How is the government deciding NHS pay?

The government has confirmed it will use the Pay Review Body process to determine a pay award for NHS staff this summer. Here's how it works

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: Firstly, the UK government 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: Secondly, the PRB gathers and takes evidence to inform its decisions. 

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

Stage four: Finally, 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, Matt Hancock, wrote to the PRB on 18 December 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. 

Similar remit letters have also been issued by health ministers in Wales and Northern Ireland.  

The Scottish government has not asked the PRB to make recommendations. Instead, it has stated its intention to engage in direct negotiations with health trade unions on pay for NHS staff in Scotland.

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. This year, the PRB organised a number of virtual visits across England, Wales and Northern Ireland. Wherever possible – the RCN ensured that the voices of nursing staff were heard loud and clear.  
 
The PRB also takes written and oral evidence from NHS trade unions, including the RCN, NHS Employers and providers and the government.   
 
On 18 January the RCN submitted our written evidence which was overseen and reviewed by your elected Trade Union Committee and Council.   
 
At the heart of the submission are the views of RCN members – expressed through our annual member survey. 
 
It also sets out a robust, evidence-based case for why nursing staff need a substantial 12.5% pay rise: 

  • which recognises and fairly rewards the complex and safety critical care provided by nursing staff as has been so clearly demonstrated throughout the COVID-19 pandemic 
  • which attracts and retains nursing staff within the service. 

The RCN plans to publish its submission shortly, after the government has submitted its evidence to the PRB. 
 
The RCN has also worked within the NHS Staff Side to prepare a joint union submission – making the case for an early and significant pay rise for NHS staff. 

The joint submission sets out why substantial investment in NHS pay is needed to equip the NHS to recover following the pandemic. It shows it is affordable and is supported by the public.  

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 by May 2021.  

The RCN and other health unions have expressed concern about this timeline – asking for it to be sped up – NHS staff should not have to wait for a pay rise.

Graphic of voting hands

Stage four

Government ministers consider the PRB’s advice, but pay increases and how they're funded are political decisions, for which ministers are accountable.

What happens after the announcement? 

Once the government announces a pay award after the PRB process, this will not be put to a vote of NHS staff. 

The RCN has however committed to asking all members whether they feel the award is adequate and what further action they might wish to take. 

Campaign with us for fair pay

The RCN’s Fair Pay For Nursing campaign aims to secure a fully funded 12.5% pay increase for all nursing staff covered by Agenda for Change terms, as part of a one-year deal that applies equally to all bands. 

Find out more and get involved.

 

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