Dean also floated the idea of multi-year pay deals for the NHS 1.4 million strong workforce and stressed the need for medical consultants to accept changes to their contracts.
Writing online for HSJ ahead of the NHS Pay Review Body making recommendations to the government on pay, which are expected to be published later this month, Dean repeats claims the expected 1 per cent pay rise for NHS staff will cost the service £500m - equivalent to the salaries of 15,000 nurses.
He says employers cannot go on asking for pay freezes but instead need to be “creative and bold” in tackling the “pendulum swing” of public sector pay.
“Let’s explore options for multi-year deals - could we get cross government support?” he writes. “Or let’s explore how we could move towards the ‘living wage’.” Dean highlights the potential costs and impacts that a living wage would have, including on the contracting of services and pay differentials.
Dean adds: “It’s a wicked problem but surely its right to explore and test out assumptions, to see if it will help us contain costs, secure jobs and allow a smooth exit from a period of pay restraint. That has to be good for patients, for staff and for employers.”
Unions have demanded better pay for NHS staff, highlighting the real-terms fall in incomes over recent years following two years of a pay freeze, higher pension costs and a 1 per cent pay rise in 2013.
But the focus of employers is not just on pay but also terms and conditions which are currently the focus of negotiations between the British Medical Association and NHS Employers, who negotiates on behalf of the NHS and government.
Dean says: “In these conversations, we are not asking for radical change, just the same sort of changes we have already agreed with other staff groups – more local discretion on increments and clinical excellence awards, and no veto on weekend work.
“Nurses, therapists, admin staff and support workers have already accepted changes and we need doctors to do the same. We can’t expect patience from employers and I know trusts are already looking at implementing local solutions.”
“The finance clock is ticking,” he warns.
This article featured in HSJ on 21 February 2014.