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Exclusive: Nine in 10 practice nurses want standardised contracts



The overwhelming majority of practice nurses want nationally standardised contracts, with many frustrated they have lower terms and conditions than NHS colleagues, a survey has found.

The Nursing in Practice poll of 210 nurses, ANPs and nurse practitioners revealed 93% think their contracts should be standardised. Many want their hourly pay, sick pay, maternity pay and holiday pay to match NHS colleagues on Agenda for Change (AfC) contracts.

The survey, which ran between 27 August and 3 September, revealed 34% do not get occupational sick pay – and must survive on statutory sick pay of just £96.35 a week if ill or self-isolating because of Covid-19 – while 53% do not get maternity pay.

Practices ‘can get away with paying the bare minimum’ because contracts are not standardised, a GPN based in the East Midlands argued. Another in the North West echoed: ‘Some GPs do not value GPNs and you are at the mercy of that.’

A GPN in the South West deemed it ‘totally unfair’ that her annual leave and sick pay entitlement is ‘less than hospital colleagues’. Another in the East Midlands agreed: ‘If nurses can be added to AfC terms and conditions then we would be happy.’ 

The median hourly rate was £18.44 for the 164 GPNs who answered the question, with a low of £13 and high of £24. Of 25 nurse practitioner and ANPs, median hourly pay was £23, ranging from £18.60 to £50. And only 8% of respondents said their pay matched AfC.  

Many felt undervalued, with one GPN in the East of England saying pay, terms and conditions were ‘awful, low and do not reflect the work we do’. Another in the South West asid: ‘Underpaid for what we do and how much is expected from us.’

Nurses also argued their poor pay, terms and conditions has left practices struggling with recruitment and retention as they cannot compete with secondary care or other careers.

One GPN based in the West Midlands said: ’NHS terms and conditions are needed to prevent issues with recruitment.’ Another in the North West argued the sector is ‘not able to  attract new staff’ because of poor pay, terms and conditions.

The survey also found seven in ten had not been awarded a bonus this year. Bonuses ranged from £100 to £900, while others were given as an hourly rate rise (between 20p and £3 extra an hour). And three-quarters said their bonuses were discretionary, not annual.

For those who had them, annual leave entitlements ranged widely, from just 22 days to 41 days. Maternity pay guaranteed anything in between 6 weeks and 12 weeks full pay.

Annual salary increments were only included in the contracts of 6% of nurses, and just 13% of respondents said their practice paid their £120 NMC annual registration fee for them. This fee must be paid to maintain professional registration and be allowed to practice.        

Practice nurse contracts are made with the employing GP, meaning pay, terms and conditions can be highly variable between practices and even within practices. In contrast, all non-medical NHS staff are on nationally standardised AfC contracts.

Nurses on AfC contracts receive 35 days holiday a year for first 5 years, 37 days after 5 years’ service and 41 days after 10 years’ service. For maternity leave, they get 8 weeks full pay and 18 weeks half pay. They also have pay progression built into their contracts.      

Last year, Nursing in Practice revealed some GPNs have said they feel ‘undervalued’ after not receiving full pay when self-isolating because of Covid-19.

RCN professional lead for primary care Heather Randle said: ‘If general practice it to retain the nurses it has, as well as attracting newly qualified nurses into the profession, then they must have fair pay, good terms and conditions and the opportunity for career progression.

‘Nursing staff working in General Practice are often the first point of contact patients have with the NHS and it is vital that they feel valued and receive equitable terms and conditions to their NHS colleagues.’