‘Stretched’: DHSC submits evidence for 2024-25 pay deal

The Department of Health and Social Care (DHSC) has said a 2024-25 pay deal for nurses and other NHS staff needs to be “fair but affordable”.

In its written evidence to the NHS Pay Review Body (PRB), submitted today, the government did not put forward a recommended figure for this year’s pay rise, like it has done in previous years.

“Nursing staff will not accept suggestions by ministers that NHS budgets are too stretched to deliver on pay”

RCN spokesperson

Instead, it just warned that budgets in the department as well as the NHS were “stretched” and that a pay award must keep in mind the need to reduce inflation and reduce the country’s debt.

Health unions have criticised the government for not recommending a figure for this year and have once again reiterated calls for the PRB process to be abandoned in favour or direct negotiations with unions and employers.

It comes as health unions have raised concerns about the independence of the advisory body, which has been recommending the pay rates of NHS workers for several years.

DHSC said in its submission to the NHS PRB that putting NHS workforce supply in England on sustainable footing was “collectively driven by multiple factors, not just pay”.

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For example, it said workforce sustainability relied on things like workload, reforms to education and training, improved working environments, flexible working and opportunities for continuous professional development.

It noted the efforts that had been made to boost the NHS workforce, including the publication of the NHS Long Term Workforce Plan and meeting its target of 50,000 additional nurses, and argued that recruiting and retaining staff was “essential to meeting key health objectives”.

DHSC said in its submission that budgets for a 2024-25 pay offer would not be able to stray from what had already been forecast in the government’s 2021 spending review for the NHS.

In the review, the government pledged to increase NHS spending by 3.8% a year until 2024-25 and DHSC had a forecasted budget allocation for each financial year.

The submission said: “As we enter the final year of the spending review settlement agreed in 2021, and despite additional funding that has been made available in the intervening period, the NHS England and DHSC settlement is stretched.

“The recurrent impact of the 2023 to 2024 pay awards continues to affect budget capacity in 2024 to 2025 and means flexibility beyond the planned affordability at the 2021 spending review is extremely constrained.”

Meanwhile, DHSC urged the NHS PRB to “consider the historic nature” of the pay awards that were given for 2023-24.

For that financial year, the government gave NHS staff on Agenda for Change contracts  in England a 5% pay rise, while an additional one-off bonus of at least £1,655 was also provided to top-up the 2022-23 deal.

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This improved deal came during direct negotiations with health unions, following months of strike action by nurses and other NHS staff.

DHSC warned that the ongoing impact of inflation and industrial action had also put “unforeseen pressures on all budgets”.

It said that these factors have had a financial impact “which has necessitated the reprioritisation of budgets for 2024 to 2025”.

If further reprioritisation was required, it could “impact on NHS priorities” including supporting urgent and emergency care services and tackling waiting lists, the submission claimed.

It added: “Pay awards above affordability may also necessitate further government borrowing at a time when inflation remains above target and headroom against fiscal rules is historically low.”

The submission concluded: “These are challenging times for everyone, and our focus is ensuring a fair pay award which recognises the vital importance of public sector workers while minimising inflationary pressures and managing the country’s debt.

“It is therefore essential that within this fiscal and economic climate, pay remains fair but affordable.”

Health unions have been calling on the government to put forward a meaningful pay deal for 2024-25 to improve the current state of pay.

“Getting health unions and employers in for pay talks would be the fastest, smartest way for the government to start to solve the staffing crisis”

Helga Pile

Responding to the government’s submission today, a Royal College of Nursing (RCN) spokesperson said: “The government has rightly acknowledged that recruitment and retention is essential to meeting health objectives, but in its submission stopped short of naming a number on pay.”

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In its own submission to the NHS PRB, the RCN demanded an above-inflation pay rise for nurses and additional payments to support recruitment and retention.

The spokesperson added: “But we must be clear that nursing staff across England will not accept suggestions by ministers that NHS budgets are too stretched to deliver on pay.

“Governments have many options at their disposal to increase health service budgets and provide an above-inflation pay rise for nursing staff.

“By choosing not to deploy these options they continue to undervalue this vital profession.”

Meanwhile, the acting head of health at Unison, Helga Pile, criticised the government for once again starting the PRB process too late, meaning NHS staff are likely to face a delay in receiving their pay rises.

Ms Pile said: “NHS workers should be getting this year’s wage rise in a matter of weeks.

“But because ministers were so late getting the pay review body process started and didn’t get their own evidence in on time, staff will now have to wait months.

Helga Pile

“This simply isn’t good enough.”

Ms Pile reiterated calls for the government to “cast aside” the NHS PRB process and instead have direct pay negotiations with health unions.

She added: “Getting health unions and employers in for pay talks would be the fastest, smartest way for the government to start to solve the staffing crisis.

“The government must negotiate a proper pay package for health workers to halt the steady drain of experience from the NHS.”

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