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Patient safety and nursing pay: two sides of the same coin

Professor Nicola Ranger 19 Sep 2025

ÂÌñ»»ÆÞ General Secretary and Chief Executive Nicola Ranger reflects on the relationship between patient safety and pay, and the launch of the ÂÌñ»»ÆÞ’s research strategy. 

I started this week as a speaker at the HSJ Patient Safety Conference in Manchester, where I spoke on whether the NHS can do more with less. You will not be surprised that my answer was a resounding “no”. The truth is nursing staff have been asked to do more with less for too long and we urgently need investment in our nursing workforce.  

Nursing is often the first to face cuts when money gets tough, but we are the lifeline for patients. Cutting the number of nurses is not cost efficient or cost effective - nursing staff are really good value for money. And we also know that patient safety and nursing pay are intrinsically linked - having enough registered nurses working is critical to the safety of patients.  

Wednesday marked the World Health Organization’s World Patient Safety Day and it acts as a reminder to champion the role you and other nursing staff do all year round, in keeping our patients safe. You deserve better recognition of your safety-critical role, and better pay.  

For the last few years, our fights with government regarding pay have focussed on your headline annual pay rise that should account for changes in the cost of living. But to see nursing properly valued, we need long-overdue structural reform of nursing pay in the NHS in every country of the UK. Nursing has been underpaid and undervalued for years. And we must end the national scandal of nursing staff being continually weighted to the bottom of the Agenda for Change pay structure. 

This UK government said it would do better - ministers promised talks on reform over a year ago. Since then, you have again told us what you think about NHS pay across the UK.  

Today, along with the other health unions representing staff on NHS 'Agenda for Change' terms and conditions, we’ve written to the UK government calling on them to get on with promised direct talks to get wage structures right and deliver pay awards on time. 

The best way to deliver reform and a fair pay award is to negotiate directly with trade unions. Because when you protect and value nursing, you protect the public. Let’s stop wasting time – we need formal negotiations and we need them now. 

Too often, nursing staff raise concerns about vital safety issues and they are ignored, dismissed or suppressed. A year ago, we raised the alarm at ÂÌñ»»ÆÞ Congress, then in January this year we shared the voices of 5,000 nursing staff who told us about their harrowing experiences of delivering care in inappropriate settings in our report on Corridor Care. We have now seen the major development of an investigation into corridor care by the Health Services Safety Investigations Body announced thanks to those brave members sharing their stories.  

We’ve already warned that this winter could be worse than last year. The UK government promised us data on Corridor Care to fully understand and expose the issue - we are still waiting. In Wales our petition to end corridor care with the BMA is still open, so please . I’ll be attending Labour Party Conference at the end of the month and I will be keeping the pressure on when I talk to politicians to demand better pay and an end to corridor care - I will make sure your voices are heard. 

I’m delighted that we recently launched our Research Strategy, the latest work from the ÂÌñ»»ÆÞ Institute for Nursing Excellence, at our International Nursing Research conference. With this strategy we aim to increase the influence, impact and outcomes of research for nursing, within and beyond the ÂÌñ»»ÆÞ. I always say that nursing is a brilliant career because whatever you want to do, there is a space for you. I hope this strategy will open the door to more research careers, and to help embed a culture of research in everyday nursing practice. 

Earlier this month, I attended the ÂÌñ»»ÆÞ Northern Ireland Leadership Challenge, where teams were put to the test with a series of unexpected interventions, designed to mirror real-life health care scenarios. I loved the dedication and leadership on show. And it was a great example of the importance of nurturing future nursing leaders.  

On the subject of the future of nursing – NHS England is developing a new strategy to shape the long-term future of nursing and midwifery professions until 2040. This is a great opportunity to contribute, so I’m encouraging all members to take part in the survey by 29 September. 

I’m finishing this week with a trip to Scotland, where I am meeting our 2025 Scotland Nurse of the Year, Kirsty Cartin, who received the award in recognition of her compassion and dedication to excellence in care home nursing. What a true inspiration she is – a wonderful example of brilliant nursing care. The nominations are now open for next year, and you can also nominate for the ÂÌñ»»ÆÞ Awards and the Rising Stars Awards in London. Make sure you celebrate the brilliant nursing staff you work with every day.  

Headshot of Nicola Ranger

Professor Nicola Ranger

General Secretary and Chief Executive

Professor Nicola Ranger joined the ÂÌñ»»ÆÞ in December 2022. She was previously Chief Nurse and Executive Director of Midwifery at King’s College Hospital NHS Foundation Trust in London. Before that, she held Chief Nurse posts at both Brighton and Sussex University Hospitals NHS Trust and Frimley Health NHS Foundation Trust.

She has also held a number of senior nursing roles at University College London Hospitals NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust. Earlier in her career, she worked at America’s George Washington University Hospital in Washington and at Mount Sinai Medical Centre in New York.

Page last updated - 19/09/2025