Summary of NHS Employers evidence

As last year, our evidence is based primarily on information gathered from employers via an online questionnaire designed to collect evidence on issues related to the remit of the Nurses and Other Health Professionals' Review Body (NOHPRB), the Doctors' and Dentists' Review Body (DDRB) and the Pay Negotiating Council (PNC).

The evidence, which represents the views of NHS employers in England only, has been approved by NHS Employers' policy board.

Overall, the key messages from employers in the NHS to the review bodies are:

• Employers want a generic pay uplift across all staff groups, with affordability being dependent on an appropriate increase in the pay element in tariff
• A pay award in line with the CPI inflation target is the most that could be afforded by NHS employers
• Given that the spending plans for the NHS in forthcoming years are subject to the outcome of the 2007 comprehensive spending review, a multi-year pay award would be undesirable at this time
• Employers reported that recruitment and retention is generally improved or remained stable, and was helped by a fall in staff turnover in most areas

• Economic context
• Employers pay proposals for 2007/08
• Agenda for Change
• Benefits realisation and productivity
• Pensions
• Redundancy and early retirement compensation review
• Recruitment and retention
• Consultant contract
• Doctors in the non-consultant career grades
• Doctors in training
• Salaried general medical practitioners (GMPs)
• General medical services
• Salaried primary care dental services
• Commissioning general dental practice services
• Collaborative fees

Economic context

The evidence gives a mixed view of the economy, with strong growth in GDP and moderate growth in house prices combined with increasing unemployment and a recent downward trend in employment. Affordability is dependent on an appropriate increase the pay element of tariff reference prices for 2007/08.

Given the evidence outlined by NHS Employers, we would ask the pay review bodies to consider carefully the impact that any pay increase deemed unaffordable by NHS employers would have on an already difficult financial position.

Back to top

Employers pay proposals for 2007/08

Given that spending plans for the NHS in forthcoming years are subject to the outcome of the 2007 comprehensive spending review, we believe that a multi-year pay award at this time would be undesirable. Employers have stressed that affordable pay settlements are necessary to ensure that the current financial position in the NHS does not worsen. They have also emphasised the importance of a generic pay uplift across all staff groups. Responses to the questionnaire issued by NHS Employers indicate that the majority view was that a pay award that does not exceed the CPI inflation targets was the most that could be afforded.

Back to top

Agenda for Change

The implementation of the Agenda for Change agreement is virtually complete in trusts across England. Employers are beginning to use the system to deliver benefits and to enable service development and organisational change. This is a tremendous achievement for the service, brought about by sustained hard work and by managers and staff representatives working in partnership.

Back to top

Benefits realisation and productivity

Over the last three years significant focus has been placed on the introduction of new pay arrangements across the NHS with the expectation that improvements will be made in service delivery and productivity. Many organisations are only just reaching the end of the implementation phase of this work and we have yet to see the range of potential benefits from the new pay and development system. Organisations have been consistent in their early feedback about the kinds of benefits that have emerged as a direct result of putting Agenda for Change in place, including accelerating role redesign and service improvement.

Back to top

Pensions

NHS Employers agrees with trade unions that pensions are deferred pay. It is important when considering appropriate levels of remuneration to look at both current and deferred pay. Employers believe that increases in the proportion of employees deferred pay should not be taken into account when considering levels of pay increases.

Back to top

Redundancy and early retirement compensation review

NHS Employers in partnership with NHS trade unions are carrying out the review on behalf of the Department of Health and the National Assembly for Wales. Subsequently NHS Scotland joined the review. Northern Ireland is conducting a separate consultation exercise of the review proposals. Consultation ended on 11 September 2006 and recommendations have been agreed between the trade unions and NHS Employers following a consideration of responses. An update will be provided in due course.

Back to top

Recruitment and retention

Employers reported that recruitment and retention was generally improving or remaining stable and was helped by a fall in staff turnover in most areas. There are, however, some areas of concern and this varies across professional groups and geographical locations. Employers in the main have not needed to use recruitment and retention premia to address recruitment difficulties.

Back to top

Consultant contract

NHS Employers is content that the 2003 consultant contract, in its most recent revised form, is working well and sees no current need, with the exception noted in the evidence, to revise its content further. With regards to the DDRB's recommendations for 2007/08, it continues to be NHS Employers' position that we seek no difference in the increase awarded to those on the pre and post 2003 consultant contracts. We would also ask that the pay award for consultants should be in line with the awards made to other health workers.

Back to top

Doctors in the non-consultant career grades

Negotiations are ongoing between NHS Employers and the BMA to agree a new contract of employment for staff and associate specialist grade doctors and dentists. As work is still ongoing on the final details of the proposal for a new SAS contract, it would be counter productive for this group of doctors to be awarded a significant pay increase. We would therefore propose that the pay uplift for SAS doctors should be in line with other staff.

Back to top

Doctors in training

Given that annual increments already add around 4-6 per cent to basic pay, we would suggest that any uplift for doctors in training for 2007/08 should be limited to no more than inflation and that it should be in line with awards made to other health workers.

Back to top

Salaried general medical practitioners (GMPs)

We are seeking an uplift to the pay range in line with that of other directly employed doctors.

Back to top

General medical services

NHS Employers is currently in negotiations with the BMA's General Practitioners Committee regarding the arrangement for independent GMPs throughout the UK under the GMS contract for 2007/08.

Back to top

Salaried primary care dental services

NHS Employers has been mandated by the Department of Health to negotiate new terms and conditions for salaried primary care dental services (SPCDS) in England with the British Dental Association. Negotiations began on 9 June 2006 and to date we have met on three occasions. Negotiations are progressing well and we intend to submit joint evidence with the BDA as supplementary evidence.

Back to top

Commissioning general dental practice services

The Office of Manpower Economics asked NHS Employers to gather information from PCTs about the commissioning and provision of NHS dental care, which is outlined in our evidence.

Back to top

Collaborative fees

We would ask that the uplift for these fees is once again recommended by the Review Body, and that the uplift for 2007/08 should not exceed the target for inflation.