Many GP practices in Wales are concerned about their ability to employ nurses because they are ‘unable to offer competitive wages’, the British Medical Association (BMA) has warned.
General practice nurses (GPNs) have also told Nursing in Practice they are feeling disappointed and ‘disgruntled’ about the ongoing lack of a pay rise for 2023-24.
Dr Gareth Oelmann, chair of the Welsh GP Committee at the BMA, said ‘broken down’ negotiations with the Welsh Government over a financial agreement for the GP contract had meant practice nurses and colleagues had been wrongly ‘kept waiting for a fair pay uplift’.
‘We know many practices are concerned about sustainability and their capacity to employ nurses and other staff, as they are unable to offer competitive wages,’ he told Nursing in Practice.
It was announced in October that GP contract negotiations between the BMA’s GP Committee for Wales, the Welsh Government and NHS Wales had ended without resolution, as reported by our sister title Pulse.
And in December, as reported by our other sister title Management in Practice, the absence of a financial agreement on the contract has left practice managers struggling to afford pay rises for staff.
Dr Oelmann said today that the committee is ‘continuing to push’ the Welsh Government for funding for GP practices in Wales, and that it had recently met with the Royal College of Nursing (RCN) to reaffirm its commitment to negotiating uplifts to the contract that ‘would allow fair and proportionate pay awards’ for all staff.
Associate director of nursing (employment relations), RCN Wales, Nicky Hughes, confirmed she had met with the BMA before Christmas and told Nursing in Practice: ‘GPNs provide pivotal and essential care within GP surgeries [and] they too deserve fair pay for what they do, and good terms and conditions.
‘With the cost-of-living crisis we need to make sure that nurses have got enough money to be able to live and to feed their family and have a roof over their head.
‘So, we would always be advocating for fair pay for our GPNs, similarly as we would for any nurse working in any setting.’
Responding to the concerns raised, a Welsh Government spokesperson, said it remained open to ‘engaging further with GP representatives to secure a pay agreement for everyone working in general practice’.
They added: ‘We want to be able to offer GPs and their teams a pay award that reflects the pressures they are under and the impacts they are seeing due to the cost-of-living crisis.
‘We want to see general practice staff, including practice nurses, receive a pay offer commensurate with similar roles in the NHS.’
However, they warned that the current offer to GP representatives was ‘at the limit of the finance available to us and reflects the pay position reached with other health unions’.
Meanwhile, practice nurses have described how the pay situation has affected morale.
Diane George, a GPN in Newport, said the workforce was feeling ‘quite disgruntled’ over the lack of a pay rise for practice nurses for 2023-24, especially amid a 5% uplift given to nurses on Agenda for Change contracts in the NHS last summer.
She said there should be provision put in place for practice nurses to be given pay uplifts that match Agenda for Change awards.
This would help ensure nurses working for the NHS in Wales were ‘on the same playing field’ as GPNs and may also ‘encourage some of the secondary care [nurses] to come into primary care’.
Ms George described some of her GPN colleagues as ‘struggling on a day-to-day basis’ because of their pay and said one colleague was using a food bank.
Issues around pay, as well as poor terms and conditions regarding sick pay and annual leave, was compounding GPN recruitment and retention problems in Wales too, warned Ms George.
At her practice in Newport, they have been unable to replace two experienced full-time nurses who left to work elsewhere around 10 months ago.
Sue Brooker, a GPN in Barry, agreed that employment terms in general practice in Wales were ‘unfair’.
‘There are practice nurses on such low pay, with such high responsibilities,’ she told Nursing in Practice.
‘Practice nurse pay alters hugely between surgeries. Two nurses can be doing the same job and will be getting paid very differently and it’s not fair.’
Ms Brooker, who moved to general practice from the NHS around a year ago, warned that surgeries were working on the ‘goodwill’ of their staff.
Ceri-Ann Jones-Mathias, who also works as a GPN in Barry, agreed. She said the situation around pay and terms and conditions ‘makes you feel super undervalued’.
‘General practices nurses work independently, we’re super accountable for what we do and are really skilled,’ she said.
‘[But] it feels like you almost get punished for leaving the NHS and that the government doesn’t really care about us.’
Meanwhile, Emma Tanner, a GPN in Western Vale, was given what she described an ‘at risk’ pay increase for 2023-24 in line with Agenda for Change.
Her practice was not reimbursed or given any additional funding for services provided in the practice, but she said all staff had decided to take ‘unpaid annual leave’ to ‘make the business viable’.
It was her view that GPNs needed ‘something mirroring’ Agenda for Change contracts, to help standardise pay and conditions for practice staff.