Debate: NHS/Independent Sector

RCN members work throughout all sectors of the health economy, including in the NHS, independent sector, prisons, care homes and hospices, although the shape of services in the four countries of the UK means that public and independent sector boundaries may vary slightly.

Yet despite the range of sectors in which members work, the overwhelming majority of the RCN’s messaging is aimed at those employed in the NHS.

Up to the end of December 2017 RCN membership in the NHS fell for the second year running, while membership outside of the NHS grew. Approximately 20% of RCN members now work outside the NHS across the UK, in contrast to 59% in the NHS.

However as a member working outside the NHS, you would possibly have little idea of how the RCN was supporting you as your trade union and professional body.

You might not know what thousands of RCN members in the independent sector do at work day after day, as there is little coverage of this and little engagement at branch level to try to understand the diverse roles.

There are huge variances in pay and conditions in the independent sector but where are the RCN campaigns around poor pay and conditions for RCN members in social care, for example?

We therefore ask that the RCN rebalances its resources and messaging to reflect the high percentage of members who work in the independent sector.

Although the RCN has trade union agreements with around 50, usually larger, employers, these agreements cover thousands of members.

However, the recruitment and retention of accredited representatives in workplaces outside the NHS remains a particular challenge, and hence the visibility of the RCN to members working in the sector is often less than in the NHS. Pay and other conditions of service vary widely across the sector, and can often be inferior to the NHS.

Around 50% of cases with the RCN Legal Services Department in England and Wales involve members in the independent sector (for example, 58.9% NMC cases; 45% coroners’ inquests; 48% criminal cases).

The RCN in Scotland has committed significant resources to responding to issues facing members in the independent sector and continues to focus on nursing within care homes. For example, in the past year the RCN has commented on the Care Inspectorate’s draft quality framework, influenced the new national health and social care standards, contributed to a parliamentary inquiry into the sustainability of care homes, promoted nurses and health care support workers in the sector, and published a report and nursing tool on bed-based intermediate care, which was developed with members. In 2017, 25 learning and development sessions were delivered within the independent sector, reaching over 250 members and prospective members.

In Wales, the RCN has had significant success in reforming new social care legislation to ensure it protects the value of nursing in the independent sector. The RCN maintains close working relationships with Social Care Wales and Care Inspectorate Wales to ensure the interests of members are represented. An Independent Sector Plan guides the focus of RCN Wales’s resources and activities within the independent sector. A Primary Care, Community and Independent Sector Adviser supports the workforce and the RCN Wales Study Centre provides an ongoing programme of learning and development for nurses and health care support workers working in this sector. The RCN Wales Nurse of the Year awards includes a category celebrating excellence in independent sector nursing.

In Northern Ireland, according to the RCN KPI dashboard as at December 2017, 42% of members work outside the HSC (NHS), of which 48.5% work in the independent sector. In December 2015, the RCN in Northern Ireland published a comprehensive report outlining the workforce and funding challenges in the independent sector. The RCN in Northern Ireland promotes the inclusion of members working in the independent sector through targeted professional development activity and support for the Independent Sector Nurse Managers Network. It also promotes the recognition of excellence in nursing practice within the sector through the annual RCN Northern Ireland Nurse of the Year Awards. 

View all of the Congress debates.