Staffing is the issue keeping NHS leaders awake at night - and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, by HSJ workforce correspondent Annabelle Collins, will make sure you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce. Contact me in confidence.
NHS England warned last year that any pay uplift for senior doctors above 2 per cent would “hamper” the ambitions of the long-term plan.
Despite this, the government has this week announced a 2.8 per cent rise for consultants and associate specialist and specialty doctors, to be backdated from April 2020. Doctors are among 900,000 other public sector workers who are also set to see their pay packets boosted after the chancellor’s announcement.
HSJ understands that although the government has not announced any new investment in pay following the uplift, extra funding agreed with the Treasury in response to the covid crisis should enable it to be met without additional reductions in spending elsewhere. This will see many employers breathe a sigh of relief.
It is difficult - impossible, even - to separate this above inflation uplift from the current context of the covid-19 pandemic. Rishi Sunak said: “These past months have underlined what we always knew – that our public sector workers make a vital contribution to our country and that we can rely on them when we need them.”
Who has been left out?
Rather than being any sort of "thank you" for the covid effort, many consultants will view the 2.8 per cent rise as a baby-step towards reversing years of pay restraint. But others welcome the uplift in the context of economic hardship due to be experienced by many other sectors.
The announcement had some notable exceptions - junior doctors and all other NHS staff on the Agenda for Change contract. The British Medical Association described this as “grossly unfair” and called on the government to provide a more “significant” pay award to all doctors.
Junior doctors are still bound by the four-year negotiated pay deal which followed the first strike action in 40 years, which will see doctors in training receive an annual 2 per cent rise along with £90m investment in other aspects of the contract. Agenda for Change staff (all non-medical staff bar senior managers) are also coming towards the end of a three-year deal that was agreed in March 2018.
Sarah Hallett, chair of the BMA junior doctors committee, said juniors must “at the very least” receive the equivalent to what is being offered to senior colleagues. Despite the agreed pay deal the pandemic has “changed the context”, she said.
The Hospital Consultants and Specialists Association president Claudia Paoloni also called for junior doctors’ pay to be revisited and described the government’s announcement as a “fresh psychological blow”.
Although the 14 staff-side unions have exerted pressure on the government to start AfC pay negotiations early, senior sources close to discussions have suggested that it would be unlikely for any pay talks to start before January.
The chancellor’s announcement, and the health secretary’s comments, inextricably linked the 2.8 per cent uplift to the pandemic and they chose to leave out the majority of other NHS staff. A small recognition for junior doctors and almost one million other NHS staff who worked through the covid peak, could have helped to take the sting out.
Also this week, in a Public Accounts Committee session, chief people officer Prerana Issar said the People Plan will be published in two parts, with the section on supporting staff and enhancing wellbeing ready to go imminently. HSJ understands this will be known as the "People Promise".
Anything not linked to culture and requiring a multi-year funding settlement, will be published later, towards the end of this year and after the spending review.
As potentially the only thing recognising the hard work and sacrifice made by NHS staff this side of Christmas, the "People Promise" has a lot of heavy lifting to do.