Trusts will not be given additional funding to pay for the 'nurse consultant' posts outlined by the government last week.

Guidance on how trusts are expected to implement the nursing strategy unveiled by prime minister Tony Blair will make it clear that they must fund the new posts from general allocations.

But there will be more money to finance nurse education and training proposals. Trust managers will also be told that nurse consultants should be treated as entirely new posts, rather than vehicles to promote existing senior nurses.

The guidance will say they should be created as part of general service reconfiguration, perhaps as part of implementing national service frameworks.

Roy Tyndall, human resources director of Royal Liverpool and Broadgreen University Hospitals trust, welcomed the strategy as 'positive'. But he warned: 'A significant number of nurses might be queuing up to say they qualify as consultants, but the numbers will be restricted, ' he said.

Mr Tyndall said he had seen a paper for the prime minister suggesting that the salary scale should stop just short of£45,000. 'Some doctors will say that if they have to pay around£40,000 to£45,000 for a nurse consultant, they would rather have another medical consultant instead, ' he said.

The Making a Difference strategy suggests that nurses, midwives and health visitors are not included in Mr Blair's criticism of public sector workers last week.

But it says the current clinical grading system has hindered rather than supported nurses who take career breaks, and failed to reward competence.

The NHS Confederation welcomed the strategy as recognising 'the need to attract greater numbers into and back into nursing'.

But human resources chair Andrew Foster said it was 'not particularly helpful that such a detailed picture is proposed of the role and pay of nurse consultants'.

That should be part of the current negotiations on the new pay system for the NHS, he said.

Royal College of Nursing general secretary Christine Hancock said the strategy was a 'breakthrough document' that acknowledged that 'a high quality NHS and a strong nursing workforce are two sides of the same coin'.

Unison head of health Bob Abberley said the strategy 'will enhance recruitment and retention, benefit standards of care and spells good news for staff and patients'.

Making a Difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare.

www.doh.gov.uk.nurstrat.htm

Pay-offer collision course Industrial action is looming over the 3 per cent offer made to more than 200,000 health service staff whose pay is not subject to pay review bodies.

Both health union MSF and Unison are consulting affected members with a recommendation that they reject the offer, which is significantly below the awards made to nurses, doctors and professions allied to medicine. Consultative ballots will warn members that they should be prepared to vote on taking industrial action if they reject the offer.

Both unions are predicting members will vote for rejection.

Making a Difference

New nurse consultant posts with salaries of up to£40,000 a year - compared with a present maximum of£29,000.

A radical overhaul of nurse education and training, including 'take a break' arrangements to spread training over more than three years, and national vocational qualifications to provide new pathways into nursing.

Enhanced roles for midwives so they can advise and help women throughout their lives.

A national campaign to ensure implementation of 'family friendly' employment policies.

A Partners Council including patients to provide a framework for post-registration education and continuing professional development.

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