Services risk being scaled back over unfunded NHS pay rises

Last week, the Royal College of Nursing rejected a 5 per cent pay rise for Agenda for Change staff. Any deal eventually struck will affect all AfC staff, including those working in services commissioned by public health departments from the NHS, including health visitors and those working in sexual health clinics. 

However, a letter, seen and first reported by LGC, sent by Office for Health Improvements and Disparities director general Jonathan Marron to all council chief executives and directors of public health, informed councils the public health grant will need to “cover all pay pressures for 2023-24, including the impact of NHS pay settlements”.

Senior figures in the sector have warned that without adequate funding, agreed pay increases for NHS staff could mean the scaling back of frontline services, including sexual health clinics and home visits.

A letter sent to health secretary Steve Barclay and co-signed by the NHS Providers and NHS Confederation community network chair, Siobhan Melia, and vice chair, Richard Kirby, also pointed out concerns around the lack of adequate funding for NHS pay rises.

The letter, which was also signed by NHS Confederation chief executive Matthew Taylor and NHS Providers deputy chief executive Saffron Cordery, warned that “if the costs of meeting the nationally agreed NHS pay rise are not met centrally, community providers will have to absorb the pay rise for staff within their own budgets, which are already stretched”.

It added: “Regrettably this means that unfunded pay rises are likely to contribute to the scaling back of public health services at a time when they are playing an essential role.”

Association of Directors of Public Health vice president and Sheffield City Council director of public health Greg Fell told LGC: “The numbers just don’t add up.

“You might well say, you can find efficiencies from elsewhere, but there aren’t any. There are no efficiencies left.”

He told LGC no one is arguing NHS staff don’t deserve a pay rise but added that we “can’t pretend” the public health grant can “go further than it actually can”.

Mr Fell noted “the narrative is all about NHS pay inflation” but added: “I’ve got to meet their pay inflation as well, because it’s not particularly fair or right that NHS staff funded by the block of money coming in from the public health grant do get a pay rise, and local voluntary and community staff don’t.”

He added that without proper funding this “will have consequences” for frontline, preventative services. “There’s just no way it won’t have consequences,” he told LGC.

This year, the government gave the public health grant a 3.3 per cent cash terms increase. However, over the past decade, the grant has been cut by 27 per cent and inflation is currently running at over 10 per cent.

The Local Government Association has estimated the amount required to cover the cost of a 5 per cent pay rise would be around £66m.

The Department of Health and Social Care said it is “absolutely committed to ensuring the NHS has the funding it needs to deliver for patients” and “there will be no impact on frontline services or quality of care that patients receive as a result of this offer”.

The DHSC added it is working with HM Treasury to ensure the department has enough money to fully fund the pay offer, with funding made available for a 3.5 per cent pay increase within existing budgets.

It said any funding on top of that will come from a combination of reprioritisation and new funding for the DHSC.