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Northern Ireland nurse crisis branded 'public safety issue'


Nurse shortages in Northern Ireland are now a “public safety issue”, Royal College of Nursing leaders in the country have warned, as they also seek to ramp up pressure for better pay with a potental ballot on industrial action.

They have agreed to embark on an 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.

”We are very aware of the frustrations facing health and social care staff”

Department of Health spokesman 

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 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 RCN and other trade unions have entered into fresh discussions with government officials and employers for Agenda for Change pay and conditions deliberations for 2019-20. 

A spokesman for the Northern Irish Department of Health said: ”We are very aware of the frustrations and workload pressures facing health and social care staff.

“Health and social care pay policy is a devolved issue,” he added. “We have made clear that UK-wide pay parity in health and social care would involve significant budgetary and pay policy issues that would require ministerial and cross-departmental decisions.

“The department continues to face well documented budgetary pressures and cannot spend money it does not have,” the spokesman said. 

He noted that the department had increased the number of pre-registration nursing and midwifery student places from 710 in 2015-16 to 1,025 this financial year. 

An additional £2.5m had also been invested in 2018-19 in post-registration education and training for nurses and midwives, the spokesman added. 




Readers' comments (4)

  • Yet hundreds of wishful nursing students apply each year and are turned away! Iv been through this process and know the numbers of hopeful students turned away far out-way the number of places trained each year! There is clearly a huge demand for more nurses surly the numbers they train each year should be massively increased!

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  • Anonymous 14.05; you still have to meet the requirements . Applying isn'y enough you have to meet the academic and other requirements as you do with other professions. There are avenues to receive the required support to do this.

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  • Of course I totally agree! However there are so many that do meet these requirements but there isn’t enough places in the universities in Northern Ireland to take them on.

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  • I don't know about the other fields, but in Mental Health there is already a shortage of clinical experience placements and availability of mentors. There is no point in accepting more students if there aren't enough useful learning places available.

    We need to look at ways of reducing burnout and retaining experienced staff

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