The Agenda for Change pay framework should be adapted so nurses who “demonstrate a commitment to patient care” are paid more than others, under recommendations made by Robert Francis QC.
His landmark report from the Mid Staffordshire Foundation Trust public inquiry suggested nurses should be rewarded and “incentivised” for showing the right skills, such as compassion and good care.
Mr Francis said that as well as showing a commitment to patient care nurses who also recognised the priority that dignity and respect of patients deserved could be rewarded under the existing Agenda for Change pay framework.
This could also include nurses who seek training to develop their leadership skills.
The report concludes: “The leadership required for the delivery of excellent nursing care should be recognised and incentivised in the remuneration structure by a more explicit reference to the delivery of excellent care, and by use of professionally formulated and accepted performance measures.”
He said more effort was needed to promote professional development within nursing and recommended the knowledge and skills framework could be amended to reflect the skills nurses should show and be used to reward those who meet standards.
Mr Francis suggests in his report that this could be done when nurses reach the gateways in their pay bands under the Agenda for Change framework.
He accepted the KSF had seen “variable take-up” across the NHS and while good patient care and developing skills were “implicit” in the framework he said “neither necessary characteristics are explicitly headlined or highlighted specifically for every nursing post.”
The report said: “In Stafford, wards that were well led generally provided an acceptable standard of care. The terrible experiences of which the various inquiries received so much evidence came largely from wards lacking in strong, principled and caring leadership.”
Prime minister David Cameron welcomed the idea of performance related pay in his speech to the Commons responding to the report.
He said: “Another issue is whether pay should be linked to quality of care, rather than just time served at a hospital.
“I favour this approach,” he said.
But Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “I want to see the details…what does it mean?
“We’ve got the kind of headline, but now we’ve got to wait and see how it drills down. It will be interesting to get the detail on that,” he told Nursing Times.