Expert advice

Workforce: widening the gap between Scotland and England

Increasing policy divergence between NHS Scotland and NHS England is making it harder to sustain a UK-wide perspective on the NHS nursing workforce, says workforce expert James Buchan. 
Scotland_gap-Alamy.jpg

Increasing policy divergence between NHS Scotland and NHS England is making it harder to sustain a UK-wide perspective on the NHS nursing workforce, says James Buchan

Differences between the employment situation of NHS nurses working in Scotland and England are becoming ever more pronounced.

This was reinforced recently in the report from the NHS Pay Review Body (RB) on staff pay in Scotland.

Some key points of difference were positive news for the government, and nurses, north of the border.

In general, staff in Scotland get paid more under Agenda for Change (AfC) than their peers elsewhere in the UK. The use of costly external agency staff is lower than in England, and the number of applicants to nursing courses in

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Increasing policy divergence between NHS Scotland and NHS England is making it harder to sustain a UK-wide perspective on the NHS nursing workforce, says James Buchan 


In general, staff in Scotland get paid more under Agenda for Change than their
peers elsewhere in the UK. Picture: Alamy 

Differences between the employment situation of NHS nurses working in Scotland and England are becoming ever more pronounced. 

This was reinforced recently in the report from the NHS Pay Review Body (RB) on staff pay in Scotland. 

Some key points of difference were positive news for the government, and nurses, north of the border. 

In general, staff in Scotland get paid more under Agenda for Change (AfC) than their peers elsewhere in the UK. The use of costly external agency staff is lower than in England, and the number of applicants to nursing courses in Scotland appears to have dropped by just 4% on the previous year, compared with 23% in England. 

Policy divergence 

Other differences, however, are a more challenging read for Scottish stakeholders. Six out of ten AfC staff in Scotland are at the top of their pay band and are not eligible for incremental pay increases. 

And if the existing public sector pay policy in Scotland, which focuses on a 'living wage', continues, it will 'exacerbate existing compression at the bottom of the pay distribution'. This means, for example, that the pay differential between a band 2 assistant and a band 5 nurse will narrow in future years. 

The RB also calculate that staff in Scotland with taxable income of more than £45,000 will pay an additional £400 per year of income tax, compared to similar NHS staff elsewhere in the UK. This is because the Scottish government did not increase the threshold for a higher rate tax. 

Although these are incremental changes, they contribute to a year-on-year trend of increasing policy divergence between NHS Scotland and NHS England, which is then reflected in cross-border variations in NHS nursing employment experience. 

It is becoming increasingly difficult to sustain a single 'UK-wide' perspective on the NHS nursing workforce. 


About the author 

 

 

 

James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh 

 

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