Expert advice

NHS industrial action ballot: what nurses need to know

With nurses voting on taking action, read our guide to the rules of the ballot and what it could mean for pay and patients

With nurses voting on taking action, read our guide to the rules of the ballot and what it could mean for pay and patients

Fury over this year’s ‘pitiful and insulting’ pay offers for NHS staff on Agenda for Change (AfC) contracts is putting nursing staff on a collision course with governments.

The RCN is

With nurses voting on taking action, read our guide to the rules of the ballot and what it could mean for pay and patients

Picture: iStock

Fury over this year’s ‘pitiful and insulting’ pay offers for NHS staff on Agenda for Change (AfC) contracts is putting nursing staff on a collision course with governments.

The RCN is balloting its NHS members in England and Wales on taking strike action. The postal vote opened on 6 October and runs until 12 noon on 2 November. Ballot papers were posted to members by first class post on 6 October. Naturally, many nurses will be asking themselves what this might mean for them and their patients. Here, an RCN spokesperson explores some of the issues facing nurses, and the regulator explains its position on nurses who take industrial action.

What are the different types of industrial action?

Industrial action can take two forms:

  • Action short of strike – There is no definition of this, but generally it means ‘working to rule’ – keeping strictly to the terms of your contract of employment. This can include taking all of your contractual breaks, starting and finishing your shifts strictly on time and not taking paid or unpaid overtime.
  • Strike action – This is a complete withdrawal of labour. It could be for half a day, a day or even longer, depending on the dispute. Strike action will almost certainly result in disruption to an employer’s business and place greater pressure on an employer to reconsider its position in any industrial dispute.

Unlike workers in many other sectors, during a strike some nursing staff continue their work, to ensure patients are safe. This is negotiated carefully with employers.

A way of maintaining safe staffing levels is through derogations, where certain staff have an exemption from taking part in industrial action. During the 2019 strike in Northern Ireland, derogation was used to ensure safe staffing was maintained in, for example, intensive care units.

Nursing staff in other countries have achieved significant wins by striking while also maintaining a safe level of staffing.

Who can take part in ballots and any strike action that may follow?

The RCN is only allowed to ballot its members and only those eligible to vote. In this case, that is members working for the NHS on AfC terms and conditions.

There are strict rules governing strikes. Unions must declare a dispute between workers and their employer, and then conduct a ballot of members.

There are important legal thresholds for voter turnout in England, Scotland and Wales. Industrial action ballots must achieve at least a 50% turnout and a majority of that number must vote in favour of industrial action for that action to be lawful.

In England and Scotland, where balloted workers are delivering ‘important public services’, the number in favour of industrial action must be at least 40% of all those eligible to vote.

Can nursing staff join the RCN if they want to vote in the forthcoming ballot and are not already members?

If you are not a member of the RCN but want to join and vote in this ballot as an NHS employee working on AfC, we encourage you to take up membership as soon as possible. New joiners are entitled to cast a vote.

The law says this ballot must take place by postal vote and be overseen by an independent scrutineer. This means existing RCN members must make sure we have their up-to-date postal address and employer on our MyRCN system.

Can I be sacked for taking part in industrial action?

An employer might consider taking disciplinary action against a member of staff for participating in industrial action and, unfortunately, there is an absence of protection against such victimisation.

However, most employers recognise that taking disciplinary action would be counterproductive. It would be difficult for an employer to initiate disciplinary proceedings against large numbers of staff.

The RCN can offer some financial assistance during strike action
Picture: iStock

What will happen to my pay if I strike?

If a member strikes – deliberately withdrawing their labour – their employer is not obliged to pay them for the period when they did not work.

The courts have decided that when the employer is determining how much pay to withhold because of strike action, the correct test is to consider what pay the member would have received had they been at work.

Will unions offer financial assistance in the event of strikes?

The RCN has a strike benefit policy that provides a discretionary daily payment to eligible members. RCN members who participate in strike action and lose pay are entitled to £50 per day.

Members will be entitled to this benefit after they have participated in two complete strike days. This benefit is not intended to replace daily earnings but is a contribution, to reduce the impact of lost pay, and the fund has been boosted by £15 million, now standing at £50 million.

What is on offer in this year’s pay deals?

This year’s NHS pay offers are highly complex and each nation is at a different stage of the process. We have a Q&A to help you navigate the issues, plus the latest from around the UK:

Could I be struck off or face fitness to practise proceedings for taking part in industrial action?

Patient safety is maintained during any strike action Picture: iStock

Nursing and Midwifery Council executive director of professional practice Geraldine Walters says: ‘Taking part in industrial action is not a sole basis for a fitness to practise referral.

‘However, you should remember that our Code and standards always apply. This means that we expect that people will abide by the Code and behave in a way that promotes professionalism and trust at all times, and that during a period of strike action, nurses will engage with colleagues and employers to make plans to keep people safe.’

RCN members in Northern Ireland went on strike over pay in 2019-20 – did they get what they wanted?

In December 2019 and January 2020, RCN members in Northern Ireland voted to take industrial action, including strike action, over pay parity with the rest of the UK and the need for urgent measures to promote safe staffing.

As a result, the Northern Ireland Executive agreed in January 2020 to the immediate restoration of pay parity and published a framework for safe nurse staffing, which is being implemented. RCN members voted to approve these measures and the industrial action was suspended.


Further information

This article was first published on 5 August and updated on 10 October 2022

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