Nurses could face lower pay awards in years to come to help the government afford its plans for regionally aligned pay, it has emerged.
The Department of Health has published documents supporting a move to make the pay of NHS staff “more appropriate to local labour markets”. But health unions have repeated their opposition to any plans that would lead to reduced pay.
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.
Evidence submitted to the review body by the DH today reveals that instead of imposing local pay scales at trust level, it hopes to keep the Agenda for Change national pay contract and instead graft new higher pay zones – similar to London weighting – onto the existing framework.
This would allow trusts in those areas to pay staff more. However, nurses working in other parts of England would suffer what the DH describes as “a prolonged period of constrained headline pay awards” to allow “headroom” for the extra zones to build up.
Initial suggestions are for one or two higher pay zones, with one option covering the south and areas around the London fringe, including Oxfordshire, Cambridgeshire and Hampshire.
A second option includes two zones. This would comprise an area taking in parts of the Midlands and around Manchester and Leeds, as well as the zone covering the south and London fringe.
The DH said it thought its plans for “market facing pay” could start to be implemented as early as April next year.
It said: “Current rates of pay in the NHS do vary geographically, but significantly less so than the pay of comparable staff in the private sector. The introduction of more sensitive market facing pay would enable more efficient and effective use of NHS funds.”
Headline pay for nursing staff earning more than £21,000 has already been frozen in 2011-12 and 2012-13 – though this excludes incremental pay rises.
Health unions – including Unison, Unite and the royal colleges of nursing and midwives – issued their joint response to the review in March, calling for national pay rates to be retained.
Responding to the DH submission, Unison head of nursing Gail Adams said: “What will not work is any reduction in the level of earning. That’s where the problem will be.
“Nurses are already facing a pay cut, the government says it is a pay freeze but the reality is their cost of living, utility bills and mortgages etc have all gone up.”
RCN chief executive and general secretary Peter Carter said: “It remains our belief that a move to local pay among NHS staff will lead to damaging competition between trusts for staff, drive down pay in certain areas and risk lasting damage to staff morale and motivation.
“The current system is tried and tested. It ensures that employers in any part of the country can recruit staff with the right skills and experience to give patients the care that they need.”
Rachel McIlory, research and information officer at the RCN, said: “Basic pay will be kept down and there will be the introduction of a few more high cost areas supplements, but there is no money to pay for that in the short-term.”
She also warned that the introduction of the DH’s proposals could lead to recruitment and retention problems in those areas outside of the higher pay zones, in contrast to the government’s intention to improve it within them. “It could lead to problems on wards,” she told Nursing Times.
Ms McIlory added however that the government’s apparent commitment to continue with national pay bargaining for the time being was welcome but warned that unions were still concerned about the threat of local pay. “This is not as bad as we thought, but we can see the direction of travel,” she said.