NHS Pay
MPs will debate NHS pay on Wednesday 13 September. This will be an be an opposition day debate. This Commons Library briefing page contains Library briefings, press coverage, Parliamentary Questions and select committee reports.
Since 2013 the Government has funded public sector workforces for average pay awards of 1%, including in the NHS. During the period 2011-2013, a public sector pay freeze was in place for public sector workers, excluding those earning £21,000 or less, who received pay increases of at least £250. The 2015 Summer Budget announced that the 1% public sector pay award would continue for four years from 2016/17 to 2019/20.
In setting pay across various areas of the public sector, the Government receives recommendations from eight public sector pay bodies. These pay bodies work within the remits provided to them by Government, and report annually with recommendations to the relevant Secretary of State on pay for the forthcoming year.
There are two pay bodies that cover the NHS. The NHS Pay Review Body (NHS PRB) makes recommendations on the Agenda for Change payscales, which covers all NHS staff except doctors, dentists and some senior managers, while the Review Body on Doctors' and Dentists' Remuneration (RBDDR) makes recommendations for doctors' and dentists' pay.
On 12 September 2017, it was reported that the Government would be providing pay awards of above 1% for prison and police officers, as part of a "move to a more flexible approach" to public sector pay.
The Treasury is expected shortly to send out letters setting out the remit for the public sector pay review bodies for their 2018/19 recommendations.
General background information on public sector pay can be found in the Commons Library briefing paper, Public Sector Pay.
NHS pay review bodies 2017/18 reportsThe NHS PRB and RBDDR 2017/18 reports both recommended 1% pay increases across all bands and professions. Both had a remit from the Treasury to operate within the 1% public sector pay policy, as well as respective remits from the Department of Health to use pay increases to encourage recruitment and to protect jobs.
- National Health Service Pay Review Body 30th report: 2017
- Review Body on Doctors’ and Dentists’ Remuneration 45th Report: 2017
BBC report on 2018/19 remits
On 11 September, the BBC reported that the Treasury's guidance to the NHS Pay Review Body for next year may call for the easing of the 1% pay cap, to address recruitment issues, particularly in nursing.
- BBC News, 'Public sector pay cap to be lifted for police and prison officers', 11 September 2017
NHS incremental pay
In response to a UK Parliament petition (Demand an end to the pay restraint imposed on agenda for change NHS staff, Petition 168127) the Government stated that the NHS is one of the few public sector workforces that receive incremental pay:
Around half of AfC staff receive incremental pay of around 3% on average. A typical qualified nurse (Band 5) can expect seven years of pay progression averaging around 3.8% a year, in addition to annual pay awards.
The NHS Pay Review Body 2017 Report reported that slightly more than half (54 per cent) of NHS staff in England were due to receive pay increments of around 3-4% on average in 2016/17, in addition to the 1 per cent pay award. The report says that this is due to “pay progression, career progression, geographical movement and changes in personal working patterns” rather than due solely to pay progression.
In response to an April 2017 PQ from Grahame Morris, the Government set out figures from its longitudinal studies into NHS pay 2010-15:
- Total earnings of Hospital and Community Health Service (HCHS) doctors increased by an average of 3.3% each year between 2010 and 2015; and
- Total earnings of Agenda for Change increased by an average of between 1.7% and 2.9% per year, depending on staff group.
The average annual Consumer Price Index figure over the same period was 2.4%.
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The Department’s longitudinal studies ‘Earnings change for HCHS Doctors 2010-2015 – a longitudinal study’ and ‘Earnings change for Agenda for Change contracted employees 2010-2015 – a longitudinal study’ can be accessed at:
https://www.gov.uk/government/publications/information-for-the-ddrb-pay-round-2017-to-2018
https://www.gov.uk/government/publications/information-for-the-nhsprb-pay-round-2017-to-2018
Impact of NHS 1% pay awardIn response to a July 2017 PQ Bill Esterton, the Government claimed that pay restraint in the NHS had helped fund the recruitment of an additional 33,800 profesionally qualified clinical staff since May 2010.
However, other organisations have claimed that pay restraint is impacting on the NHS's ability to attract and retain staff (see, for example, The Royal College of Nursing's Scrap the Cap campaign). In April 2017, the Lords Select Committee on the Long-term Sustainability of the NHS reported that:
There were concerns expressed about the capacity of the NHS to retain domestically-trained staff because of low pay and morale and the competitiveness of the international market for scarce clinical skills. The evidence suggested this was a particular issue in nursing, where the proportion of nurses leaving services increased from 6.8% in 2010–11 to 9.2% in 2014–15.
More information on NHS staffing figures in England can be found in the Commons Library briefing paper, NHS Indicators: England, June 2017.
NHS pay in the devolved administrationsAs health is a devolved policy area, NHS pay is set by the Scottish and Welsh Governments, and by the Northern Ireland Executive. The NHS PRB and RBDDR provide recommendations to the devolved administrations, as well as the Department of Health, on NHS pay for the forthcoming year.
The Scottish Government's 2017 Programme for Government gave a "pledge to lift the public sector pay cap for NHS and other public sector workers."
In June 2017, the Welsh Health Secretary Vaughan Gething called for the UK Government to increase funding for the NHS in Wales to allow for a greater than 1% pay increase.
Further reading- Westminster Hall debate, Agenda for Change: NHS Pay Restraint, 30 January 2017
- Lords Question for Short Debate, Public Sector Pay Cap, 13 July 2017
- House of Lords Select Committee on the Long-term Sustainability of the NHS, The Long-term Sustainability of the NHS and Adult Social Care, April 2017
- The Health Foundation, In short supply: pay policy and nurse numbers, April 2017
- The King's Fund, When it comes to public sector pay, caveat emptor, August 2017
- Nuffield Trust, The big freeze: Is the NHS pay deal fair?, March 2014
- Institute for Fiscal Studies, UK health spending, 2017
- UNISON, Time to talk about NHS pay
- Trades Union Congress, Public Sector Pay Restraint in England, 2016
- Health Service Journal, 'Pay rises are not the priority for the NHS', 8 September 2017
- Office of Manpower Economics, Wage growth in Pay Review Body Occupations, July 2017
- Full Fact, 'Are NHS workers getting a 4% pay rise?', April 2017
- National Health Service Pay Review Body 30th report: 2017
- Review Body on Doctors’ and Dentists’ Remuneration 45th Report: 2017