Pay review body backs seven day services

But, the body added, the introduction of seven day services will “inevitably” have to be traded off against affordability.

The report has been released to coincide with Jeremy Hunt’s major speech on NHS reform this morning, and represents a challenge to the British Medical Association. The BMA is at odds with the government over the issue.

The Pay Review Body advises the government on the pay of NHS staff – but it does not cover doctors and dentists, whose pay is subject to separate agreements with the government.

The report says the case for adopting seven day working practices is “compelling”, on the grounds of improving outcomes for patients treated at weekends. Negotiations over the national Agenda for Change contract should not delay local implementation of seven day services.

The document says: “This is an area where all parties are in agreement, and this common desire to improve patient care provides a positive basis in which to frame further discussions. From the feedback we received at our visits to case study sites, and from the evidence presented from the joint staff side and individual trade unions, it is clear that, where a case can be made on the grounds of clinical need and improvements to service, staff are generally willing to support and help enable the change to seven day services.”

However, it concludes: “How quickly and uniformly seven day services are required to be in place will inevitably have to be traded off against affordability.

“If the priority is affordability, for example, then the slower and less uniform the pace of change. We note that the costs of seven day services are principally in employing more staff, including consultants.”

The only way seven day services could be brought about without an increase in cost would be by cutting the pay of staff that already work more than seven days “if unsocial hours definitions and premia are looked at in isolation”.

The pay review body considered the impact of both adopting seven day working, and the abolition of extra payments for working unsocial hours. It concludes that “unilateral changes to unsocial hours definitions and premia would be risky, in the light of the potentially negative impact on recruitment and retention and morale and motivation”, as well as the lack of understanding of the impact it would have on individuals.

Instead, “discussions about unsocial hours definitions and premia are better taken forward as part of negotiation on other parts of the pay system, with the aim of agreeing a balanced package of updates to Agenda for Change”.

Mr Hunt this morning affirmed his commitment to seven day working, setting a September deadline for negotiations with the BMA, and insisted that they should not be a “road block” to reform.