Unions have suggested that nurse pay rises could be linked to increases in efficiency in the NHS.
Their proposals have called for a reward system within the NHS similar to one used by business, where gains in productivity are linked to pay increases.
This focus on efficiency followed claims by NHS organisations that budgets within the health service were expected to shrink in the coming years as the effects of the recession filtered through to the public sector.
The subject was discussed at a meeting earlier this month of the NHS social partnership forum, a partnership between the Department of Health, NHS Employers and NHS trade unions to improve working relationships within the NHS.
Making efficiency and cost savings could help to save jobs should NHS finances come under serious pressure, said Mike Jackson, UNISON senior national officer.
Mr Jackson said: ‘There would need to be something in it for staff – that might be an opportunity for a future pay round. This could be negotiated with the pay increase.
‘In other industries, productivity margins are shared – if there are margins created by the workforce for employers, then the benefits are shared.’
One stumbling block is that traditional productivity measures of inputs and outputs cannot always be used in healthcare settings.
For example, having one nurse look after a greater number of patients may look like a cost saving on paper, but could lead to adverse clinical outcomes.
Barrie Brown, Unite lead officer for nursing, added that successes such as meeting the one-hour waiting and MRSA targets already showed that productivity had increased in the NHS.
‘This issue of productivity has come up in the past. Our view is that there have already been big productivity gains,’ he said.
‘The targets that have been set in the NHS have been exceeded and this has been an achievement of frontline NHS staff.’
He warned that he did not want to see this issue overshadow the debate about the continued use of the pay review body process to determine future pay awards.
There has been no discussion about whether the PRB will continue when the current three-year pay deal expires in 2011.
‘There are no discussions about the continuation of the Pay Review Body process for the future pay awards,’ he added.