Call for expanded role for pay review bodies

The government initially refused to increase its offer to agenda for change staff for 2022/23 above that proposed by the NHS Pay Review Body (PRB). However, unions claimed that the process was out of date and did not take into account the impact of rapidly rising inflation. They also criticised the body’s lack of independence, given that government appoints its members and provides an affordability ceiling for pay increases.

The pay offer of 5% for 2023/24 plus one-off payments for 2022/23 has now been accepted by the NHS Staff Council, although some unions are still rejecting the deal. However there remains uncertainty over the future role of the pay review process. Claiming the PRB had presided over more than a decade of real wage cuts for NHS staff, unions withdrew from the evidence submission process for the 2023/24 process ahead of the government offer.

NHS Confederation chief executive Matthew Taylor, told a specially arranged session of the Commons Health and Social Care Committee this week that the PRB still had an important role to play going forward. He said the process had worked ‘reasonably well’ over the years. But there needed to be an understanding that the body was asked to work within strict parameters and that the job was particularly difficult during a period of volatile inflation.

Danny Mortimer (pictured), chief executive at NHS Employers, pointed out that the brief given to the two NHS pay review bodies – the PRB and the Review Body on Doctors’ and Dentists’ Remuneration – was ‘often so narrowly set that the pay review bodies aren’t able to go much further than recommending pay awards’.

Instead, he said they should be able to recommend broader changes to staff contract structures. ‘We’ve now had the consultant contract for 20 years and agenda for change for slightly longer,’ he said. ‘Actually those contracts need updating, they need modernisation and the pay review bodies need to be given greater scope to say to employers, trade unions and the government [that they] should work together to improve these areas of the contract. The limited terms of reference they are given prevent them from doing that and we would really welcome that role.’

He also acknowledged that the trade unions’ loss of confidence in the pay review body process was not just a result of the last year, but the perception that there had been limited investment in staff for more than a decade. ‘It is really important that we find a way to commit to processes that rebuild that confidence,’ he said, insisting that the whole point of the pay review body process was to avoid the kind of disputes the NHS has experienced recently.

Julian Hartley, chief executive of NHS Providers, said employers also had a role to play in creating a positive culture for staff. He claimed that NHS staff had a ‘unique sense of real purpose, drive and energy’, but that the ‘tank was running dry’ on discretionary effort. ‘It is important that we rebuild that really strong commitment and to do that we need to get over the pay dispute and we need to really focus on the needs of our people and workforce,’ he added.

In January, the Nuffield Trust set out an 11-point plan to improve the current pay review process. This included  having a force majeure clause whereby pay deals were reviewed if the economic or service conditions fell outside of set parameters. It also called for affordability to be considered in the context of the public purse, not just narrowly in terms of individual department budgets.