An overwhelming majority of provider trust human resources directors believe further reductions are needed in NHS staff pay, terms and conditions, an exclusive survey suggests.

HR barometer

HSJ/NHS Employers HR Directors Barometer

There were 117 respondents to the first HSJ/NHS Employers Barometer survey of NHS HR directors, of which 70 were from provider trusts.

Their responses reveal a widespread belief that changes to the Agenda for Change framework agreed in February, following a renegotiation with unions, were not leading to enough reduction in providers’ costs.

The survey asked whether the February deal “went far enough”. Eighty-one per cent of the HR directors who responded said it did not. Fourteen per cent said it did, while 5 per cent they did not know.

One respondent said: “When calculated for our trust, [the Agenda for Change alterations] save a seventy-seventh of the financial challenge this year.”

Another said: “We need to make Agenda for Change more affordable for employers, otherwise trusts will look to move away from national terms and conditions.”

Another respondent said: “The financial challenge and 24/7 working means the framework is out of date.”

When asked whether further changes were needed to pay, terms and conditions, 95 per cent of provider HR directors said yes. Many said changes were needed to annual leave and sickness entitlements, and called for the costs of the medical workforce - which is not covered by Agenda for Change - to be addressed.

NHS Employers is seeking to negotiate both the consultant and junior doctor contracts this year.

Poole Hospital Foundation Trust chief executive Chris Bown, who was also chair of a group of trusts in the South West which earlier this year considered seeking a regional breakaway deal from Agenda for Change, told HSJ: “These results speak for themselves and are a clear message to our national negotiators and indeed national trade unions to get back around the table to ensure pay, terms and conditions are fit for purpose.

“That will be incredibly difficult but it doesn’t mean we should bury our heads in the sand. It is an enormous challenge for NHS Employers but it is not going to go away as an issue.”

Foundation Trust Network chief executive Chris Hopson said: “Trusts need to quickly and fully implement the Agenda for Change deal that has been done as that offers some really good opportunities.

“But clearly we need to go further. We need a debate across the sector about what going further means and what radical options need to be considered,” he added.

Trade unions are likely to oppose attempts to reduce pay and terms further.

Unison senior national officer Sara Gorton told HSJ: “Our members are telling us that they already have concerns about the quality of care being provided.  With demand on the up… this could spiral out of control.  Cutting pay and driving down morale will only make this situation worse.”