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Battle lines for this year's NHS pay round were set last week with publication of evidence from government, employers and unions to the pay review bodies.

At the same time, a new government survey found that less than 3 per cent of nursing and consultant posts are vacant (see box).

The four health departments say pay rises should be 'realistic and affordable'. Employers want an equal award for all staff at a level 'only modestly above the rate of headline inflation'.

Health unions are demanding a staged approach to close what they say is a 17 per cent gap between average pay for graduates working in professions allied to medicine and the starting salaries for graduates across the economy.

Nurses' and doctors' unions, whose evidence will be published in the next few weeks, are expected to press for more pay to tackle continuing staff shortages.

But a joint statement from the NHS Executive, employers and unions, expected within weeks, will warn the review bodies against making any further changes to the existing pay structure. The statement will argue that sufficient progress is being made in negotiations on the proposals for a new NHS- wide pay system.

Last year, the nurses' review body altered increments for both nurses and PAMs in a bid to tackle staff shortages. Evidence from both the NHS Confederation and the government expresses hopes for the new system through current negotiations.

Staff shortages are a key point for all bodies. The confederation says its annual survey shows that recruitment and retention are still major problems.

But the 'huge growth' in applications for training places indicates 'that an attractive starting pay has now been set and that numbers coming into the service will grow'.

The main priorities now are to improve working lives in order to raise retention rates and bring staff with interrupted careers back into the NHS.

The confederation says the emphasis should be on increasing the numbers of staff to cope with extra workload in the NHS, to relieve pressure on existing employees, meet output and quality targets and to provide a better service to patients.

The health departments say in their evidence that recruitment and retention of qualified nurses and PAMs is 'tight but getting better' and that motivation is best addressed through the government's modernisation programme, including human resource strategies. They say paybill increases should be significantly below the headline level of NHS resource growth.

Pretty vacant: posts without people The government's survey of staff vacancies in the NHS covers 98 per cent of English trusts. It found the following posts vacant for three months or more:

6,900 (2.6 per cent) out of 265,000 qualified nursing and midwifery posts;

440 (2.3 per cent) out of over 19,000 medical consultant posts;

25 (4.8 per cent) out of over 500 dental consultant posts.

Unison said it would soon be publishing evidence that over half of NHS wards have nursing shortages.