Accepting the NHS Pay Deal doesn't mean we stop fighting

 Jude Diggins 3 May 2018 London Pay

It’s now over a month since the NHS Pay deal was announced. In chatting with members both on and offline over the course of that time, it’s fair to say that there are strong opinions on both sides of the debate; those that want to accept because the deal is a historic, fully funded package in a time of sustained austerity, and those who believe very strongly that we can do better.

The next few hundred words are not written with the intention of twisting arms behind backs or bending ears, they will just be my best attempt at saying what I believe we, as a profession, must consider when voting on the pay deal.

Nursing staff have seen first-hand how the politics of austerity has forced the NHS through the worst funding squeeze in its entire history and overstretched and worsened the quality of our services. The biggest fear going into negotiations was that the government would try to fund any pay increases from existing budgets and consequently push services over the edge - this was a big red line for the unions. Securing £4.2bn of new money to fund the deal is an important victory and is one that has not been replicated in any other public sector negotiation. The Police and prison officers have been handed increases of 1% and 1.7% respectively with both being made to fund the rises from existing budgets – this often ironically means jobs are lost to fund pay increases!  Our deal gives some relief to staff and protects patients.

This pay deal and the reforms to Agenda for Change mean that the unions have made progress in the war on poverty pay in the NHS. At present, there are around 80,000 low paid NHS staff who – on their current terms and conditions - would be financially better off working in the retail sector. This is not only not right, it is absolutely unsustainable for the future of the NHS workforce. The deal will see band 1 removed completely, raise the wages of the lowest paid to above the official Living Wage for the first time, and then deliver further increases in every year of the deal. Getting to the top in bands 2 and 3 will now take two years where it previously took six.

Everyone else does ok out of it too. Those at the top of their bands will see basic pay go up by 6.5% and receive an additional 1.1% lump sum. The hard won reforms to Agenda for Change mean the pay of those who haven’t yet reached the top of their band will increase by much more. In future, staff will move much quicker through the bands with the deal finally doing an end to the perverse situation in which pay overlaps between bands saw promoted staff remain on the same pay as junior colleagues. These overlaps are gone.

At the other end of the scale for those just starting in a role, one of the major benefits of the deal is the significant increases to starting wages. Starting wages in bands 3, 4, 5, 6 and 7 will, by the end of the three year deal, have increased between 12% and 22%. This is not only a step in the right direction in ensuring that nursing staff new to roles are properly rewarded, but also in that it will help to make nursing more financially attractive to those considering it as a career. At a time when more nurses are leaving the register than joining, student numbers are falling and EU nurses are leaving in bigger numbers, raising starting wages – as the deal does – will help bring in the nurses of the future.

Back in London where I am Regional Director, I know our members need a pay rise as much as anyone. The years of pay restraint coupled with living in one of the most expensive cities in the world has been a struggle to say the least. This deal won’t solve the cost of living crisis in London. If only it could! The deal does, however, secure a 6.5% increase to the High Cost Area Supplements which will be awarded on top of the basic pay uplift. 

I know, having spoken to many of you, that there are issues that you remain concerned about – namely changes to unsocial hours payments for bands 1 to 3, performance related pay and inflation. It’s always been my style to address issues head on, so I will.

In cash terms, there are no cuts to unsocial hours payments. Staff on bands 1 to 3 will still receive the same cash amount for each unsocial hour. What’s different is that it won’t be calculated as a percentage of basic pay. The deal categorically protects the cash values for three years while pay changes take place, and allows them to go up as a percentage thereafter alongside basic pay increases.

Members should also not be concerned about performance related pay. The deal is just a formalisation of what is already standard practice across many NHS providers. All money provided by the Treasury is based on staff automatically progressing and we have secured the power to force all trusts to report into our NHS Staff Council should they try to deny increments to staff.

Finally, on the issue of the pay rise being considered below inflation. For a majority of staff, the pay uplift is well above that amount, and for those at the top of their pay band currently, the increases represent a bigger pay rise than anybody else in the public or private sector. We must not forget either that the deal has also secured the right for unions to re-open negotiations should inflation increase significantly during the deal.

To those that want to reject, I understand. As nurses, we are embodied by that determination to seek better, not only for our patients, but for ourselves. You only have to look at the anger at the savage cuts to CPD budgets and the removal of the student bursary to know that. But equally we have to, as we do day in day out on the wards and in our communities, weigh up the evidence and make decisions based on what we know will have a positive impact on people’s lives. Rejecting the deal, returning to the PRB process and watching the government take the £4.2bn off the table won’t lead to positive outcomes for staff, patients or the profession.

Acceptance isn’t acquiescence, nor does it signal an end of the fight to improve the material conditions of our health worker colleagues. That fight never ends. But what this deal does present, however, is an opportunity – after 8 years of harsh austerity – to finally take a step forwards and continue that fight from a healthier position.

My final plea is that no matter which side you fall on, use your vote and make sure others do so to.


Jude Diggins, RCN London Regional Director

Jude Diggins

Regional Director, RCN London

Jude became the RCN London Regional Director in April 2018.

Page last updated - 05/09/2018