AROUND 3,500 SENIOR NURSES and midwives are set to begin a work-to-rule next week in the latest industrial action to hit the health service.

The action will begin on Tuesday 29 September, following a long-running dispute over changes to how senior nursing and midwifery managers are paid and graded.

The Irish Nurses and Midwives Organisation (INMO), Psychiatric Nurses Association (PNA) and trade union Siptu say their members have waited years for a new system to be fully introduced.

Those taking part include Directors and Assistant Directors of Nursing and Midwifery, Advanced Nurse and Midwife Practitioners and tutors.

They work across hospitals, mental health and maternity services, community care, public health nursing, paediatric services and palliative care.

The dispute dates back several years, with the current system for determining the pay of senior managers based on hospital activity levels from 1999.

Following the major nursing dispute in 2019, an expert review was established to examine a range of issues affecting the professions.

It subsequently recommended scrapping the existing hospital banding system and replacing it with one that better reflected the roles and responsibilities of senior nurses and midwives in the modern health service.

The unions say a new structure was eventually determined in February 2025, but has still not been fully implemented.

INMO’s Deputy General Secretary Edward Mathews said members had “waited years for this issue to be resolved”.

“The health service of 2026 bears little similarity to the health service of 1999,” Mathews said.

“Services have expanded, responsibilities have increased and the complexity of healthcare delivery has changed enormously.”

Mathews said senior nurses and midwives carried “enormous responsibility” for safe patient care and managing increasingly complex services.

PNA’s Deputy General Secretary Michael Hayes said this was particularly evident in mental health services, where managers were dealing with increasingly complex patient needs while under pressure from staffing and resource shortages.

Siptu Health Sector Organiser Damien Ginley said members had engaged “constructively” with efforts to resolve the issue, but described continued delays as unacceptable.

“The recommendations arising from the expert review process must be implemented in full,” Ginley said.

The action comes amid wider unrest across the health service over pay and working conditions.

Separately, more than 11,000 Siptu health workers across 30 hospitals are due to begin a work-to-rule next Wednesday (30 September) as part of a dispute over a new public-service pay agreement, with a one-day strike planned for 14 October.

The unions stressed that the action announced by senior nursing and midwifery managers is a separate dispute.