NHS Employers' Pay Review Body evidence 2023/24

Read our evidence to the NHS Pay Review Body (NHSPRB).

1 February 2023

Read NHS Employers' submission to the NHS PRB 2023/24 External link icon

The independent NHS pay review body (NHSPRB) makes recommendations to the government on pay awards for nurses, health professionals and other NHS staff. NHS Employers submits evidence to the review bodies, based on information collected from our policy board, our regular meetings with NHS HR directors and our online surveys. Final decisions on pay awards are made by the government.

Our evidence has been informed by a continuous cycle of engagement with a full range of NHS organisations about their priorities. Below are some of the key messages, download and read the full evidence here.

Key messages

  • 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. 

In addition to the key messages above, there are some specific workforce challenges:

  • There are simply not enough people working in health and social care to meet rising levels of demand for services. While NHS workforce numbers have increased by 2.4 per cent (headcount) in the year to August 2022, employers have told us that this growth has not been sufficient to keep pace with rising demand on services.
  • High vacancies have impacted on service provision as employers cover vacant posts with agency staff and other temporary staff, which comes with significant financial impact. It can also create challenges in ensuring continuity of care.
  • In addition to increased demand, employers are dealing with a reduction in workforce capacity due to rising sickness absence rates. NHS staff were working under pressure even prior to the COVID-19 pandemic, but the pandemic brought increases in the amounts of pressure on NHS staff and has led to many staff experiencing symptoms of burnout.
  • For the NHS to fully recover long-term from the pandemic, tackle the waits for treatment for our patients, and support its staff, it will need the government to provide the necessary investment for an ambitious and sustainable long-term plan for the workforce.