*Updated 23 May*
NHS staff across a number of unions are either undertaking industrial action or being consulted by their union on the government’s pay offer.
This fact sheet sets out the Department of Health and Social Care’s position on strikes by NHS staff.
What is your latest response to NHS industrial action?
Our recent statements are as follows.
Statement in response to BMA Junior Doctors Committee announcing further strike action - issued 22 May
A government spokesperson said:
“It is both surprising and deeply disappointing that the BMA Junior Doctors Committee has declared further strike action while constructive talks were ongoing. These will be hugely disruptive for patients and put pressure on other NHS staff.
“We made a fair and reasonable opening offer, and were in active discussions about both pay and non-pay issues.
“Unfortunately, it seems the BMA is unwilling to move meaningfully away from their unaffordable headline demands on pay. The government has been clear that strikes must be paused while talks take place, so while the BMA has chosen to end our current discussions, we remain ready to continue them at any point if strikes are called off.”
Statement in response to BMA Consultants Committee ballot opening - issued 14 May
A Department of Health and Social Care spokesperson said:
“We hugely value the work of NHS consultants and they received a 4.5% pay uplift last financial year increasing average earnings to around £128,000. They will also benefit from generous changes to pension taxation announced at budget and are eligible to apply for additional financial awards worth up to £40,000 a year as part of the NHS consultant contract.
“We urge the BMA to carefully consider the likely impact of any action on patients.”
Statement in response to NHS Staff Council formally accepting the government's pay offer - issued 2 May
Health and Social Secretary Steve Barclay said:
“I’m pleased the NHS Staff Council has voted to accept our pay offer, demonstrating that a majority of NHS staff agree this is a fair and reasonable deal.
“It is now my intention to implement this for all eligible staff on the Agenda for Change contract and where some unions may choose to remain in dispute, we hope their members – many of whom voted to accept this offer – will recognise this as a fair outcome that carries the support of their colleagues and decide it is time to bring industrial action to an end.
"We will continue to engage constructively with unions on workforce changes to ensure the NHS is the best place to work for staff, patients and taxpayers."
When will you implement the pay deal?
- We’re working on this at pace as we understand the importance of getting this into pay packets as soon as possible.
- Staff should see this in their pay packets from June.
What is the deal which has been accepted by the NHS Staff Council?
The fair deal accepted by the NHS Staff Council includes steps on pay as well as measures to improve working conditions. The offer covers:
- A one-off award of 2% for 2022/2023 on top of at least £1,400 already received for this year. The one-off 2% award is worth between £405 and £2,189 depending on their pay band.
- A one-off NHS Backlog Bonus worth between £1,250 and £1,600 depending on how much experience staff have and their pay band. The average nurse in pay band 5 with at least four years of experience, for example, would receive £1,350.
- A 5% pay rise for 2023/2024, worth at least £1,065. In addition, the lowest paid staff will see their pay matched to the top of band 2, resulting in a pay uplift of 10.4%, or £2,113.
- Non-pay reforms to make the NHS a better place to work. This includes a drive to tackle violence against staff, measures building on existing safe staffing arrangements, amendments to terms and conditions to support NHS staff to develop their careers through apprenticeships, and a consultation to make the suspension of the pension ‘retire and return’ rules introduced during the pandemic permanent.
What will this deal actually look like for staff?
- For example, a newly qualified nurse would see their salary go up by more than £2,750 over two years from 2021/22 to 2023/24. On top of this they would also receive over £1,890 in one-off payments for the financial year 2022/23.
- A band 6 paramedic with less than two years’ experience would see their salary go up by more than £3,000 over two years from 2021/22 to 2023/24. They would also receive over £2,020 in one-off payments for the financial year 2022/23.
What pay rise have nurses already received?
- Most nurses received around a 4-5% pay rise in 2022-23, dependent on where they are in their band, for example:
- Full-time basic pay for newly qualified nurses starting at the bottom of Band 5 has increased by £1,400, equivalent to 5.5%, to £27,055 from £25,655 in 2021-22.
- Under this new offer, the same nurse would now receive £28,407 in basic pay in FY 2023-2024 (5% increase from 2022-2023). In addition, the same nurse would receive a backlog bonus of £1,350 and a one-off payment of £541 for 2022-2023.
- A full-time nurse at the top of band 5, which requires at least four years of experience, had a 4.4% increase in basic pay and received a salary of £32,934 in 2022-23.
- Under this new offer, this nurse would now receive basic pay of £34,581 in 2023-2024. In addition, the same nurse would receive a backlog bonus of £1,350 and a one-off payment of £659 for 2022-23.
- Full-time basic pay for nurses after promotion to the bottom of Band 6 has increased by £1,400, equivalent to 4.3%, to £33,706 in 2022-23 from £32,306 in 2021-22. With the 4% enhancement, full-time basic pay at the top of Band 6 (for nurses with at least five years’ experience after promotion to Band 6) has increased by £1,561, to £40,588 in 2022-23 from £39,027 in 2021-22.
- Under the new offer, a full-time nurse at the bottom of Band 6 would receive basic pay of £35,392 and a full-time nurse at the top of Band 6 would receive basic pay of £42,618 in 2023-2024. In addition, the same nurse would receive a backlog bonus of £1,350 and a one-off payment of £812.
- Nurses also receive a pension contribution worth 20% of their salary.
How will this deal be paid for?
- We are absolutely committed to ensuring the NHS has the funding it needs to deliver for patients. There will be no impact on frontline services or quality of care that patients receive as a result of this offer.
- DHSC is working with the Treasury to ensure the department has the money it needs to fully fund this pay offer.
- There is already funding available for up to a 3.5% pay increase within DHSC’s existing budgets – funding on top of that will come from a combination of reprioritisation and additional funding, which is new money for DHSC.
