Fresh calls have been made on the government to reach a resolution over nurse pay, as NHS staff battle “a crisis at work”.
Current pressures mounting on the health service have seen several organisations declare critical incidents, as staffing levels hit “below minimum levels” and rates of influenza and Covid-19 rocket, health leaders have warned.
“It is in everybody’s interest to reach agreement, compromise and let nursing staff focus on what they do best”
The situation comes alongside plans for further strike action by nursing and ambulance workers in the coming weeks as part of an ongoing dispute over the 2022-23 pay award, which saw many nurses receive a £1,400 rise.
Meanwhile, reports suggest NHS staff could be in line with for another below-inflation pay award for 2023-24.
This week, union and health leaders have once again appealed to the government to open negotiations on pay and support NHS staff amid this particularly challenging period.
The NHS Confederation, which is a membership body for NHS organisations, has reported instances where oxygen cylinders have run out temporarily and where patients have waited more than two days for a bed.
There were also cases where “ward staffing numbers are now below minimum levels”, said NHS Confederation chief executive Matthew Taylor.
“Health leaders have been telling us that the pressures their staff are facing are becoming unbearable,” he said.
“It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised.”
“Health leaders are working together and doing all they can, but this is only crisis management”
Data from NHS England showed that at the end of November 2022, there were 3,746 patients a day in hospital with flu. Of those in hospital, 267 were in critical care beds.
In a stark comparison, there were only 34 patients in hospital with flu, two of whom were in critical care, at the end of December 2021.
Separately, data from the government, which was last updated on 22 December 2022, showed more than 7,100 patients had been admitted to hospital with Covid-19 in England in the previous seven days. This was a 36% increase on the week before.
Thousands of NHS staff have also been impacted by illness this winter, with data showing an average of more 60,500 absences due to staff sickness every day towards the end of December 2022.
Mr Taylor added: “Health leaders are working together and doing all they can, but this is only crisis management.
“We need the government to commit to do everything within its power to prevent the NHS from entering the next winter in this same fragile state that has sadly become the norm over recent winters.”
Mr Taylor stressed that tackling the health and care workforce crisis was “essential” and that this started with “negotiating with the unions on pay so we can avoid more damaging strike action when services will be at its most fraught”.
The Royal College of Nursing, which has plans for a second round of strike action in England on 18 and 19 January, has also once again appealed to the government to find a resolution on nurse pay and help avert strikes.
It follows reports that NHS staff could receive a pay award in 2023-24 of between 2-3%.
RCN general secretary and chief executive Pat Cullen said the prime minister “has to decide if this is the way he wants to spend the new year”.
“He can battle against NHS staff who are dealing with a crisis at work, or he can grasp the nettle and negotiate with us,” she said.
Ms Cullen stressed that with just two weeks to go before further strikes, she was asking the prime minister to “think hard”.
“It is in everybody’s interest to reach agreement, compromise and let nursing staff focus on what they do best,” she said.
An NHS England board meeting on 1 December 2022 confirmed that its budget had already been set for next year and includes funding for a 2% pay rise for staff.
However, there is also a £1bn “contingency” pot that could allow for an additional 1%.
Julian Kelly, chief financial operator at NHS England and Improvement, told the meeting: “We have been funded in the previous spending review for a pay settlement of 2%.
“Now, we are able, in line with government requirements, to hold £1bn general contingency and we will just need to see what the government policy is, what the pay review body’s recommendations are, and the government response to those recommendations, in due course.”
While the government is yet to give its recommendation on staff pay for next year, in a letter to the NHS Pay Review Body in November launching the 2023-24 pay round, health and social care secretary Steve Barclay stressed that the NHS budget had “already been set until 2024 to 2025”.
Anita Charlesworth, director of research at the Health Foundation, said a pay rise of 2% would mean “a further cut in real earnings” for NHS staff and cause risks to recruitment and retention.
However, she added that “long waiting lists and major pressures across the service mean that there is little to no headroom to fund additional pay costs” from existing NHS budgets.
Over the Christmas period, interim chief executive of NHS Providers, Saffron Cordery, highlighted the need for pay rises above that budgeted by the NHS to be covered by the government.
She said: “It is unclear whether systems will be provided with additional funding if next year’s pay settlement exceeds what has been budgeted.
“We must not see a repeat of this year, in which NHS England and trusts were forced to deprioritise investment in care improvements following the government’s failure to fully fund the pay award.”
A Department of Health and Social Care spokesperson said: “We have not yet set out our position of affordability to the independent pay review body for 2023-24.
“The government hugely values and appreciates NHS staff and we have committed to give NHS workers a pay rise, asking the independent pay review bodies for recommendations on pay for staff in scope.
“This follows the acceptance of last year’s recommendations in full which saw the lowest earners in the NHS receive a 9.3% pay rise.”