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by Anne Crandles
13 June 2017

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A workforce worth investing in

The recent announcement that NHS staff are to be awarded a 1% pay rise this year, while disappointing, is perhaps the percentage uplift most people had been realistically expecting.

On the whole, staff might have accepted this with a resigned shrug, given the current financial pressures on the health service. But then we learned that MPs are to enjoy a 1.4% increase, which, according to the Daily Mirror, gives the politicians a new take-home pay of £76,011 per annum.

Compare that to the new rates for, say, an Agenda for Change (AfC) band 5 nurse on £24,793, or a porter on £17,344 at band 2 (mid-point figures) and any previous stoic understanding instantly evaporates.

These below-inflation pay rises will not keep the wolf from the door and could lead to levels of financial hardship that force good, well-trained staff to look for jobs either outside the NHS, or worse still, outside the UK. It is little wonder that public sector trade unions are up in arms.

Significantly, the growing numbers of salaried practices across the country are seeing these rates applied to their teams’ salaries.

While I empathise with healthcare professionals in these practices – particularly those starting out in their careers – I worry most about the reception staff paid at AfC band 2.

Why would you keep turning up every morning to deal with red-hot phones, demanding and often abusive patients, poor working environments and archaic IT when you could earn twice as much scanning items through a supermarket checkout? The risk of losing these vital members of staff is a legitimate threat.

Historically, many practices chose, although they were not obliged, to base their staff pay uplifts on the Pay Review Bodies’ recommendations (as used by the NHS). But in recent years they have drifted away from this guidance.

The majority of these staff may be graded more appropriately, but do not have a nationally set pay scale – and a 1% rise may be more than many staff receive this year.  

At the time of writing this article, I asked local practice manager colleagues if they were planning to pay the 1% award. Tellingly, only 12.5% of my straw poll had decided to do so. Some 62.5% were making no award and 25% had still to reach a final agreement.

The reasons behind these decisions are solely financial, as practices struggle with falling income and ever-increasing costs. It seems that practice managers face telling their staff that there will be no pay rise – effectively a cut. 

No doubt as the practice manager delivers this news, they will be wondering how they can motivate, engage and retain staff over the coming months.

As in salaried practices, the consequences could include staff resigning, taking their knowledge and expertise with them, leaving behind demotivated colleagues, potentially resulting in a poorer quality service for patients.

Naturally, such scenarios will require more of the practice manager’s already-stretched time and attention – and a 1% rise for the practice manager undervalues and undermines that role too. This applies to the practice nursing team too. GPs be warned.

Indirectly, the Government contributes to practice staff costs through its payments to practices for work carried out via the main GMS contract and enhanced services level agreements, but this is nowhere near the 80% reimbursement of staff costs that practices once received.

If the Department of Health is serious about saving the NHS with its vanguard sites and sustainability and transformation partnerships (STPs), models with general practice at their core, it must find a way to ensure practices are adequately resourced to employ the best teams to implement and carry out that work. Perhaps that it could be funded by a future freeze on MPs’ uplifts?


1. Fury as NHS workers get ‘miserly’ 1% pay rise while MPs get more Daily Mirror (accessed 30 March 2017)

2. NHS Agenda for Change Pay Scales 2017-18  Nursing Notes (accessed 30 March 2017)

3. New Care Models NHS England (accessed 2
April 2017)