Pay Banding for Nurses holding a Specialist Practitioner Qualification

At the QNI we are committed to sharing the voice of community nursing and to supporting the nursing workforce through gathering evidence and sharing best practice.

During discussions on the QNI field specific standards, there appears to be varied approaches to pay structures for nurses after qualification as a specialist practitioner.

We would like to collate information about these differences in pay to demonstrate to all stakeholders what is being done in different areas, as the current approach is not consistent.

It would be really useful if you can let us know what the current pay structure for students undertaking the SPQ is, and what the expectation in pay band is after gaining the SPQ (please include which SPQ and whether the course includes the V300 prescribing).

We understand that in some areas the current remuneration during the programme and afterwards is one element that impacts on recruitment to undertake the SPQ programmes. We hope that by sharing current practices, this will contribute to the professional debate on recruitment and retention in community services.

We hope to publish collated information about this on our website, but of course all information we publish will be completely anonymised. We may also wish to follow up with you on this subject as our study of pay structures progresses.

If you can help, please email Amanda.young@qni.org.uk and put ‘SPQ’ in the email subject line.

Examples submitted Spring 2023

Example 1

In [city], staff are paid mid-point band 5 while they complete the course, unless they are already a band 6 (some staff from historical organisations were promoted to a band 6 in preparation for doing the SPQ course and they remain on band 6 for the duration of the course). The SPQ course currently being completed has V150 and staff will be paid at band 6 on completion and be a caseload holder; we have one band 7 team leader per neighbourhood. We did have a cohort complete the apprenticeship route with V300 but they also were paid band 6 on qualification. We lost some of these staff to trainee ACP, as these are paid at band 7 while training and 8a on qualification.

Example 2

We have both traditional route and apprentices on the district nurse course and they come from six different Trusts – each with varying pay bands. The remuneration for district nurses is a sore point, as there is significant diversity amongst the student group; then there is the issue of retention; as the apprentices have the V300, a masters level course and clinical skills; the scope for them to move into an advanced nurse practitioner role is huge. This creates a worrying level of instability in the DN workforce.

Example 3

We are introducing new senior nursing roles, a Lead Specialist Practitioner and a Community Nurse Educator (both are band 7, and both are for experienced DN SPQs). We are also working on introducing an advanced clinical practice role at band 8a that will be aligned to the 4 pillars of advanced practice.

When recruiting nurses to the SPQ programme, we ask that they have at least 6 months experience of working as a B6 senior staff nurse and can demonstrate clinical competence in a range of community nursing skills. Once on the programme they are paid at B6 for the duration. On qualifying as a DN they will continue in the B6 post for a period of consolidation, this is particularly important to enable them to embed their learning in leadership, health assessment and prescribing. We are finding that our newly qualified DNs are being offered B7 and B8a posts (by other employers or units) as soon as they qualify without any evidence of them being able to use their new skills in practice.

We are exploring the option of a 2-year SPQ with a built in 3-month consolidation at the end of year 1 and 4 months at the end of year 2, supported by one-to-one career coaching from our professional nurse advocates throughout the programme. I would feel more comfortable that nurses on this route would be ready for a B7 post than those who have completed a very condensed 1-year programme.

Example 4

We currently work with four NHS trusts and all of them pay their SPQ holders a band 6 post-qualifying. Some trusts employ staff at band 6 without the SPQ. We currently offer the programme with the V100 integrated; the new course will offer the V300 and trusts have indicated that this will not affect the pay of the SPQ nurses.

Example 5

In 2022 we successfully placed a paper to the board to upgrade the SPQ staff once qualified to a band 7 to acknowledge their specialist skills. The SPQ DNs have advanced clinical practice and V300. Aligned to other advanced practitioners in the organisation, it was important to raise the value of this role. They hold a smaller but more complex caseload. They provide an umbrella caseload function that band 6 non-SPQ caseload holders can refer into. Once reviews have occurred, and stability maintained with care planning direction, they return to the band 6 caseload holder. This gives the band 7 nurses time for complex caseload management and the ability to increase their knowledge from an education and caseload scenario.

Example 6

In our Trust, we currently recruit staff to undertake the Children’s Community Nursing Specialist Practice Qualification at mid-point Band 5. Usually if they are internal candidates, they will be seconded on the banding they are currently being paid, so either Band 5 or Band 6, but this is currently being reviewed by the Trust. Post qualification, they could work as a Band 5 or Band 6; it would depend on what positions are available and whether they were successful at interview. Most of CCNs who have the SPQ are Band 6 and above.

Example 7

Within our Trust there is no progression in pay band when qualifying from the SPQ. The only amendment to their job description relates to the prescribing qualification.

I am currently undertaking the SPQ, due to complete this summer. I am currently a Band 7 community nurse team manager, and there is no plan to alter my pay band on qualifying. In my line management, I have had Band 6 Specialist Nurse (Community) team leaders also complete the SPQ recently, who have not received any change in pay band on qualifying. Currently there are also Band 5 community nurses undertaking the course, and again I have no knowledge of any intention to progress in pay banding on qualifying for them either.

In my opinion, there should be recognition of the higher level of competency in practice on completing the SPQ. I feel it should be reflected in an increase of salary to compensate for the additional professional accountability and performance. Having almost completed the course myself, I fully understand the commitment and hard work required to achieve this qualification and can fully appreciate the advanced level of nursing practice provided as a result. Recognition of this achievement would allow our staff to feel valued and also increase the amount of interest in the course as a whole.

Example 8

In [name deleted] Trust, on commencement of the course, students were paid at the bottom of band 6 and contracts commenced from this pay point.

In [name deleted] Trust, students were paid as band 5 throughout the first year of the course, then upgraded to band 6 on starting the second year.

[Name deleted] Trust paid students at band 5 throughout the course and on completion of the course upgraded to band 6.

In [name deleted], students must work 37.5hrs a week; they have 22.5 hours paid as a band 5 and the remaining hours are paid as bottom of band 6. After completion of the course, they will start as bottom band 6.

Example 9

Only permanent Band 6s can apply for the SPQ. On qualifying they remain at Band 6. But they can apply for a Band 7 – Advanced District Nurse Specialist – post, when one comes up. However, we only have seven of these posts across the county. We hope to have 18 Advanced District Nurse Specialist posts at B7 (one in each PCN level DN team) to lead the teams.

Example 10

Our DN SPQ students are paid a band 6, as generally it is our senior Community Nurses who apply. Once qualified, they are then interviewed for DN team leader posts and if successful they are paid at Band 7.