The wages of some of the lowest paid nurses in the country are likely to be hit further by the government’s plans to introduce local pay bargaining, figures obtained by Nursing Times reveal.
Last Wednesday chancellor George Osborne confirmed local pay could be rolled out to parts of the public sector from this year.
If applied to the NHS, this may lead to the Agenda for Change pay framework being scrapped and wages negotiated on a regional, or even trust-by-trust basis.
As previously reported, the NHS pay review body is due to report to the government in July on whether, and how, pay could be made more in line with private sector rates.
The Treasury argued in documents submitted to the body on the day of the budget that public sector staff in some parts of the country were paid up to 17.5% more than their peers in the private sector.
The areas it said had the biggest gap between private and public sector wages were Yorkshire and the Humber – with the exception of West Yorkshire – Strathclyde in Scotland, Wales and more rural parts of the West Midlands.
But previously unpublished data from the NHS Information Centre, obtained by Nursing Times, reveal that nurses at around two dozen trusts in some of the areas highlighted by the Treasury are already among the lowest paid in the country.
Qualified nurses, midwives and health visitors at these trusts have combined average earnings below £34,400, the national average across all 165 acute trusts in England.
The lowest average nurse pay, excluding specialist trusts, was £32,100 at Royal Bournemouth and Christchurch Foundation Trust, while at Doncaster and Bassetlaw Hospitals Foundation Trust the average nurse received £32,800 and those in Wye Valley Trust got £32,900.
A Royal Bournemouth spokeswoman insisted the trust paid nationally agreed Agenda for Change rates, followed national guidelines for pay and worked closely with staff side representatives.
The highest wages were mainly found in London trusts, such as Homerton University Foundation Trust, where nurses earn £40,700 on average.
NHS organisations in the capital and its surroundings are already permitted to pay staff “London weighting” of up to a fifth more than the standard Agenda for Change rate.
NHS Employers, the organisation that represents trusts, suggested last week that similar supplements could be extended to other parts of the country, especially other major cities.
Professor James Buchan, from the social sciences and healthcare faculty at Edinburgh’s Queen Margaret University, said the current differences were likely to reflect staff turnover and the age and skill levels of nurses.
But he said local pay setting carried “high risks of unintended consequences” in the NHS. “Working out where the supplements should be paid will be challenging and problematic,” he said.
For example, Oxford and Edinburgh have high living costs, suggesting a supplement would be appropriate. But they probably face less competition from the private sector for nurses than other areas, meaning market pay rates could be lower.
The figures also reveal the size of pay gap between nurses, managers and medical staff.
At the lowest end of the scale, nurses at Western Sussex Hospitals Trust earn on average £33,400. This represents just over two fifths of the £77,000 average salary for the trust’s managers.
But at Hinchingbrooke Healthcare Trust in Cambridgeshire nurses earn four fifths of average management salaries – though clinical managers are not included in the figures.
Western Sussex’s finance director Spencer Prosser suggested different workforce definitions could affect the data. He said his trust took an “extremely strict interpretation” of what classified as a manager or senior manager and that others trusts “may take a difference approach”.
Nurses at the Homerton receive average wages that are 57% of its doctors’ average pay, but at Central Manchester University Foundation Trust they are only worth 29%.
Announcing his plans for local pay setting in the budget statement last week, Mr Osborne said he wanted to make public services “more responsive, and help our private sector to grow and create jobs in all parts of the country”.
But Unison general secretary Dave Prentis said local pay would weaken already-depressed areas.
“The dismantling of Agenda for Change would be the government’s final nail in the coffin of our NHS,” he said.
See the attached Excel sheet for information (right) for more details on the average nurse pay at your trust and those across the rest of the country.