In its evidence to the NHS Pay Review Body this year, the government expressed its intention to cut unsocial hours payments severely.
It has argued that this is necessary for the NHS to deliver its seven-day services vision.
I, like many other nurses, already undertake night and weekend work, and work on bank holidays. I accept that this is necessary to ensure patients receive high-quality care. However, there is a view among senior NHS decision-makers that “unsocial” simply means not being able to socialise with friends at the weekends.
They ignore the more severe effects that working unsocial hours has on home, family and personal health. For example, there is evidence to suggest that working unsocial hours has a negative impact on nurses’ health and wellbeing. Pay enhancements help to compensate for these sacrifices that nurses make on a daily basis.
Since the coalition government came to power, a band 5 nurse not at the top of their pay grade will have lost at least £2,832 from below-inflation pay rises. Unsocial hours payments have become a significant part of most NHS nurses’ salaries - one-third in most cases. Without them, many nurses would struggle to get by.
Some nurses are already in hardship and struggling to make ends meet - even with unsocial hours payments. Unison has been told by some NHS nurses that they’ve had to use food banks to manage until they get paid each month. If the government cuts unsocial hours rates, this will result in a huge cut in pay and the number of NHS nurses relying on food banks is likely to increase.
Alternatively, NHS nurses may need to increase the number of hours worked or take on a second job outside the NHS to compensate for the reduction in their pay. For nurses with children or caring responsibilities, this is likely to result in increased childcare or caring costs.
Many nurses are proud to work for the NHS because of its values - care at the point of need. However, this latest attack on nurses’ pay has left many feeling undervalued. NHS nurses are already at breaking point, and morale is at an all-time low. Not paying them fairly when they are working at night and over the weekend is the final straw.
Many nurses have already left the NHS, and others are now considering it. The health service is already experiencing recruitment difficulties, and this attack on unsocial hours rates will only make things worse. Because of high nurse vacancy rates, the NHS is heavily dependent on agency workers. Dependency on agency workers will increase if unsocial hours rates are cut because these staff will be required to cover hard-to-fill shifts. This will be expensive in terms of both finances and care quality.
In its submission to the NHS Pay Review Body, Unison argued that the government’s proposals to cut unsocial hours rates would place serious limits on the ability of the NHS to deliver the seven-day services vision. If nurses are not getting paid extra for working nights, they might as well work days. Because the NHS will find it difficult to fill shifts, it will become over reliant on costly agency staff which will, in turn, have a detrimental impact on NHS spending.
Instead of cutting unsocial hours payments, I believe that there should be an uplift in unsocial hours rates. This would help motivate people to work out of hours, helping the NHS to achieve seven-day services. It would also help to offset cuts to basic pay. This would result in a highly motivated workforce capable of delivering outstanding patient care.
Ann Moses is chair of the Unison National Nursing and Midwifery Sector Committee