Nurses could in the future see their unsocial hours payments reduced or removed altogether under government proposals to make the NHS in England a “seven-day service”.
Ministers want to modify the current system for unsocial hours payments, which they claimed is “out of date” and created a “potential barrier” to providing affordable care at the weekends and in evenings.
Last autumn the DH asked the NHS Pay Review Body to look into “affordable out of hours working arrangements”, as part of wider plans to reform Agenda for Change.
“If these extra payments are cut, not only would staff suffer directly but it would also be difficult for the NHS to get cover for evenings and weekends”
In its submission to the review, published last week, the Department of Health claimed around £1.8bn per year was spent on unsocial hours payments to non-medical NHS staff.
It has put forward six options. These include eliminating the payments altogether, although an additional 10% of salary would be paid for night shifts falling between 8pm and 6am.
Lowering unsocial pay rates for Sundays and bank holidays is also being considered, “to bring the NHS more in line with other sectors”.
Another suggestion is to retain the payment, but give all staff the same rate. Currently unsocial hours remuneration is calculated based on a workers’ salary band.
Removing Saturday as an eligible day for unsocial hour payments and pushing back the time from which this money can be claimed during a night shift – from 8pm to 10pm – has also been mooted.
Another approach suggested by the DH, and inspired by practices used at car breakdown firm the AA, would see out-of-hours payments calculated depending on how flexible staff are.
Its final option is to revise progression pay within Agenda for Change contracts to make it “fairer, more competitive, more attractive to employers and new starters, and more rewarding to staff who excel in their role”.
Unions have criticised the proposals, claiming the government is trying to prevent health workers from earning the extra money that they rely on.
Unison head of health Christina McAnea said: “If these extra payments are cut, not only would staff suffer directly but it would also be difficult for the NHS to get cover for evenings and weekends.”
The Royal College of Nursing warned the changes risked making NHS an unaffordable career for many nurses and healthcare assistants, and accused the government of being “utterly reckless” in light of current NHS recruitment problems.
Unions and the organisation NHS Employers will also make submissions to the review body before it publishes its final recommendations.
However, the DH said it did not believe unsocial hours payments were in themselves necessary to recruit and retain the staff the NHS required or that they led to better patient care.
“Indiscriminate use of premium pay rates at levels which may be higher than is necessary to attract and retain staff, and which are not aligned to patient need, could act as a barrier to sustainable seven day services and service innovation,” it said.
A DH spokesman said: “In the 21st century NHS we need patients to get the same high-quality care every day of the week - the need for care is not limited to office hours.
“This will speed up diagnosis and discharge and reduce the amount of time patients spend in hospitals.”