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What is the Pay Review Body or ‘PRB’?

Governments can use different routes to decide pay increases. Often UK governments ask the NHS Pay Review Body, known as the PRB, to look at evidence and make recommendations, before ministers set the award for NHS staff employed on Agenda for Change contracts.  
There are four key stages to the PRB process:
Stage one: Governments must issue a remit letter to the Pay Review Body (PRB). This letter from a minister sets the parameters and is the first indication of the timeline. 

Stage two: The PRB gathers and takes evidence to inform its decisions. 

Stage three: The PRB reports to the government setting out its recommendations on pay. 

Stage four: The government decides any pay increase for NHS staff after receiving the report. 

What will the PRB process mean in practice this year?

Graphic of a letter coming out of an envelope

Stage one

The Secretary of State for Health and Social Care in England, Sajid Javid, wrote to the PRB on 30 November asking it to advise on NHS pay for England.   

In line with the UK government’s spending review, the formal remit letter underlined the need for the PRB to consider the difficult economic context and the affordability of any pay award for NHS staff. It also said the government must balance the need to ensure fair pay for public sector workers while protecting funding for frontline services. These are arguments we will continue to challenge.  

Similar remit letters were issued by health ministers in Wales and Northern Ireland.   

The Scottish government did not ask the PRB to make recommendations. Instead, it will make its own pay offer in direct negotiations with unions and NHS employers. While the PRB has not been asked to make a recommendation in Scotland, members will draw heavily on the RCN’s evidence to the PRB in their negotiations. 

Graphic of an ear listening

Stage two

Before making recommendations, the PRB can commission research on pay and related matters. It also visits workplaces to hear from employers and staff. The PRB organised a number of visits across England, Wales and Northern Ireland for this year’s pay round. Wherever possible, the RCN ensured that the voices of nursing staff were heard loud and clear.   

The PRB takes written and oral evidence from NHS trade unions, including the RCN, NHS Employers and providers and the government.    

This year the RCN submitted written evidence which was overseen and reviewed by your elected governing members.    

At the heart of our submission are the views of RCN members – expressed through our annual member survey.  

Our evidence sets out a robust, evidence-based case for why nursing staff need a substantial pay rise of 5% above Retail Price Index (RPI) inflation, which was running at 7.5% in December.  

The Retail Price Index is an important economic measurement of how quickly the cost of everyday retail goods is rising. 

Our evidence says a pay award that goes 5% above RPI is needed to: 

  • Cover the cost of living: we want an above inflation pay award that absorbs increases to National Insurance and pension contributions, and factors in rising food and energy costs. We’re also calling for the real living wage for those on the lowest pay.  
  • Address the staffing crisis: we stress the link between pay and safe staffing and call for Retention Premia Payments and Recruitment Premia Payments to be paid for all nursing roles to begin addressing a chronically understaffed workforce. 
  • Begin to recover lost earnings: over the past 10 years, the value of Agenda for Change pay has fallen in real terms by between 9% and 14%. Once you factor in National Insurance increases and upcoming pension contribution rises, a band 5 nurse with seven years’ experience will take home £400 less this year than they did in 2021.  
Graphic image of a calendar

Stage three

After considering all the evidence, the PRB will make recommendations to the governments. Ministers have indicated that they expect the PRB to report in May.

When the government first indicated this timeline we expressed bitter disappointment that, once again, your pay award – which you should get by 1 April – will be delayed. We’ll continue to pressure governments across the UK for timely action so members are not left waiting.

Graphic of voting hands

Stage four

Government ministers consider the PRB’s advice, but pay increases and how they're funded are political decisions – ministers have the option all along to invest in nursing.

In our submission to the PRB this year, we urge the body to assert its independence to make wide-ranging and meaningful recommendations.

What happens after the announcement? 

Once the government announces a pay award after the PRB process, they are not obliged to put it to a vote of NHS staff. The RCN has, however, committed to asking members whether they feel the award is adequate and what further action they might wish to take.

On the other hand, in Scotland, where the government will make a pay offer rather than a pay award, health unions will ask their members whether they accept or reject the offer. 

Campaign with us for fair pay

The RCN’s Fair Pay for Nursing campaign aims to secure a fully funded pay increase of 5% above inflation for all nursing staff covered by Agenda for Change terms, as part of a one-year deal that applies equally to all bands.  

While the PRB process applies to NHS staff, the RCN is clear that there must be parity of pay and other terms and conditions for nursing staff in all settings.     

Read these 10 things to say about pay and spread the word among your colleagues.

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