to give the college a seat on negotiations for the 2026/27 General Medical Services (GMS) contract.

This comes after the government announced that the British Medical Association (BMA) would no longer be the sole negotiator of GP contract terms for the next financial year, and that other organisations, including the Institute of General Practice Management (IGPM) and Royal College of General Practitioners (RCGP), had been given a place at the table.

Ms Marquis says she is continuing to press the government for an answer, adding: ‘If they don’t agree, then that will be a major issue for us because we do think that the best mechanism for addressing nursing leadership and influence, and nursing pay, terms and conditions, is through that negotiation of that GMS contract.’

In an article for Nursing in Practice last week, Liberal Democrat MP Mr Morello suggested there was ‘no one for the government to sit down and negotiate with’ when it came to GPN pay and that the profession lacked advocacy from a professional body.

He wrote: ‘We need stronger advocacy from a professional body for better worker rights, working conditions, or benefits from employers. There is no one body speaking for GP nurses. The RCN’s remit extends to GP nurses but does not speak for them exclusively and it might be reasonably argued does not give them equal preference to its other members.’

Mr Morello mooted the idea of a Royal College of GP Nursing, arguing that until ministers had ‘someone it can sit down and negotiate with, improving pay and conditions will continue to be an uphill struggle’.

In response, Ms Marquis says she has reached out to the MP to explain the work the college is doing and insists the RCN is very much the organisation that should be at the negotiating table for GPNs.

‘It is really, really positive to see someone who is really on it and wanting to learn more about [GPN pay, terms and conditions],’ she notes.

But she adds: ‘From our perspective, it was disappointing to note some of his comments, particularly around there not necessarily being a strong voice or “one organisation”.’

‘We have got a whole team of people that work on general practice – both on professional and pay issues – and for us it is one of our major pieces of work,’ says Ms Marquis.

‘We are very clear that we are the organisation that should be doing this. There are other people, but we have got the rights to negotiate for the NHS and across health and social care for nursing, and we represent a significant majority of general practice nurses. So, we’re clear that we are the organisation to do it.’

The RCN director for England agrees ‘there is no proper fora’ for GPNs but adds that is ‘one of our big things to create at a national level’.

In his article, Mr Morello also floats the idea of a ‘Primary Care Review Body’ to replace the Doctors and Dentists Review Body (DDRB) that would have a ‘remit to look at pay levels for all staff, not just doctors’ – recognising that many GPNs miss out on annual pay rises because they are not mandated.

Ms Marquis says while she ‘understands where the idea is coming from’, the picture was more complicated and that the issue was ‘all tied up in how the contract works’.

‘Unless there is some national agreement that says “this is what has to happen”, then there’s no mechanism in place to implement whether it’s the DDRB or a primary care review body – there’s no mechanism in place, which is why we’re saying the GMS contract needs to be different.’

Another idea would be to introduce a mechanism where GP practices have to confirm when they have given pay uplifts to GPNs, as is the case in Wales, says Ms Marquis. As part of its contract proposals for 2026/27, the BMA’s GP Committee has also asked that this be introduced for salaried GPs in England next year.

‘So, that’s another way of doing it, building something in that says to have to commit [to the pay rise],’ she says.

But ultimately, it all comes down to funding issues, she notes.

‘We’ve been very clear we think the whole funding mechanism needs to change and needs to be updated. And as part of that, these wider issues about nursing pay and the nursing voice need to come through in that whole contract renegotiation.’

Speaking to Nursing in Practice last month, Ms Marquis suggested the government appears to want to address concerns around the pay, terms and conditions of GPNs and that ministers were talking to the union about general practice nursing in a way that ‘hasn’t always happened before’.

Last year, the RCN asked the DDRBs to investigate why many GPNs are not being given an annual pay rise and to ensure its future recommendations ‘expressly and explicitly’ include the nursing profession.

The RCN used the findings of a Nursing in Practice survey to inform its case – including that half of practices nurses had not received any pay uplift for 2024/25 as of autumn 2024.

A separate survey by the RCN some months later at the start of 2025 found that almost a third of general practice nursing staff were still waiting for a pay increase.

‘The RCN is the organisation to negotiate on practice nurse pay’

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