Opinion

Who gets paid what in the NHS?

With an army of 1.7 million employees, the NHS is now the fourth biggest employer in the world, behind the Chinese military, Wal-Mart and Indian Railways. It is a vast machine that deals with a mind-boggling influx of demand. In just 24 hours, the NHS will deal with 60,000 visits to emergency departments, 820,000 GP appointments and 108,500 dental procedures.

Only half of those employed by the NHS are clinically qualified staff: the essential front line. A significant chunk of the other half is covered by those who need to organise the network and keep it ticking. Management careers in the NHS have seen a significant boom in the past decade, with the number of managers rising by 66%.

With more than 350 careers available in the NHS, some are more lucrative than others, and it comes as no surprise that some managers get paid more than those on the front line, who face higher stress levels but fewer rewards. However, most NHS careers are progressive and the rigid pay scale is designed to see every employee’s salary go up every year for several years. But who are the best-paid workers in the NHS? And who gets left underpaid and overworked?

The NHS pay scale works on nine ‘bands’, numbered 1 to 9, with 1 being the lowest paid. Depending on which career path they choose, many NHS staff move up the bands as the years progress. However, some NHS workers get paid less than the living wage - a rate of pay set by the Joseph Rowntree Foundation as the minimum wage a single person needs for an acceptable standard of living, which currently stands at £14,400. Those on band 1, the lowest band the NHS pays (£14,294), are porters, kitchen workers and domestic support staff, who are all essential to keeping a hospital and other facilities clean, and patients happy.

It’s no surprise that cleaners are at the bottom of the pay scale, but who are at the top? The highest bands on the NHS pay scale are 8 and 9, with band 8 being divided from 8a to 8d, meaning that there’s a wide range of salaries inside the 8 band – from £39,239 to £98,453. Band 9 is the top band, hitting the ceiling at £98,453, and those inside it are few and far between. Team managers and department heads are often placed in this exclusive band, which is higher than most GPs’ salaries.

When it comes to nursing, the top job is the controversial modern matron position, created in 2001 in response to widespread problems with dirty hospitals and infections. The modern matron oversees a hospital department and overlooks cleaning, food and care standards and budgets, and is placed in band 8, well above a hospital nurse in band 5.

Controversially, some managerial positions are paid a better salary than highly qualified doctors. GPs can earn up to £81,969, which is also the same as the top salary for an experienced dentist. Hospital consultants, however, go above band 9 and can earn up to £101,451 in exchange for long hours and a high-pressure job. Doctors fresh out of university earn a basic wage of £22,636, which soon grows when training is over.

What about the crucial employees in the first response ambulance services? Despite the dangers and stresses of the job, ambulance drivers are on one of the lowest pay bands, band 3, starting at £16,271. A qualified paramedic is on band 5 - the same as a nurse and a midwife. The highest band that those in the ambulance service can reach is band 7, as an emergency services area manager.

One bone of contention when it comes to NHS staff is the number of administrative and bureaucracy employees hired to organise one of the largest institutions in the world. An administration manager earns as much as a nurse. However, some of the lowest paid positions in the NHS are also administrative. Health records assistants and clerical officers languish in band 2, in which the first year of employment is paid below the living wage. Higher clerical positions include library manager and head of IT training at a hospital, both of which are at band 7, which starts at £30,764 and can rise to £40,000 over six years.

Specialist therapists get paid a range of salaries despite training for the same amount of time: a speech therapist starts at band 5, whereas an art therapist is two bands higher at 7, a significant difference.

Pay rises are often promised to NHS workers and consequently frozen. But despite pay conflicts, 78% of NHS staff say they are satisfied in their work, according to the 2012 NHS workers survey.

About the author

Alex works alongside nhstaxrefund.co.uk. When she isn't writing up about the latest news in the medical profession, Alex can be found helping healthcare professionals to save some of their money.