Analysis

A cap of 1% on pay means nurses will feel the squeeze even more

The Department of Health’s (DH) evidence to the independent NHS Pay Review Body (RB), published on January 16, argued that NHS nurses in England should receive a pay rise of only 1% for 2016/17.

The DH also said that the NHS pay award should not be targeted to ensure some professions or bands receive a higher than 1% increase.

It claimed that further increases are unaffordable and reaffirmed its intention to remove the automatic incremental pay progression in Agenda for Change (AfC) and link it more closely to performance.

This is despite the acknowledgment that pay satisfaction has dipped in recent years.

Picture credit: Daniel Mitchell

Health unions are not surprised by the submission after the announcement in chancellor George Osborne’s summer budget that from 2016/17 public sector pay increases will be funded at an average of 1% each year until 2019/20.

The last time that nurses received a pay rise greater than 1% was the 2.25% awarded in 2010.

Should pay restraint continue to be capped at 1% until 2020, nurses will have endured ten years of frozen pay or pay rises of no more than 1%.

Last year, the RCN’s survey of 4,137 members in the NHS and independent sector revealed that 51% are working extra hours to earn money to pay bills and basic living expenses and 40% have worked night or weekend shifts to make ends meet.

RCN head of employment relations Josie Irwin says the DH’s submission is ‘miserable reading’.

‘What we want to see is pay increases reflecting the rise in inflation and our members’ increasing cost of living. The result of pay constraint since 2010 is a gap of at least 12% between members’ earnings and the cost of living. A 1% pay increase doesn’t even begin to bridge that gap.’

Coupled with this, she expresses concern that nurses are under greater stress because they are trying to make ends meet financially while also facing greater workloads.

Food banks

She says: ‘There are nurses who are not on the bottom pay points but are having to resort to food banks, so there are some real examples of economic stress.

‘People have to make ends meet at the same time as dealing with the increasing pressures on them at work.’

The RCN’s submission to the RB highlighted the reductions in pay for nursing staff between 2011 and 2015 in real terms, from 10.3% for band 5 nurses to 6.3% for band 9 staff.

Ms Irwin says pay restraint is making basic living unaffordable. ‘Electricity, services, gas and food have been subject to inflationary pressures yet at the same time pay has not gone up.’

Unison’s submission to the RB in September last year made similar warnings about the impact of continued pay freezes on nurses, stating that continued pay restraint will ‘severely exacerbate’ recruitment and retention.

Battling to keep heads above water in the face of chronic understaffing

The submission said the workforce is ‘struggling to make ends meet financially, and battling to keep their heads above water in the face of chronic understaffing and mounting pressures’.

A Unison survey of 10,589 members from the NHS carried out from May to July last year revealed that for almost two thirds of nurses, pay has worsened in relation to the cost of living over the previous 12 months, particularly in relation to food and transport.

Retail prices in November 2010 compared with November 2015 Source: Office for National Statistics

Unison deputy head of health Sara Gorton argues the DH is not acknowledging that a 1% pay rise will be cancelled out by an increase in national insurance contributions.

The DH’s evidence said the AfC pay structure needs to be reformed to ‘remove the expectation of incremental progression regardless of performance’.

It also reiterated its commitment to extending plain time working – hours when AfC staff are paid their basic salary and do not receive any unsocial hours premiums – ‘to help employers ensure they can afford to roster the right staff at the right times across seven days’.

However, Ms Gorton explains: ‘Our members have been reliant on unsocial hours payments. As pay has remained frozen, more staff have been working extra hours to make up their pay.’

South London practice nurse Linda Drake fears further pay restraint could exacerbate current recruitment and retention problems in practice nursing.

She says many practice nurses are on locally negotiated pay with GPs who cannot afford to pay nurses more. She wants the government to provide greater financial support to GP practices.

‘GP practices are struggling with huge financial pressures and morale is low. I know if I asked for a pay rise that it will come out of GPs’ incomes and these are people who have been close colleagues for many years.’

The RB expects to publish its recommendations for England, Wales and Scotland by the end of March.

Under Pressure

Nurses alter shopping habits as pay restraint takes its toll

Drew Payne, a community nurse in North London, says: ‘As my pay decreases in real terms, I worry about how I will cope. Already we have had to cut back. I choose cheaper holidays, I buy clothes only as my old ones wear out, and I go out just once or twice a month now.’

Kate Tantum, a research and education specialist sister in intensive care based in Plymouth, says: ‘Everyone I know shops in budget superstores to reduce their weekly food bills. We are all becoming more aware of the financial burdens of everything.’

Kevin Takooree, team leader at Kent and Medway NHS Social Care and Partnership Trust, said: ‘Life is going to get much tougher. I used to go out nearly every Friday and Saturday night, but now I have to think about where I will go and whether there are places where I can get cheaper food. When I go shopping, I look out for discounts and I also look for cheaper places to go on holiday.’

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