Fair pay, safe staffing and support during COVID-19: priorities for nursing in 2021

The RCN general secretary on being an advocate for nursing in its most difficult year to date

The RCN general secretary on being an advocate for nursing in its most difficult year to date

  • The COVID-19 pandemic has put nursing in the spotlight like never before, says RCN general secretary Dame Donna Kinnair, with nurses ‘stepping up to the plate’ to deliver care
  • Nursing has more than proven it is a safety critical profession, so it’s time nurse pay reflected this
  • Professor Kinnair outlines RCN priorities for 2021, including supporting members through the pandemic and continuing the fight for fair pay and safe staffing
RCN general secretary Dame Donna Kinnair
RCN general secretary Dame Donna Kinnair Picture: Justine Desmond

For Dame Donna Kinnair, if there has been one good thing to come out of 2020, it’s that she no longer has to explain to people what nursing actually is.

‘It’s been a year that’s highlighted the best about our nursing role,’ she says.

COVID-19 has shown what nurses do

‘Nobody is asking me what nurses do now – it’s there for everyone to see, and I think that’s one really positive thing. We’ve been in the spotlight and the best of nursing has been shown.

‘And yes, it’s been fraught with difficulties; I guess nobody could have expected COVID-19 to come over the horizon. But this year has shown that we have stepped up to the plate.’

As RCN general secretary, Professor Kinnair has always been an advocate for nursing and nurses. But in 2020 this responsibility has been tested like never before.

Inadequate pay, sickness and unsafe working conditions

‘There have been a huge number of difficulties,’ she says, citing access to personal protective equipment (PPE), ensuring the right guidelines were in place, and making sure that staff were paid properly when they were off sick or self-isolating.

‘Some of our functions in employment relations have had to come to the fore to protect our members, so it’s been an all-round busy year – but I think it shows what our college and trade union can do.’

She has, she says, been hugely proud of everything that nursing has achieved in 2020. Some of it she witnessed herself, working shifts in London’s NHS Nightingale Hospital.

‘I can’t help but be moved by so many stories I heard and saw about nurses going the extra mile to deliver care to their patients,’ she says.

On the front line at NHS Nightingale

Professor Kinnair describes standing by a patient as he came out of a coma.

‘The first thing he asked me and the doctor that were attending him was for an iPad so he could speak to his wife. It was nurses who did that – they sought to give iPads to patients in hospitals so they could still see their families, because contact was really important.

‘That was a proud moment for me because it demonstrated that although we lost so many people in the Nightingale, it is always a highlight when you give the care and somebody makes it through.’

One of the most difficult things about the pandemic has been the number of nurses and other healthcare staff who died after contracting the virus.

To date, almost 100 members of the UK nursing family have died with COVID-19.

‘My heart goes out to every single family that has lost a nurse,’ she says.

‘It demonstrates the dedication that nurses have shown as they have literally put their lives on the line, and sadly some have lost their lives to deliver safe care to patients.

‘Those individuals were representative of the professionalism that has been demonstrated by all nursing staff during this pandemic.’

Other healthcare services are yet to recover

COVID-19 has also had an indirect impact on others, Professor Kinnair says – and for everyone’s sake, she hopes that healthcare services can return to some sort of normality soon.

‘Many families will have suffered this year and we need to think about maintaining other services in the NHS, such as cancer services. I’d like to see these things start to pick up as soon as possible.

‘Members of my own family have been diagnosed with conditions in the middle of this and we would like to see them, and others like them, getting decent treatment.’

‘Nurses need resources, time and encouragement to put themselves first. We’ve seen them struggle to take the necessary time off to get well – even when they have had COVID’

Dame Donna Kinnair, RCN general secretary

Action is also needed to support the nursing workforce as a whole because it has been a difficult year both physically and mentally, she adds.

‘There’s a huge amount of work to do to make sure that the trauma from having been through this year – the number of deaths and the level of sickness that nurses have witnessed – is addressed,’ she says.

Nurses will need time to heal after trauma

‘We have had some good wins in terms of getting support, but the trauma is still there. In our own recent surveys, 36% of nurses say they are thinking of leaving the profession.

‘Nurses need resources, time and encouragement to put themselves first. We’ve seen them struggle to take the necessary time off to get well – even when they have had COVID.

‘We need to continue to give support for burnout and all those things that are coming over the horizon for us.’

In that same survey of RCN members, 15,047 nurses said they were thinking of leaving the profession – and 61% of these said it was due to pay.

RCN students committee chair Jessica Sainsbury
RCN students committee chair Jessica Sainsbury in the RCN Fair Pay for Nursing Campaign film

The RCN has called for all UK nursing staff to receive a 12.5% pay rise in the next pay round, and fair pay will continue to be high on the agenda for the RCN throughout 2021.

Nurses will have to wait until at least late spring to find out what sort of pay rise they can expect.

In December, health and social care secretary Matt Hancock wrote to the NHS Pay Review Body, which advises the government on pay for Agenda for Change staff employed in the NHS, to set out timescales for the 2021-22 pay round.

