NHS Employers' evidence to the pay review bodies 2023/24

We have published our 2022/23 written evidence to the NHS PRB and DDRB. Our evidence has been informed by a continuous cycle of engagement with a full range of NHS organisations about their priorities, opportunities, and challenges.

NHS PRB key messages

Access the NHS PRB evidence.

• The additional £3.3 billion revenue budget funding announced in the recent Autumn Statement is welcomed, however, this needs to be backed up with a sustainable and longer-term financial settlement to enable the NHS to address the underlying challenges facing the health and social care system.
• The current competitive labour market is adding to NHS employers’ workforce challenges around attraction, recruitment and retention, particularly in lower-banded roles where other sectors can offer competitive reward packages.
• Employers are increasingly concerned about the impact of the delay of the pay award and the inability to implement this from its effective date of 1 April each year.
• We strongly urge that every effort is made to get the pay award timetable back on track to support future annual pay award uplifts being implemented on time and on the effective date (1 April).
• Base pay and take-home pay in the NHS are becoming an increasingly important issue with the rising cost-of-living pressures impacting on NHS staff. Increasing competition between sectors also means that base pay rates are becoming a recruitment and retention challenge for employers.
• Pay in the NHS and across the public sector has also been falling relative to the private sector. This is shaping views of staff on the attractiveness of alternative employment offers for working outside of the NHS, even for relatively small and marginal differences. 

 DDRB key messages

Access the DDRB evidence.

• Employers are currently experiencing exceptional workforce challenges. 
• For the NHS to fully recover from the pandemic, tackle its waiting lists and support its staff, it will need the government to provide investment for an ambitious long-term plan for the workforce. 
• Employers want to see a pay award that is fully funded and sustainable, allowing them to continue to prioritise workforce growth in key areas. 
• There has been lower investment in the medical paybill relative to other staff over the last 12 years. Long term contractual agreements have meant lower pay awards in some cases, and there are taxation issues related to pensions that undermine the value of the total reward package for some senior clinicians. 
• There is a worsening position on health and wellbeing measures across all occupation groups and the numbers of doctors leaving the workforce remains high.  
• It is important to bring the timetable of the pay review body back to normal, enabling a return to prompt implementation and payment of pay awards to staff.