Posted 02 March 2023 - 05:00
Posted 02 March 2023 - 05:00
News
Who decides what nurses are paid in the UK
With nurses pausing strike action amid top-level talks behind closed doors, we spell out how things stand on pay for the current year as well as 2023-24
With nurses pausing strike action amid top-level talks behind closed doors, we spell out how things stand on pay for the current year as well as 2023-24
With a dispute over the pay offer for the current year still unresolved and next year’s offer already under consideration, things can get confusing when it comes to the pay situation for nurses.
Nurses have overwhelmingly rejected the NHS Pay Review Body’s (RB) recommendation of a 4% pay rise for 2022-23, but how was that figure decided and what is happening with the dispute?
What are the current talks between the RCN and government about?
The RCN has paused strike action in England after official pay talks began with health and social care secretary Steve Barclay on 21 February. But it is not known if the talks are solely focused on the 2022-23 offer of 4% or if there will also be discussion of a 2023-24 offer.
It is hoped a new offer for 2022-23 will soon be on the table for members.
To confuse matters, on the same day the DHSC also sent its evidence to the RB for the 2023-24 pay round. It recommended a pay rise of no more than 3.5% for NHS workers.
However, this is not why strikes were in England were paused. The RB has not completed its review into pay for 2023-24 and may recommend a higher figure than suggested by the DHSC.
What is the NHS Pay Review Body and how is pay decided?
The RB makes recommendations to the DHSC on annual pay rises for NHS staff on Agenda for Change contracts in England, Wales and Northern Ireland.
The panel is chaired by Philippa Hird, pro chancellor of the University of Manchester. She has headed the panel since 2017.
Ms Hird told a parliamentary committee that each year the RB tours a wide range of acute and community NHS employers across the three countries to interview managers and staff about pay.
She said: ‘On each visit, we talk to staff at every level of the organisation. We have small focus groups, clinical and non-clinical staff, at all pay bands, so we have in-depth discussions with staff.
‘They tell us how they feel about their work and their pay, so we get a fair amount of good quality input from staff.’
The RB also reviews evidence from the government and trade unions, which formally submit a case for a recommended pay rise for that year. Ms Hird said it also gathers its own economic evidence through specialists on the panel.
After collating a report, the RB will make a formal recommendation to the government on whether staff should be given a pay rise and by how much.
Does the NHS Pay Review Body do what the government asks?
There has been a lot of media coverage about the RB being a government organisation, but it does not always do what the government wants. There have been two recent recommendations by the RB that were higher than proposed by the government.
In 2020 the government said it could only afford 1% and the RB recommended 3%. Then in 2022 the DHSC again said it could only afford 2% and the RB recommended 4.8%.
Ms Hird said that while affordability was ‘an important consideration’, the RB must balance this with concerns over recruitment and retention.
Equally, the government does not have to follow the RB’s suggestions. Former health secretary Jeremy Hunt, now chancellor, rejected a 1% pay rise recommendation in 2013.
What is happening with the 2023-24 pay round for NHS staff?
Progress is slow. Health unions have refused to submit evidence to the RB for 2023-24 while the 2022-23 award is still in dispute. Ms Hird said that while some unions have contributed, leading nursing unions have not.
Meanwhile, the government delivered its evidence six weeks late, meaning a recommendation from the RB is unlikely to be made before the end of April, weeks after the start of the new financial year.
Although the government has recommended a rise of 3.5%, the RB has scope to say nurses and other healthcare staff should be getting more.
With both sides tight-lipped on the current pay award and next year’s offer, what comes next?
It is hard to know what will happen with the current pay award and next year’s offer. The RCN and the DHSC are remaining tight-lipped about the pay talks currently under way.
If they progress well, a new offer for 2022-23 could be on the table for RCN members in England to vote on. But if talks break down, nurses could be back on the strike.
In the meantime, the RB is still working on its report for the 2023-24 offer. This is going to be later than planned, but only time will tell whether it will recognise the real concerns from nurses on pay and staff retention that drove them to the picket lines this year.
If nurses are unhappy with the offer that is put on the table then trade unions could once again ballot members on strike action.
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