Separate pay spine for nursing evidence submission

Summary of our response to the Department of Health and Social Care’s call for evidence on a separate pay spine for nursing.

11 April 2024

In January 2024, the Department of Health and Social Care (DHSC) asked for evidence to understand the benefits and challenges of introducing a separate nursing pay spine.

Over the past few weeks, NHS Employers has consulted with employing organisations to inform an employer-led response. Following this consultation, we submitted our formal response to the call for evidence online portal which closed on 4 April.  

Below is a summary of our evidence following these discussions:

  • There were consistent messages from across the country and an overwhelming consensus that employers in the NHS do not support anything that would threaten the integrity of the original Agenda for Change (AfC) agreement, as this created the unified pay and banding system we have in place. 
  • On employers behalf, we outlined the potential risks associated with moving away from this system and stated a strong belief that resources and capacity would be better spent on modernising the pay structure to benefit the whole AfC workforce.    
  • Employers were concerned that any move to pay nursing staff in a different way would threaten the equal pay principles (equal pay for work of equal value) that are the foundation of the AfC structure.
  • The employers view was that this would impact on the cohesion and focus on team working and multi-disciplinary approach to service delivery. We drew attention to roles which are undertaken by any of a variety of professions and the knock-on effect if nurses were on a separate pay spine and/or job evaluation system. Employers considered the risk to morale and consequently patient care to be too great.
  • Employer experience shows that any difficulties in respect of professional development and career progression are not felt to be unique to nurses. New roles and responsibilities, coupled with new ways of working, have been developed across the workforce, not just in nursing.
  • Employers would prefer resources to be directed towards changes to the pay structure for the benefit of the whole AfC workforce. There was consistent feedback regarding gaps between pay bands, pay step progression, and incentives for promotion. There was employer concern about the potential impact on capacity (national and local) should such a change be made together with the potential impact on employment relations and staff morale.

Next steps

We understand that the DHSC will consider all submissions received before deciding next steps. We will keep you informed of any updates.