The NHS workforce is facing rising workloads and pressures, tougher working environments and staffing shortages and the scale of the problem across the UK simply cannot be ignored, the Royal College of Nursing (RCN) and other unions* warned yesterday. They called for realistic expectations over the impact that pay agreements can make in such a generally challenging environment, and in particular in the light of the uncertainty surrounding Brexit terms.
In their joint submission to the NHS Pay Review Body (NHSPRB), the unions acknowledged that the lifting of the NHS pay cap and the commitment of £4.2bn investment by the Westminster government “were a major step in the right direction towards fairer pay and improved recruitment and retention”, and they welcomed long-awaited structural reforms to the Agenda for Change (AfC) framework. They were also pleased to have agreed with NHS employers shared aims for the NHS to pay above the living wage, and for supporting the attraction and recruitment of new starters to the NHS, as well as for retention, health and wellbeing and improved engagement of existing staff.
But they argued: “However, the pay agreements do not make up for lost earnings over the period of pay restraint since 2010.”
In their evidence the unions listed several key indicators illustrating just some of the challenges facing the AfC workforce:
- Average annual earnings among AfC staff are estimated to have increased by between 2.1% and 9.3% between 2011 and 2018, during which time inflation has increased by 24%; and fewer than a third (31.2%) of all staff expressed satisfaction with their pay in the 2017 survey compared with 36.8% in 2016.
- NHS providers in England reported about 103,000 vacancies in July-September 2018 (compared with about 1.1 million whole-time equivalent staff) and the number is forecast to increase further during 2019. High levels of vacancies, sickness absence and staff turnover have resulted in an 11% increase in spending on bank and agency in a year. The nursing vacancy rate in Northern Ireland is about 10%, with no data available for other staff groups and no data available for Wales.
The unions said: “The pay agreements put in place in Scotland, Wales and England represent a significant step in securing meaningful pay uplifts for Agenda for Change staff, yet the joint trade unions are clear that there are other challenges facing the NHS which need attention and planning, including staff shortages and the pressurised working environment. There will also be challenges from the removal of the NHS bursary and the shift to tuition fees in terms of both numbers attracted to the NHS and possible changes to their psychological contract with the NHS as an employer.”
They insisted: “Progress over pay levels in the NHS must be matched by real attention and investment in workforce planning; the recruitment of new starters; and the training, development and career progression of existing staff.”
*British Association of Occupational Therapists, British Dietetic Association, British and Irish Orthoptic Society, Chartered Society of Physiotherapy, College of Podiatry, Federation of Clinical Scientists, GMB, Royal College of Midwives, Royal College of Nursing, Society of Radiographers, Unison, Unite.