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Friday 14 May 2021

A pay rise is an investment for the future

By Jon Restell

Our members survey sent a clear message that the emergency effort can't be sustained forever. We need more staff and that means real investment in NHS pay this year.

Jon Restell portrait 2021

The message from our members’ pay survey in March was so strong and clear that the Independent covered it in depth as an exclusive. Thank you for taking part in such large numbers. Many of you said the government’s proposed 1% pay rise was insulting. You spoke about Herculean efforts by you and your teams, the intense and sustained pressures, the long hours without proper rest or annual leave, the risks run and the sacrifices of family life and wellbeing. 

NHS staff have done this willingly in a national emergency. There’s great pride in what’s been achieved, and hope that we can lock in the best new ways of working. But an equally strong message was that the emergency effort can’t be sustained indefinitely, and certainly not for the up to five years it may take to recover from the pandemic.

As managers, your views carry weight, and MiP has presented them to the NHS Pay Review Body. You spelt out that this year’s award is more about the future than the past. I share the view that it should not be seen as a reward for tackling the pandemic or—even worse—as ‘danger money’. The Covid bonus in Scotland and Wales risked sending such a message—but hats off to Wales for giving it to social care staff too.

We went into the crisis with an estimated 100,000 vacancies, and now face a potential exodus of exhausted but experienced staff, including many managers. Wellbeing may be as important as pay but, as many said in our survey, having enough staff is the most important ingredient of staff wellbeing.

The public values the efforts of NHS staff more than ever, and are fully behind a significant pay rise. But, after the pandemic, they will want to see waiting lists reduced, as well as better access to care and improvements to mental health services. 

To achieve that, we need more staff. And that means an effective approach to recruitment and retention. Ninety-two per cent of you considered, as senior managers, that a significant pay award is needed to recruit new people and retain our experienced staff. There are four reasons for that. 

First, people are rightly excited about growing student numbers and rising interest in NHS careers. But filling the bath with the plug out is hard work. We still need to retain the staff we recruit, and keep a balance between experienced and newly qualified staff; without that, risks to patients will rocket. 

Secondly, while management and culture are important, it will be staff numbers and workloads that ultimately determine what it feels like to work in the NHS—and whether people want to work in it. 

Thirdly, making the NHS an attractive place to work requires high-quality management. But our survey shows many managers are thinking about leaving early and only 58% would recommend NHS management as a career to family and friends. The supply of experienced managers is not inexhaustible—indeed, the health service management is now on the government’s list of occupational shortages. 80% of you said a significant pay rise would make you more likely to stay in the NHS. 

Fourthly, the economic recovery will further reduce the competitiveness of NHS pay. Inflation is already above 1% and RPI is forecast to rise beyond 3% next year. Private sector pay settlements are expected to top 3% in 2021—and don’t forget that public sector pay has been declining relative to the private sector for over a decade. 

It is obvious that the government’s 1%, and even NHS England’s planned 2%, fall short of the mark. But what does ‘significant’ look like? The Scottish Government has shown the way, offering awards averaging 4% to Agenda for Change staff. The offer is weighted to the lower paid and backdated to December 2020, which we support, but capped for senior bands, which we obviously don’t. 

Without such significant and early investment in pay, patients in England will not see their waiting lists or access times improving anytime soon. There just won’t be enough staff. That could see NHS waiting times return as a big political issue at the next election. Let’s hope the government listen to you. 

  • Jon Restell is chief executive of Managers in Partnership. A full report on the pay survey and MiP's evidence to the review body will be published on this site soon.

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