This site is intended for health professionals only

Read the latest issue online
Climbing the leadership ladder

How to negotiate better pay

Many nurses have not seen their financial or non-financial rewards increase for some time.

Many nurses have not seen their financial or non-financial rewards increase for some time.

Whatever candidates might state at a job interview, pay and rewards are some of the most important factors to join an organisation, but it is doubtful that most nurses would know about a practice’s pay and benefits structure, or any process for the grading of roles, pay progression or rewards for development.

In a very small practice, it may be asking too much to insist on all of these things, but the larger partnerships and super-partnerships should consider setting up proper reward management processes. However, we must also consider the constraints faced by many GP employers, so it is important in any negotiation to recognise that the hands of the practice manager and partners may be tied by having to provide increased services against static budgets.

Opening a discussion

Sometimes nurses are told that they cannot discuss pay and conditions in appraisal meetings, and that these meetings should concentrate only on training and skills. In that case, you should organise a separate meeting to talk about pay and conditions.

While it is important for the practice to recognise the value provided by nursing staff, it is also important for you to recognise the position the organisation is in. Approach discussions by promoting the value you bring, and show an understanding of commercial pressures. This presupposes that the practice is interested in investing in its personnel. It must be said that there are surgeries that, unfortunately, have no interest in such an investment.

Assuming there is, it is important to show you are helping to achieve the organisation’s short-term, medium-term and long-term objectives. Most people would accept that this can be far better done if employees are well motivated, recognised, skilled and rewarded.

Here are some suggestions to make your case well:

  • Understand the objectives of the surgery at every level – the surgery, the nursing team and any other levels.
  • Consider how your job has been graded.
  • Research pay levels in other surgeries, both locally and across an area that is commutable (perhaps the county).
  • Research the other rewards in other local surgeries, for example, bonuses or incentives. If there aren’t any, consider suggesting them.
  • Find out whether there are other types of pay in local surgeries, in particular, for certain skills or competencies.
  • Consider local market rates against supply and demand. Currently, nurses are in short supply in many areas, and you might be able to increase your salary on this basis, or point out that you might move elsewhere for better pay. However, this can often leave a bitter taste, so it is best handled carefully. Don’t make any threats lightly. 
  • Be prepared to negotiate some of these areas. Perhaps you can link pay to making a certain type of contribution, or if certain qualifications are gained.
  • Look at novel ways of increasing pay by demonstrating productivity. In many organisations, it is possible to achieve bonuses if there is no, or very low absence, either as an individual or a team. Sick pay, particularly in a practice, can be both directly and indirectly expensive, and a reduction in the staff budget could be something that the practice might introduce rewards for.
  • Talk about non-financial rewards, such as training opportunities. These can often cost the practice less than a salary rise, but can develop an individual significantly.
  • Talk about opportunities available for progression within the organisation (which can lead to discussions about pay), appraisal systems (particularly if flawed), the pay review and reward procedure (especially if it is unclear, or apparently lacking in fairness or transparency). Ask exactly how pay progression and performance management work in the organisation.

Overall, if you can demonstrate that you are supporting the business strategy, it should be possible for all parties to benefit.