Put pay right and start to solve the NHS’ many problems, says UNISON


A proper pay rise for NHS staff in England this year is essential if there is to be any hope of filling the huge vacancies hole and stopping waiting lists from spiralling, says UNISON today (Friday).


The union – representing ambulance workers, nurses, cleaners, medical secretaries, occupational therapists, porters and a whole host of other NHS staff – has urged Victoria Atkins to convene pay talks.


UNISON says this would be the best way to agree the wage rise due in April, improve the experience of patients and avoid a repeat of last year’s strike action.


UNISON, which is the biggest union in the NHS, has this week written to the health secretary setting out the case for sustained investment in the workforce.


UNISON has also notified the acting chair of the NHS pay review body (PRB) of its decision to do this rather than submitting evidence. This is because the union says the PRB process takes too long, and is neither sufficiently independent, nor fit for purpose.


Health workers are disappointed by the government’s decision to fall back once again on the lengthy review-body process to set pay, says UNISON. The very fact Victoria Atkins didn’t get the PRB ball rolling until December means staff already know they won’t be getting this year’s wage increase on time, adds the union.


But pay is of real concern. In a recent UNISON survey, over a third (38%) of health workers said they were unable to concentrate at work because they were worrying about their finances.


The cost-of-living crisis has hit working families hard, and health workers are no exception, says UNISON. In the same poll, more than two-thirds (68%) said their rent or mortgage has risen considerably over the past year. And more than half (53%) expect their housing costs to go up significantly in the coming 12 months.


As a result, over a third (35%) of NHS staff told UNISON they had to take on extra shifts to get by, adding to an increased risk of stress and burnout, the union warns.


More worryingly, says UNISON, increased housing costs have already prompted three in ten (31%) to start looking for better-paying jobs outside the NHS, raising fears that staffing shortages could yet worsen.


Vacancy rates remain stubbornly high across every part of the NHS in England, says UNISON. With trusts more than 110,000 staff short, the impact on workload, morale and patient care is huge, adds the union.


UNISON acting head of health Helga Pile said: “There’s a staffing emergency across every part of the NHS in England. There are simply too few health workers to meet increasing demand. That leaves staff stretched ever more thinly as they try desperately to deliver quality care to patients.


“It took many days of strikes to get last year’s pay rise agreed, but since then inflation has failed to fall as far, or as fast, as experts predicted. With the lump sums that helped settle the dispute no longer part of their pay packets, health workers now think they got a raw deal and will expect a better settlement in 2024.


“As it stands, NHS staff on the lowest pay band will be earning just a penny an hour above the minimum wage when it rises in April and their salaries are well short of the real living wage.


“If the government fails to put pay right, the picture looks bleak for the NHS and everyone needing its care. Decent wage increases this year won’t solve all the health service’s problems, but they could help keep experienced employees in their jobs and attract new recruits.


“With more staff at its disposal, the NHS would be in a much better place to get backlogs, waits and delays down. That can only be good news for patients who will be seen and treated more quickly.”


As well as a decent pay rise for 2024/25, UNISON wants to see NHS staff on the correct salary bands, and a push for a shorter working week. While this may not be achievable overnight, a better work-life balance would ease employee stress and burnout, help retain staff and reduce the need for costly agency workers, says UNISON.


And all too often NHS staff are working above their salary bands, it adds. There should be yearly reviews to ensure people are getting the correct rate for the job*. Otherwise, health workers will feel increasingly taken for granted and more likely to leave for workplaces where they’ll be better appreciated, warns UNISON.


Notes to editors:
– The UNISON survey was conducted online last autumn and around 40,000 responses were received from NHS staff in England.
Put NHS pay right, UNISON’s case for investing in the NHS workforce, can be found here.
– The minimum wage is rising to £11.44 an hour in April. Staff on the bottom of Agenda for Change band 2 are currently on an hourly rate of £11.45. The real living wage is £12 an hour (£13.15 in London).
– *Healthcare assistants tend to be on band 2 but regularly undertake complex tasks more in line with the higher band 3 salary. UNISON campaigns have already seen thousands of healthcare assistants regraded on to higher salaries and many others are currently pushing for their pay to be similarly corrected.
– In Northern Ireland, health unions are about to enter intensive talks over the 2023/24 pay rise, with the PRB expected to also make recommendations for their pay for 2024/25. In Wales, the health minister only issued a PRB remit on 30 January and UNISON expects to set out a similar case for investment in the NHS workforce there. In Scotland, unions have submitted a pay claim and hope talks will start soon.
– UNISON is the UK’s largest union with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.

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