NHSE sets out instructions for trusts on Band 5 nurse role review

NHS trusts are required to submit a delivery plan for evaluating Band 5 nurse roles by 31 July, a letter from NHS England has instructed.

Plans should be ‘realistic and deliverable’ and set out how all Agenda for Change Band 5 nursing roles will be reviewed by October 2028, it said.

The letter published on Tuesday sets out how the employer-led review of all Band 5 NHS nurse roles – promised by the government earlier this year – should proceed, and how trusts will be expected to report and evidence progress.

The review is only applicable to Band 5 nurses employed directly by NHS trusts under Agenda for Change – meaning general practice nurses are largely excluded.

However, the Royal College of Nursing (RCN), which has been among the unions working with the government on the review plans, said recently that it hopes to see the outcomes mirrored across ‘the whole of nursing’.

Signed by chief nursing officer (CNO) for England, Duncan Burton, the letter reiterates how the government has committed to a ‘fairer deal for nursing, including ensuring nurses are paid correctly for the work they are asked to do’. This includes an employer-led review of Band 5 nursing roles at NHS trusts, building on existing job evaluation commitments agreed through the Agenda for Change (AfC) non-pay deal.

Related Article: Nursing in Practice takes general practice nurse pay concerns to Parliament

The letter sets out that all organisations ‘will be required to submit a nursing Band 5 job evaluation delivery plan by 31 July 2026 to their region for review’.

‘These plans should be realistic and deliverable, and set out how all Agenda for Change Band 5 nursing roles will be reviewed by October 2028, using the template and submission arrangements that will be shared by regional teams,’ it said.

The move has been sparked by updated national nursing and midwifery job profiles published by the NHS Staff Council in June 2025. Evidence gathered by the council suggested that implementation had been ‘variable’, the letter said, and informed the government’s decision to review all Band 5 nursing roles.

NHS England acknowledged that ‘reviewing the roles of a large proportion of the nursing workforce is a significant undertaking’.

‘It will require co-ordinated board-level leadership across chief nursing officers (CNO), chief people officers (CPO) and chief finance officers (CFO),’ the letter continued.

‘It must also be delivered in partnership with recognised trade unions and be underpinned and informed by robust engagement with nursing staff themselves.’

NHS trusts are asked to review, in partnership with local trade union representatives, their present position in relation to latest guidance from the NHS Staff Council on the job evaluation, and progress with this work.

In cases where Band 5 roles have already been reviewed, NHS England said organisations will still be expected to complete the relevant sections of the delivery plan.

‘This should set out how those reviews were undertaken, including how staff and recognised trade unions were engaged, how national job evaluation guidance was applied, and how postholders were able to confirm that their job description accurately reflected the work they were asked to do,’ the letter said.

Related Article: NMC unveils ‘anti-racism’ principles for nursing practice and education

‘Where this cannot be demonstrated, organisations should take corrective action through established local job evaluation and partnership processes.’

To ensure this work is completed within the national timelines, NHS boards have been asked to ensure their organisation has:

• a robust, realistic and deliverable plan to deliver this work
• effective partnership working arrangements to support implementation
• plans for engaging Band 5 nursing staff, including how postholders will be able to confirm whether their job description accurately reflects the work they are asked to do
• suitable arrangements to enable local oversight that include appropriate review of workforce and demographic data to support fairness, consistency, equality and non-discrimination in the application of job evaluation processes
• mechanisms to review progress, including through the board or an appropriate board committee

NHS England stressed that further details, including supporting materials for trusts and webinar arrangements, would ‘follow shortly’.

‘This programme is essential to ensuring fair and consistent application of Agenda for Change for Band 5 nurses, and to delivering on our commitments to nursing staff,’ the letter said.

Speaking during a keynote address at our Nursing in Practice London event at the end of April, RCN chief executive and general secretary Professor Nicola Ranger said she hopes the same principles used to improve pay for Agenda for Change 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’.

Related Article: More than half of GPNs report working while feeling mentally unwell, finds survey

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

When the move was first announced in February, it sparked disappointment among primary care nurses who warned an ‘essential’ part of the nursing workforce had been excluded, and that doing so could damage recruitment and retention efforts in general practice.