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NHS England warns against pay rise above 2% for nurses

NHS England has urged for the pay rise for nurses to not exceed 2% for this year, unless the government pledges additional money.

In its submission to the NHS Pay Review Body (PRB), NHS England warned that a pay award higher than the funding settlement agreed with the government could lead to cuts to staffing numbers and hinder service improvements.

“This could impact on staffing numbers and the ability to deliver planned activity or service improvements”

NHS England evidence

The current NHS financial settlement was agreed with the Treasury in the 2021 spending review, to cover the period up to and including 2024-25.

This settlement allowed for a 2% pay increase in 2024-25 for NHS staff working on Agenda for Change contracts.

At the time, the settlement was based on an expecation of moderate inflation and Covid-19 costs reducing to lower levels by 2024-25.

However, NHS England warned in its submission to the NHS PRB that neither of these were the reality right now.

Although in 2022 the government pledged an additional £3.3bn on a recurrent basis to address higher than planned inflation and other financial pressures, NHS England said this alone would not cover a substantial pay uplift this year.

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“Inflation has still been higher than the assumed level, and NHS real-terms funding growth into 2024-25 remains low by historical standards,” it added.

As such, NHS England has warned against a pay rise higher than the 2% for staff working on Agenda for Change contracts, unless the government pledges more money.

It said: “Pay awards that are higher than the levels contained in the funding settlement, if not supported by additional funding from government, will put further pressure on the NHS budget given the existing funding pressures.

“This could impact on staffing numbers and the ability to deliver planned activity or service improvements.”

NHS England noted that financial pressures on services had already been exacerbated by previous and ongoing industrial action, which it said was estimated to have already cost more than £1.5bn in 2023-24.

NHS England’s nursing workforce position

In its submission to the NHS PRB, NHS England put forward its position on the nursing workforce in the context of pay.

It noted that nurses were the single largest staff group in the health service and that they were “a critical part of the healthcare team needed to meet the changing demands faced by the NHS”.

NHS England said its aim was to retain qualified nurses, particularly those in the late stage of their career who may decide to retire earlier than planned.

It said there were many factors which influenced a nurse’s decision to leave the NHS; figures published in the report showed pay and reward was in the top five reasons.

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Unpublished data from the electronic staff record, which NHS England included in its submission to the NHS PRB, showed that a total of 35,207 registered nurses left the NHS in 2022-23.

Relocation was the most common reason for leaving, followed by retirement.

However, there were a significant number of nurses leaving the NHS due to pay and reward.

In 2022-23, 4,516 left the NHS due to dissatisfaction with pay, compared to 4,786 in 2021-22 and 3,644 in 2020-21.

In recent years, the NHS Staff Survey has been a key indicator of how many NHS staff are satisfied with their pay.

Up until 2022, there had been a steady decline in the number of workers satisfied with their level of pay.

Satisfaction with pay remained lowest among nursing and healthcare assistants, followed by ambulance workers and then registered nurses and midwives.

However, the most recent NHS Staff Survey did reveal slight improvements in this trend, although levels of satisfaction remained low.

In 2023, 27% of NHS staff said they were satisfied with their level of pay, compared to 22% in 2022.

For nurses and midwives, 28% said they were satisfied with their level of pay, compared to just 18% the prior year.

NHS England is the latest organisation to submit its evidence to the NHS PRB, which will make a pay recommendation to the government in due course.

Last week, health unions accused the government of letting nurses down because its delays in submitting evidence to the NHS PRB would mean that NHS staff would now receive a late pay offer.

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Unions warned that NHS staff were facing uncertainty about their financial situation as a result.

In its submission to the NHS PRB, the Department of Health and Social Care did not recommend a figure for this year’s pay rise, like it has done in previous years.

Instead, it just called for the pay deal to be “fair and affordable”, citing similar concerns about stretched budgets and the need to reduce inflation as well as the country’s debt.

Some health unions have also submitted evidence to the NHS PRB this year.

The Royal College of Nursing called for an above-inflation pay rise, as well as additional payments to support recruitment and retention.

Meanwhile, the Royal College of Midwives also called for a pay increase above inflation, alongside a “credible plan” to restore pay lost over time to increased living costs.

However, several health unions have decided to boycott the NHS PRB process, due to concerns about the independence of the advisory body from the government.

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