‘Trap door’ effect driving experienced nurses into lower-paid roles, report warns
A report led by a London South Bank University (LSBU) academic has uncovered a troubling trend in nursing: highly experienced nurses are increasingly being pushed into lower-paid, less senior positions – a systemic issue that has gone largely unnoticed until now.
The Trap Door: Understanding Career Regression in Nursing was led by Alison Leary MBE, Professor of Healthcare and Workforce Modelling at LSBU. It was produced in her role as director of the International Community Nursing Observatory (ICNO), part of the Queen’s Institute of Community Nursing (QICN).
The report examined ‘downbanding’ within the NHS Agenda for Change pay structure, introducing the concept of the ‘trap door’, a situation where skilled professionals are not only blocked from career progression but actively drawn back into lower pay bands.
It calls for urgent policy reform and cultural change to ensure fair career progression and to retain experienced nurses within the workforce.
‘Experienced clinicians’ stepping down
Based on 579 survey responses, the study found that more than 80% of respondents had experienced career regression, with most having more than 20 years on the Nursing and Midwifery Council register.
Many were experienced clinicians – including clinical nurse specialists, district nurses and general practice nurses – whose expertise is vital to patient care and the stability of the health service.
Respondents gave a variety of reasons for stepping down, with the leading driver of regression the lack of flexible working options. Other reasons cited included organisational restructuring and redundancies, experiences of bullying and toxic workplace culture, burnout and health-related challenges, and a sense that their skills were undervalued, with progression opportunities blocked.
The findings reveal deep-rooted inequities and cultural obstacles in workforce policy, where rigid management practices and a lack of recognition for nursing expertise are forcing experienced professionals out of senior positions.
Professor Leary said: “We talk a lot about the ‘glass ceiling’ and the ‘sticky floor’, but this report shows there’s also a trap door - and experienced nurses are falling through it. Many are being forced to choose between their health, family life and their professional standing.”
Steph Lawrence MBE, Chief Executive of the QICN, added: “These findings are very worrying...The reasons given [for career regression] are concerning when we see on a daily basis the results of not having enough nurses in post, the harms to patients due to lack of capacity and the stress and burnout for staff involved. We have to ensure a more flexible approach if we are to retain a skilled and competent nursing workforce.”
Header photo: Kate Stanworth, QICN