NHS Pay

In these most difficult of times and with ever increasing pressures on the NHS, they work incredibly hard, always putting patients first and keeping them safe whilst providing the high-quality care we all expect. Many NHS staff are already benefitting from the most significant pay reforms in a decade, with similar reforms planned for other staff groups.

NHS pay rises

The independent Pay Review Bodies make annual recommendations on pay rises for NHS staff. The Pay Review Bodies are made up of experts and their recommendations are based on comprehensive assessment of evidence from key stakeholders, including NHS system partners and trade unions. The Department of Health and Social Care has reached multi-year pay and contract reform agreements with trade unions across the NHS workforce.

2024 Update

The NHS Long Term Workforce Plan was announced last year and is the first of its kind – a plan asked for and created by the NHS itself and backed by £2.4 billion of Government investment to ‘Train, Retain, Reform’.

It sets out really ambitious proposals including a doubling of medical school places, increasing GP training by 50% and dentists by 40% and an aim for 130,000 fewer staff leaving the profession over the next 15 years by making the NHS a more attractive career to pursue. Most recently, the Government abolished the lifetime allowance on pensions to make sure those who want to work within the health service are not penalised for doing so.

The Government has now delivered its manifesto commitment of an additional 50,000 nurses working in the service who are performing a record number of procedures. The plan also includes proposals to recruit 60,000 more doctors, 170,000 more nurses and 71,000 more healthcare professionals by 2036/37. There is also an additional £7.5 billion allocated to social care for 2023-25 to ensure they have the resources needed to care for a growing number of people.

I know that we all value the work that the NHS carries out and so I am pleased the Government last year accepted in full the recommendations of the independent pay bodies. This meant that most doctors and dentists received a 6% pay rise last year. Over 1 million staff, including nurses and paramedics, received a pay rise of 5% and two one-off payments worth on average over £2,000. Junior doctors also received a 10.3% uplift, with the offer of further discussions about improving working conditions, to end the strikes we have seen. The discussions for the 2024/25 pay settlement are now underway.

Agenda for Change

The Agenda for Change is supported by the majority of trades unions and their members, delivers pay awards and contract reforms over three years from 2018/2019 to 2020/2021.

Staff (including nurses, midwives, healthcare assistants and others) on the Agenda for Change (AfC) deal are already scheduled to receive pay rises, with the starting salary for a newly qualified nurse increased by more than 12 per cent by the end of the AfC time period, with all nurses receiving pay increases of at least 6.5 per cent and paramedics receiving up to 11 per cent.

The multi-year deal is already benefiting around one million NHS staff. Over the three years:

Staff below the top of their pay band will receive pay increases of at least 9%; pay for most staff at the top of their pay band will rise by 6.5%;
Those on the lowest salaries in the NHS are seeing some of the largest proportionate pay rises: the lowest NHS starting salary has increased year on year from £15,404 to £18,005 in 2020/2021. Many nurses and healthcare assistants have seen pay increases of at least 2.5 per cent.
Raising the starting salary for a newly qualified nurse by over 12% to nearly £25,000
The reforms agreed are not just about headline pay but changes that will help improve the working lives of our dedicated staff. For example, by supporting them to maintain their physical and mental health and wellbeing and introducing policies to help support staff to balance their working lives with family and personal commitments.

I understand that the NHS Pay Review Body, covering AfC staff, will return to making recommendations for pay awards during 2021. I will continue to monitor this issue closely, and await the recommendations of the NHS Pay Review Body.

Junior doctors are also benefiting from a multi-year agreement (2019/20 to 2022/23) which:

ensures all pay scales increase by at least 8.2% over the four years;
includes a new higher pay point for around 1 in 8 junior doctors to reflect their level of responsibility; increases enhancements for those working the most onerous shifts; and further strengthens safety and rest limits.

The reward package also includes a pension scheme which is one of the best available. Members of the scheme can generally expect to receive around £3 to £6 in pension benefits value for every £1 they contribute. The ambition is to reach similar multi-year pay and contract reform agreements with senior medical staff to reflect their roles as leaders in our NHS and attract and retain the specialists we need.

In addition to basic pay, staff can expect to receive additional premium rates of pay for working during unsocial hours, agreed overtime and for working in and around London. This can significantly increase the total take home pay received.

I fully support the Government's announcement of a pay rise of 2.8 per cent, backdated to April 2020, in line with the recommendations of the independent pay review body for dentists and doctors. This pay rise is an important acknowledgment of the commitment and hard work of staff throughout this difficult time.

General Practice

In 2019 NHS England agreed with trade unions a five-year GP contract framework which fixed funding for the core practice contract for five years. The new contract provided funding clarity and certainty to practices and the settlement covers all aspects of practice income and expenses including practice staff pay. The full package for GP contract reform also sought to address workload by providing additional staff though the Additional Roles Reimbursement Scheme and also saw the introduction of the new state-backed scheme for GP indemnity. As self-employed contractors to the NHS, it is largely up to GP practices how they distribute pay to their employees, although salaried GPs employed within the majority of practices are expected to be on terms and conditions no less favourable than those in the salaried GP model terms and conditions including the minimum and maximum salary. Employers have the flexibility to offer enhanced terms and conditions, for example, to aid recruitment and retention. We anticipate good employers would set wage rates that reflect the skills and experience of their staff.

During Coronavirus:

NHS staff are playing an integral part of the national effort to combat coronavirus - and we owe them a great deal of gratitude for all that they do. The Government have agreed that staff should receive full pay if they are off sick with COVID-19, or if they must follow advice to self-isolate, in order to help protect NHS staff and patients from the spread of the virus. It is vital we care for those that we all rely on to care for us. The NHS has introduced a free-to-use staff support line and text service which all NHS staff can use for support, signposting and confidential listening from trained respondents. NHS staff have also been given free access to a series of apps to support their mental health and wellbeing.

The NHS Long Term Plan outlines the next steps in our mission to make the NHS a world class employer and deliver the workforce the NHS needs. The recently published NHS People Plan sets out the support that NHS staff should expect from their leaders and from each other. The plan sets out practical actions for employers and systems, as well as the actions that NHS England and NHS Improvement and Health Education England will take, over the remainder of 2020/21. It includes specific commitments around: