New "super nurses" or nursing consultants will earn pounds 40,000 a year - but initially there will only be 300 of them.
The strategy for nursing launched yesterday by Tony Blair and Frank Dobson, the Secretary of State for Health, was welcomed by the profession but dismissed as a "gimmick" by the Tories.
The Royal College of Nursing said it was wise to ensure the scheme worked properly before expanding it, but added that there should eventually be about 5,000 of the nursing consultants.
At the moment, the highest- paid nurses earn pounds 29,485 a year, but most of them are in management rather than on the wards. Less than 2 per cent of the NHS's 250,000 nurses earn that much money, and the proportion on the lower senior grades has dropped in recent years. In 1998 only 23 per cent of staff were employed on the "G" grade, the level at which a specialist community or family planning nurse might expect to be employed, compared with 32 per cent in 1991.
A Royal College of Nursing survey of nurses who had left the NHS last year found that 81 per cent would have been influenced to stay if there were improved promotion prospects. The new nursing consultants will have a managerial role but will also spend half their time on the wards. The project is a response to complaints from senior nurses that they were forced to move out of clinical work or leave the profession altogether if they wanted their pay to reflect their skills. It is backed by the Royal College of Nursing, which is already working with NHS trusts on pilot schemes. Mr Dobson said his strategy, Making a Difference, would ensure the NHS had thousands more nurses, midwives and health visitors.
In future, trainee nurses would be able to spread their education over longer periods and would be able to continue at a different hospital if they moved. The lower end of the nurses' pay structure would also be extended to include healthcare assistants.
A recruitment campaign launched in February had already brought back 1,200 nurses to the NHS, Mr Dobson said, and an extra 6,000 training places would become available over the next three years.
"In the past many of our most experienced and qualified nurses have hit a glass ceiling precisely when their skills and abilities are at their maximum. They have effectively been forced off the wards. That can't be right," he said.
Both the Royal College of Nursing and the public sector union Unison welcomed the plans yesterday. But both expressed concerns over how ward sisters who currently earned less than pounds 20,000 a year would progress to the new nursing consultant grade.
Bob Abberley, head of health for Unison, said the scheme would introduce new ways into nursing for junior staff as well as helping those at the top of the ladder. "This is the first time in 20 years that the worth of non-registered staff has been recognised by government," he said.
Liam Fox, the Conservative health spokesman, said the scheme did not go far enough. "We have made it clear `super nurses' are a reasonable idea in principle, but this is only going to affect a tiny minority of nurses on the ward. Our doctors and nurses need more than just gimmicks," he said.
THE NEW PAY SCALE
Health care assistant pounds 8,705
Pupil nurse pounds 8950
Enrolled nurse pounds 13,915
Staff nurse pounds 15,905
Ward sister pounds 20,925
Nursing consultant pounds 40,000Reuse content