Seeing some confusion about NHS pay rises this evening, and the policy nerd in me is twitching. Here's a step through... 1/16
Doctors’ and Dentists’ pay is decided by government, once they receive recommendations from the Doctors’ and Dentists’ Pay Review Body (DDRB). Other staff – employed on the NHS contract, Agenda for Change (AfC) – have the NHS Pay Review Body (NHSPRB) for the same process. 2/16
Various stakeholders submit evidence to these review bodies. Today, DHSC submitted theirs. And it’s not gone down well. 3/16
It’s worth noting that at this point, NHS pay rises have NOT been decided – all that’s happened, is evidence has been submitted to the review bodies, who make recommendations on pay awards later in the year. Govt then decide how to act on those recommendations. 4/16
So, today, DHSC submitted their evidence to the DDRB and the NHSPRB respectively. For the DDRB, they have explicitly said “In settling the DHSC and NHS budget, the government assumed a headline pay award of 1% for NHS staff.” 5/16
So DHSC are suggesting, for various reasons that they outline in their submission, that a 1% pay rise for doctors is best this year – but from the wording, it sounds like they are in fact saying this is the case “for [all] NHS staff” groups, not just doctors. 6/16
Worth noting here, that junior doctors and independent contractor GPs are under a multi-year pay deal, and SAS doctors look like they are about to agree on one, so they are exempt from this year’s pay decision. (They get what’s been pre-agreed for them.) 7/16
For the NHSPRB, it gets more confusing. DHSC have been far less clear, saying “we expect the total investment in AfC in 2021/22 to be 1.7%.” Most journos are quoting 1% as a suggested pay rise instead of 1.7%. Both are correct; following tweets explain why. 8/16
As per the multi-year Agenda for Change agreement from 2018-21, there is some restructuring of NHS staff pay scales to be done this year. This process will result in a pay increase for certain staff groups, according to their pay band. 9/16
This resultant pay increase is included in the uplift which DHSC have proposed in their submission to the NHS Pay Review Body, which states on page 98: “we have committed c0.7% in 2021/22…to enable completion of the restructuring of the AfC pay structure.” 10/16
This “circa” 0.7% investment can therefore be considered as part of DHSC’s suggestion for this year’s pay uplift for Agenda for Change staff, though it will only impact certain groups of them. 11/16
The uplift which DHSC have proposed for AfC staff is therefore a total investment of 1.7% for the overall AfC pay bill, which they say on page 8: “we expect the total investment in AfC in 2021/22 to be 1.7%." 12/16
But, this can rightly be interpreted as a 1% pay rise, given that the 0.7% is a “circa” figure which we haven’t really seen the modelling for, and being used to finish ongoing pay reform work (even though this work will increase salaries for some staff) 13/16
We need to bear in mind that this is an evidence submission, and not a final decision. But if DHSC have been led by Treasury on this, it may well be difficult for any higher pay award to be implemented – even if the DDRB or NHSPRB recommend higher ones. 14/16
If higher pay awards than this suggestion of 1% are recommended, and government accepts those recommendations, it could fall to NHS Trusts (and other NHS employers) to make up the shortfall – at a time when they are already struggling to balance the books. 15/16
This is a very knotty and emotive situation. We are all too aware of the economic landscape in the wake of COVID. But ultimately, funding the NHS – including pay rises for its staff – will always be a political choice. And today’s evidence from DHSC has been disappointing. 16/16
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