Lack of clarity over funding for the new pay offer for NHS staff in England has led to concerns that it could mean cutbacks in other areas of the health service.
The pay offer for NHS staff working on Agenda for Change contracts in England includes a one-off payment for 2022-23 that would see nurses receiving an additional £1,891-£3,789 depending on salary and experience, as well as a 5% consolidated increase in pay for 2023-24.
“Members will be keen for the government to explain the full workings of how this award will be funded”
Health unions are preparing to consult their members on the offer, with many including the Royal College of Nursing (RCN) and Unison recommending that their members accept the package.
Before the pay talks that led to the current offer, health unions were given assurances by the government that any deal would include new money rather than relying on existing NHS budgets.
However, since the pay offer was put forward at the end of last week, the Department of Health and Social Care (DHSC) has not ruled out using existing the NHS budget to fund the pay offer, merely saying that it would not “impact on patients”.
Speaking to Sky News on Friday 17 March, health and social care secretary Steve Barclay said that the DHSC would be looking at areas of underspend and administrative savings in discussions with the Treasury.
“We’ve been clear that it will not come at the expense of impact on patients. Obviously how these things are funded is a matter for the chancellor and we’ll discuss that in government,” he said.
It comes after the DHSC gave evidence to the NHS Pay Review Body stating that a pay rise of 3.5% for 2023-24 was all that was budgeted for.
The DHSC has said that the additional 1.5% of pay increase for NHS staff would be resolved by the Treasury and DHSC “work[ing] together to resolve any new funding needs in the usual way”.
It has issued assurances that there will be “no impact on frontline services or the quality of care that patients receive” as a result of this pay offer.
However, senior research economist at the Institute for Fiscal Studies in London, Ben Zaranko, has estimated that to fund the 5% pay offer for 2023-24 the DHSC would need to find an additional £1.5bn, and that this may have to come out of the NHS budget.
He said: “If no extra cash is forthcoming from the Treasury, it may be that for the second year in a row, the health service is asked to somehow absorb these additional costs – whether through reductions in headcount, or lower spending on things like digital transformation.”
“I think when our members are going to be voting on this, they’re going to be taking that into account”
Chief executive of the NHS Confederation, Matthew Taylor, said NHS leaders were keenly awaiting further detail on how the pay offer would be funded.
“Members will be keen for the government to explain the full workings of how this award will be funded,” he said.
Mr Taylor added: “Any funding for the award should not come out of already stretched NHS budgets, otherwise it will be a situation where we are robbing Peter to pay Paul, with patients bearing the costs.”
Speaking to Channel 4 News on 18 March, Unite’s national lead officer Onay Kasab said that he was “appalled” to learn that funding for the pay offer could come from the existing NHS budget.
He said: “Throughout this whole process the government has been saying that this will be new money. It was one of the conditions for the unions entering into the current phase of talks.
“So, we’re appalled to hear that news,” he added.
“I think when our members are going to be voting on this, they’re going to be taking that into account.”