Northern Ireland nurse crisis branded ‘public safety issue’

They have agreed to embark on awareness raising roadshow to inform the public about the nurse workforce and pay “crisis”.

“Staffing shortages are affecting their ability to provide safe and effective care”

Janice Smyth

Support will also be sought for a campaign to secure safe staffing legislation once the current political turmoil facing the country is hopefully over.

In addition, RCN leaders in the country have also gained approval to ballot union members on strike over pay and conditions.

The health service in Northern Ireland has a 11.6% registered nurse vacancy rate, equating to 2,103 empty posts, as well as a shortage of 421 nursing assistants. 

The cost of employing nurses via agencies has increased from £10m in 2012-13 to £32m in 2017-18.

Janice Smyth, director of RCN Northern Ireland, said: “The RCN believes that the shortage of nursing staff has become a matter of public interest and a public safety issue, as nurses are raising their concerns that staffing shortages are affecting their ability to provide safe and effective care for patients.

“It is time to explain to the people of Northern Ireland why nursing services are now at crisis point, how this situation has developed, and seek their support for the measures that the RCN believes are necessary to resolve this crisis,” she added. 

The RCN council gave the green light for the industrial action ballot during its meeting on Wednesday.

The report that went before the council written by Ms Smyth and RCN Northern Ireland interim associate director Francis Rice laid bare the “concerning” state of nursing staffing in the country.

It revealed that the real value of a nurse’s salary declined by 15.3% between 2011-12 and 2017-18.

Northern Ireland has been without stable leadership since January 2017 when the devolved government collapsed. Day to day matters are being deal with by Northern Irish civil servants.

“The RCN has been raising Agenda for Change banding of nurse posts as an equality issue”


In February, a pay uplift was imposed by the Department of Health for nurses on the Agenda for Change scheme for 2018/19 without agreement with the trade unions.

According to the report, this resulted in 780 members of staff losing money because the deal pushed them into a higher pension bracket meaning they owed more in contributions than they received in pay arrears.

However, last month it was confirmed that 2% of pension band review calculations were inaccurate due to “human error”, affecting 1,120 staff. Of those, 684 had underpaid pension contributions and 436 overpaid.

“The RCN has been contacted by a number of members who found themselves in this situation,” said the report.

Under the current political circumstances, the budget for Northern Ireland is agreed annually and the report said this had an “adverse impact” on the possibility of a three-year pay deal being agreed like it had in other UK countries. 

Meanwhile, the document stated that the pay gap between nurses in Northern Ireland and the other countries in the UK “continues to grow”.

For example, a nurse on the lowest salary in band 5 earns £22,795 in Northern Ireland compared to £24,214 in England and Wales, and £24,670 in Scotland.

Janice Smyth

Janice Smyth

Janice Smyth

The report also noted how there was a higher percentage of registered nurses at band 5 than any of the other groups of healthcare staff excluding ambulance employees.

A promised review of the Agenda for Change scheme following its implementation in Northern Ireland in 2004 had never taken place, the report added.

“The RCN has been raising Agenda for Change banding of nurse posts as an equality issue,” it added.

Meanwhile, one in six of the Northern Ireland population is on an outpatient or inpatient waiting list. In England, the figure is one in 14.

Accident and emergency departments in Northern Ireland have the longest waiting times of any part of the UK.

The RCN and other trade unions entered into fresh discussions with government officials and employers in March, but progress has yet to be made, noted the document.

The public engagement events will take place throughout May.

RCN Northern Ireland will inform the public and members about the current situation in regard to nurse vacancies, sickness absence rates, increasing agency costs and the affect on patient care.

It will discuss what actions are required to address the problems, including a call for legislation for safe nurse staffing when political stability is secured.

A safe staffing law has been introduced in Wales and is currently being considered in Scotland. The RCN is lobbying for legislation in England. 

The Northern Irish Department of Health has been approached by Nursing Times for comment on the developments.