Nurses working across community and primary care settings may ‘miss out’ on the latest NHS pay rise in England because of funding gaps, leaders across health and social care have warned.
They also fear that unless the government provides additional funding to support the pay increase for staff, some nurse-led services could be forced to close.
The news comes as more than one million NHS staff in England begin to receive a new pay rise, backdated to April, from today. The deal, which was accepted by most health unions excluding the Royal College of Nursing (RCN), will see those on Agenda for Change contracts given a 5% increase for 2023-24 and a one-off payment for 2022-23.
However, health and social care leaders, including the NHS Confederation and NHS Providers, have warned the government that non-statutory organisations delivering NHS services are currently ‘excluded’ from the central funding available to support the pay uplift.
In a letter to the health and social care secretary, the leaders explained how organisations contracted by the NHS that use the Agenda for Change pay scale, including primary care services, charities, independent services, community interest companies and nursing and care homes, will be forced to cover the costs from their own existing budgets.
The leaders warned that without extra money from the government, these organisations would struggle to cover the increased costs and retain staff. They added that some would be ‘facing tough choices’ that could result in cuts and closures within services.
The letter said the services ‘at risk are diverse’ and included district nurses, school nurses, sexual health services, substance misuse, smoking cessation and children’s public health, among others.
It also said there was a funding gap for NHS staff employed by trusts who worked to deliver public health contracts commissioned by local authorities.
In April, general practice nurses told Nursing in Practice they were concerned that a further pay rise for nurses in the NHS could leave a deeper recruitment and retention crisis in general practice. This was because practices would not be able to compete with employers offer Agenda for Change contracts.
The joint letter, also signed by Social Enterprise UK, the Independent Healthcare Providers Network (IHPN) and the Association of Directors of Public Health and the Local Government Association, called on the government to take action to ensure that additional funding is available to all providers to cover the NHS pay increase set out by the government.
If the situation goes unaddressed, the letter said an ‘inequitable, two-tier system will be inadvertently created, impacting staff and creating significant risks and concerns’.
Matthew Taylor, chief executive of the NHS Confederation, said: ‘While the 2023 pay uplift has been welcomed and may with help with retention issues, it must be fully funded for all staff.
‘The NHS is more than just hospitals, consisting of a range of vital services patients rely on including mental healthcare, primary care, district nurses and therapists, all of which are contracted indirectly.’
He added: ‘The current arrangement for central funding might see staff at these services miss out and risks the creation of an unequitable, two-tier system for different staff.
‘Providers are currently facing the unenviable choice between finding additional savings – likely through cuts to services – to fund the rise, or not implement the raise and risk staff leaving, leaving patients worse off.’
The Department of Health and Social Care was approached by Nursing in Practice about the concerns raised in the letter.
In a separate announcement today on the implementation of the NHS pay award in England, health and social care secretary Steve Barclay said: ‘More than one million of our hard-working NHS staff will begin to receive more money in their pay packet from today, including a backlog bonus for all their efforts during the pandemic.
‘We hugely value the work of NHS staff and the vital role they’re playing to cut waiting lists, which is one of the government’s five priorities, and recognises the work they put in day in and day out.’
The RCN remains in dispute with the government over NHS pay and is currently holding a strike ballot in an attempt to secure a further six months of industrial action.
RCN executive director for pay, Colin Poolman, said: ‘This offer alone will not attract people to the nursing profession, or stop the mass exodus of experienced staff needed to keep the NHS safe.
‘Nursing staff are fighting for their patients, and the very future of our NHS – not just for their pay.’