He asked the body to report back by May. Unions had previously called for an early and significant pay rise for NHS staff to be implemented before the end of 2020 amid the COVID-19 pandemic.

‘Without our profession we wouldn’t have steered our way through the pandemic,’ Professor Kinnair says.

‘But fair pay isn’t about the response to the pandemic. It is about recognising the complexity of the skill, the responsibility – which all members of the profession have displayed throughout the pandemic.

‘Without fair pay we haven’t been able to recruit the numbers of staff that we needed. We went into this pandemic with a 50,000 shortage across the UK.

‘It’s time to say that we are a safety critical profession and you need to pay nurses in the same way as you pay safety critical professions.’

COVID-19 highlights need for more UK-wide staffing legislation

The pressures of 2020 have ‘absolutely’ made the case for safe staffing legislation, Professor Kinnair says, and the RCN will be continuing to push for UK-wide change.

In Scotland, the Health and Care (Staffing) (Scotland) Act became the first legislation of its kind in the UK to apply to all clinical groups in health and social care services.

And in Wales, a consultation on extending the Nurse Staffing Levels (Wales) Act 2016 – which currently applies to adult acute surgical and medical wards – to paediatric inpatient wards closed on 16 December.

But no such legislation exists in England and Northern Ireland.

‘There’s no denying the fact that if you want to deliver safe and effective care, you have to have the right amount of people,’ says Professor Kinnair.

‘Even though we’ve got through the pandemic by the skin of our teeth, with nurses coming out of retirement and students coming out of placements, it has demonstrated our view that it’s essential to have adequate staffing. I’m looking forward to working with the government to have safe and effective staffing legislation passed.

Representing care home staff

Another focus is on supporting members in the independent sector, including care homes.

‘We want to make sure that we can support them, that we represent them and that we can work with them and help them get organised to make sure they’re getting good employment relations and good professional advice,’ Professor Kinnair says.

Education is another priority, and she is pleased with what has been achieved this year.

‘Working with RCNi, we’ve done a sterling job during the pandemic in giving access to resources to make sure our members are supported.

‘We’re educating our members to be effective organisers and campaigners, but also making sure their clinical education is well supported, which is what we need to do as the RCN.’

View our COVID-19 resource centre

Nurses are central to the COVID-19 vaccination programme

Matron May Parsons with Margaret Keenan after giving her the first injection of the UK’s COVID-19 vaccination programme
Matron May Parsons with Margaret Keenan after giving her the first injection of the UK’s COVID-19 vaccination programme

The COVID-19 vaccine programme – the largest such programme in the history of the NHS – is now underway with nurses at the forefront of its administration.

The RCN ‘actively encourages’ all members to have the COVID-19 vaccine to help protect themselves, their patients, their families and the wider community. However, it does not support mandating vaccination for staff.

Professor Kinnar says she will have it herself at the first opportunity.

The need for a vaccine was underlined for her personally in December when her husband tested positive for COVID-19.

‘We have been working from home, so you can see how contagious this virus is,’ she says.

She adds that nurses delivering the vaccination programme must be properly supported.

‘We’ve seen not only patients die, but also our front-line workers, including nurses, who put their lives on the line.

‘A vaccine is very welcome news. But having said that, who is going to provide them? Nursing is being asked to play a big part in the roll-out and, as we administer the majority of vaccines, we will continue to do that.

‘But it is a huge operation and everyone across the health service, pharmacists and others, will need to help to make it work.’

Embracing the positives from a year in the spotlight

Though 2020 has been a year of challenges, there have been some personal positives for Professor Kinnair.

Professor Kinnair on BBC One’s Question Time
Professor Kinnair on BBC One’s Question Time Picture: BBC

Asked how she feels about being named the sixth most powerful black person in the UK in the Powerlist 2021 earlier this year, she says modestly: ‘Although the recognition comes to me personally, I think the recognition belongs to the RCN and to nursing.

‘For me, whether it’s the Powerlist, or anything else, it can only be in recognition of things I’ve said, and I’ve spoken out on behalf of all nurses, whether they’re from the BAME (black and minority ethnic) community or any community that we serve.’

She has made a number of memorable media appearances during the pandemic, including three appearances on BBC One’s Question Time, where she made a powerful case for recognising the role and needs of nurses.

‘It’s never easy to do these things, but I think it’s important – I mean, they had never had a nurse on Question Time.

‘It’s absolutely right and proper that in a pandemic, nurses have a voice to share with the public about what is the right and proper care for the staff that deliver the care for our patients.’

Although Professor Kinnair knows it will be a tough year ahead, she is holding on to the positives.

‘Nursing is now in a spotlight. Previously I’d go to a meeting with MPs and they’d say “Well I know what doctors do but I’m not really sure what a nurse does”. I don’t have that now.

‘It might be short-lived, but while that’s happening, I’m going to ride on that wave.’