NHS Band 5 role review must be mirrored across ‘whole of nursing’

The government’s work to review the roles and pay of Band 5 NHS nurses on Agenda for Change (AfC) must be mirrored across ‘the whole of nursing’, the chief executive and general secretary of Royal College of Nursing (RCN) has said.

Professor Nicola Ranger recognised that while general practice nurses (GPNs) are largely excluded from the review scheme, the RCN has made it ‘absolutely clear’ to ministers that the issue of pay bands and career progression must be looked at in all nurse settings.

The government announced in February that NHS nurses on AfC contracts would receive a ‘career boost’ under plans agreed with health unions that include increased graduate nurse pay and a review of Band 5 nurse roles.

However, as a recent Nursing in Practice report shows, only 11% of nurses working in general practice are on AfC, meaning the move will not be applicable to most of those in GP practices.

Speaking during a keynote address at our Nursing in Practice London event last week, Professor Ranger said she hopes the same principles used to improve pay for AfC nurses during this review will be the same for those working in general practice.

‘What we need is everyone uplifted,’ said Professor Ranger.

She explained how nurses are ‘weighted to the bottom’ of pay scales – highlighting data which suggests nurses are the ‘most amount of Band 5s and least amount of Band 6, 7, 8 and 9s’.

‘[Nurses are] the only ones that will start their career as a Band 5 and retire as a Band 5.

‘I’ve met neonatal nurses with 20 years’ experience, who is still a Band 5. It is a disgrace.’

She said she was therefore pleased that this new scheme to review Band 5 AfC nurse roles had been agreed with the government, and vowed to ‘fight for every single nurse in AfC at Band 5 to be at a Band 6’.

The RCN’s goal is to have nurses move from Band 5 to 6 after a period of consolidated learning and experience, and then for additionality – such as a GPN or A&E qualification – to be at a Band 7.

Professor Ranger recognised the challenges of many GPNs being excluded from AfC and therefore this review scheme.

Speaking to a room of GPNs she said: ‘I know that that we can’t fight for that in the same way, because [GPNs are] not part of Agenda for Change, but the principles will be the same.

‘We’ve made absolutely clear to this government that the whole of nursing needs to mirror what we’re fighting for, for Agenda for Change, because actually, the profession needs to consolidate at a 5, sit at a 6, and additionality at a 7.’

Professor Ranger’s address followed the launch of Nursing in Practice’s new General practice nurse pay: A salary survey of the profession 2026 report – which revealed that practice nurses are earning thousands of pounds less than those in secondary care on AfC terms.

Based on a survey of almost 900 nurses across general practice, the analysis explores basic pay and salaries, annual pay uplifts, pensions, employment benefits, the additional roles reimbursement scheme and more.

Professor Ranger said: ‘I’m absolutely delighted with the survey that Nursing in Practice did – and we hear it at the RCN, that particularly our GPNs and our community nurses and independent nurses, you are not being paid your worth and your value.

‘I know you’re not on AfC and I think the terms and conditions around AfC are second to none… which is not afforded to you in GP practice.’

She said this issue would ‘hold back’ the government’s plans to shift care from hospital and into community and GP practices.

‘Pay is a really significant issue,’ added Professor Ranger.

Continue your learning by registering for our upcoming Nursing in Practice Virtual event on 4 June where the theme is Respiratory and Women’s Health, tailored for nursing professionals looking for practical, CPD-accredited learning and expert-led sessions to support high-quality patient care.

NHS Band 5 role review must be mirrored across ‘whole of nursing’

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