RCN will not let advanced practice nursing be ‘undervalued and diminished’

The chief executive and general secretary of the Royal College of Nursing (RCN) has vowed to ensure that advanced practice nursing is not ‘undervalued and diminished’ amid concerns raised around doctor substitution.

Professor Nicola Ranger used a keynote address at Nursing in Practice London event last week to express her disappointment in what she described as an ‘attack’ by the British Medical Association (BMA) on nurses.

Her comments come as the BMA has been seeking views from its members on concerns around what it says is ‘unhelpful and inappropriate blurring of the distinction between doctors and non-medically qualified staff’.

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And last week, the BMA claimed almost half of hospital trusts and boards in the UK are ‘using non-doctors to fill doctors’ roles’. It said that while advanced practitioners, including advanced practice nurses, ‘play an important role in looking after patients in the NHS’, employers were using these roles ‘beyond their level of training, moving them away from their areas of proficiency and into roles only doctors are qualified for’.

When the BMA first starting airing concerns around substitution and advanced practitioners working outside their competency earlier this year, the RCN and the Nursing and Midwifery Council (NMC) both issued statements reiterating that advanced nurse practitioners were not a substitute for medical practitioners but an autonomous and vital role.

Speaking on Thursday last week, Professor Ranger stressed once again that nurses were ‘not trying to substitute doctors’.

She said the RCN will not ‘stand back’ and have the profession ‘undervalued’ by medical colleagues.

‘I’m incredibly disappointed that in striving to sort out their challenges, the BMA have chosen to attack nurses – it’s a disgrace,’ she said.

‘You do not have to elevate and sort out your profession by picking on and devaluating another profession.’

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Professor Ranger explained that advanced nursing practice had been in place for decades, adding that she was ‘one of the first nurse consultants in the country’.

‘We are not trying to substitute doctors. We are not trying to take away learning from resident doctors, but we will be really, really clear, we will not stand by and let our medical colleagues devalue nursing in advanced practice,’ she said.

‘We didn’t start this fight. We think it’s the wrong thing to do. But let me be clear, the RCN will not stand back and have our profession undervalued and diminished.’

The Nursing in Practice London event also saw the launch of Nursing in Practice’s new General practice nurse pay: A salary survey of the profession 2026 report was launched – of which Professor Ranger welcomed as an important publication.

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The report – unveiled ahead of Professor’s Ranger keynote – revealed that practice nurses are earning thousands of pounds less than those in secondary care on Agenda for Change (AfC) terms.

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