How much is the total deal worth?
- The offer represents around £2.7 billion for the non-consolidated elements in 2022/23 and around £1.3 billion for the consolidated element in 2023/24. This is on top of the c. £2.6 billion already available within DHSC's existing budget for pay awards up to 3.5%.
Will this deal fuel inflation?
- The government firmly believes this is a fair deal which gives all Agenda for Change staff a fair and proportionate pay rise, at a time when people across the country are facing cost of living pressures and there are multiple demands on the public finances.
- It protects the Prime Minister’s promise to halve inflation as a one off payment for the financial year of 2022/23 does not create a future inflationary pressure, and the award for this year is broadly in line with pay growth in the wider economy, and so won’t drive significant growth in private sector pay.
What steps have you taken to prevent further industrial action in the NHS?
- The government held formal negotiations with unions representing staff including nurses, paramedics, 999 call handlers, midwives, and some security guards and cleaners, to find a fair and reasonable way forward on pay.
- Following constructive discussions between the government and Agenda for Change unions, the NHS Staff Council formally accepted the reasonable offer which will see more than 1 million NHS staff in England receive two non-consolidated awards for 2022-23 and an average 5% consolidated increase in pay for 2023-24.
What is the BMA’s junior doctors committee asking for and how much would this cost?
- The BMA's junior doctors committee is asking for full restoration of junior doctors’ pay to levels equivalent to 2008/2009 based on RPI inflation to April 2022.
- Meeting this demand would require an average pay award of around 35% in 22/23 (including the existing Junior Doctor pay award for this year).
- To restore real terms pay to 2008/09 levels on this basis would cost over £2 billion on top of the existing 22/23 award. This is over 1.3% of the total NHS budget (£152.6bn for 22/23)
How much do junior doctors get paid?
- A junior doctor starting training in Foundation Year 1 received full-time basic pay of £29,384 in 22/23. On average, Foundation Year 1 Doctors have additional earnings worth around 31% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctor of around £38,000 in 22/23.
- A junior doctor progressing into Foundation Year 2 received full-time basic pay of £34,012 in 22/23. On average, Foundation Year 2 Doctors have additional earnings worth around 35% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctor of around £46,000 in 22/23.
- A junior doctor progressing into specialty training can expect to have received a starting basic pay of £40,257 in 22/23. On average, doctors in specialty training have additional earnings worth around 36% of basic pay covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctors of around £55,000 in 22/23.
- The maximum basic pay as a junior doctor depends on the specialty they train in, but once they are qualified, they have opportunity for career advancement into roles in the consultant, Specialty and Associate Specialist, or general practice workforces, potentially earning significantly more.
- Junior doctors who are also members of the NHS Pension Scheme receive a pension contribution worth 20% of their salary.
- Many will progress to become consultants. On average, consultants have additional earnings worth around 31% of basic pay, covering additional programmed activities, clinical excellence awards and on-call payments This is expected to take average earnings per person to around £128,000 in 2022/23.
Are some junior doctors paid £14 an hour?
- This rate refers only to the basic pay rate for Foundation Year 1 doctors in their first year following graduation from medical school. It does not include any additional earnings – enhanced rates are payable for night work and additional supplements for those regularly working at weekends.
- On average Foundation Year 1 doctors have additional earnings worth around 31% of basic pay. This is expected to take average earnings for a full-time doctor to around £38,000 in 2022/23.
Details on the multi-year pay deal
- Junior doctors were in a multi-year pay and contract reform deal, between 2019/20 and 2022/23.
- The junior doctor pay and contract reform deal has seen all pay points increase by a cumulative 8.2% between 2019/20 – 2022/23.
- We have asked the DDRB for recommendations for 23/24.
- This deal:
- provided the most experienced junior doctors with a higher pay band, recognising that they are often taking decisions and delivering care at near-consultant level. This meant they received a cumulative increase of 24% over the four years. All junior doctors that reach the highest pay point as part of their specialty training will benefit from this.
- increased allowances for those working the most frequently at weekends.
- increased rates of pay for night shifts. Shifts between midnight and 4am are paid an additional 37% of the hourly basic rate.
- created a permanent allowance of £1,000 a year – on top of their usual pay – for junior doctors who work less than full time to recognise the additional costs they face.
- Our door remains open to the BMA for constructive conversations, as we have had with other health unions, to find a realistic way forward.
Is the BMA's claim that the majority of junior doctors are looking to leave the NHS accurate?
- The NHS Staff Survey 2022 indicated that over 79.4% of junior doctors are not considering leaving their organisation (50.9%) or if they left would be most likely to move to a different NHS trust or organisation (28.5%).
- We are committed to making the NHS the best place to work and the NHS will publish a long-term workforce plan in Spring to recruit and retain more staff.
How much do NHS consultants get paid?
- Consultants received a pay rise of 4.5% last financial year, increasing average basic pay per person to around £97,900.
- On average, consultants have additional earnings worth around 31% of basic pay, covering additional programmed activities, clinical excellence awards and on-call payments which will take total average NHS earnings to around £128,000 per person.
- Consultants who are members of the NHS Pension Scheme also receive a pension contribution worth 20% of pensionable pay.
- As announced at Budget, from 6 April 2023 the annual allowance for tax-free pension saving will increase to £60,000, and the lifetime allowance will be abolished.
- Consultants are also eligible to apply for National Clinical Impact Awards, which can see them earn up to £40,000 per year for 5 years if their application is successful. These are financial awards granted via an annual competition to consultant doctors, dentists and academic GPs. The purpose of the awards scheme is to recognise senior clinicians' achievements of national or international significance, beyond what is expected as part of their job plan.
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