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Work life: Presenting the facts

2 December, 2013

Work life: Presenting the facts

Amy Leversidge describes the evidence being put forward to the NHS Pay Review Body.
Midwives magazine: Issue 6 :: 2013

Amy Leversidge describes the evidence being put forward to the NHS Pay Review Body.



Amy Leversidge portrait 250x200

Every year the RCM submits evidence to the NHS Pay Review Body (PRB), which uses it to determine pay uplift for the following year. However, since becoming chancellor, George Osborne has not allowed the PRB to act independently and has demanded a pay freeze for two years, while capping the pay uplift at 1% last year and 1% for the next two years. 


Despite the fact that the pay uplift of 1% is below inflation (representing a real terms pay cut), the Department of Health (DH), NHS Employers and the Foundation Trust Network want to return to a pay freeze. There are also calls, led by George Osborne, to end incremental progression.


In the RCM’s evidence to the PRB, we included our findings from our annual HoMs survey, which is sent to all HoMs in the UK. This year, the survey showed some very interesting results; in particular, how maternity units in the UK are struggling to meet the demands of the service, with HoMs frequently having to redeploy staff to cover essential services, calling in bank and agency staff, withdrawing ‘non-essential’ services and closing maternity units. 


Additionally, the HoMs survey replicated previous years, revealing that there have been more cuts to training, and development opportunities are decreasing further with continued downbanding of band 7 posts. Around 40% of HoMs report that there have been incidences of bullying, harassment and abuse in their unit too. 


As well as evidence from our annual HoMs survey in April, the RCM commissioned Professor Ian Kessler from King’s College London and Richard Griffin from Buckinghamshire New University to conduct independent research into attitudes to pay, job satisfaction, morale, commitment and career development opportunities against the backdrop of service reform and increasing demands. The research comprised a nationwide survey of members and two focus groups; one in London and one in the South West. 


Some 1025 RCM members responded to the survey, which found that while the vast majority are highly motivated and committed to their roles, loyalty to their trusts is fragile and limited, and there is a high level of dissatisfaction with pay. Key findings revealed that 83.2% said they are ‘very dissatisfied’ or ‘dissatisfied’ with their last pay rise and 76.7% said they ‘strongly disagree’ or ‘disagree’ with the statement: ‘I am paid fairly considering the responsibilities of my job.’


In addition to feedback from our surveys, we also included evidence about the rates of inflation compared to the rates of pay in the NHS. The pay freeze started in April 2011, when retail price index (RPI) inflation was at a high of 5.2%. RPI inflation has come down since then but has stayed fairly consistent at around 3.2%, resulting in a continued devaluation of NHS employees’ pay, and with recent announcements by energy companies raising their prices, we are seeing a real crisis in the cost of living. 


Furthermore, we highlighted how the costs of working have risen in the last year, with the NMC increasing its registration fee by 31.6% from £76 to £100. If midwives are unable to pay the registration fee, they will not be able to legally practise as a midwife.


Also, NHS employees have seen their pension contributions rise substantially, with the majority of midwives seeing their contribution rise from 6.5% to 9% in the last two years, with a further increase planned in April 2014 to 9.3%. 


We strongly argued that incremental progression cannot act as a substitute for an annual increase in basic pay. Incremental progression represents reward for increased skill and experience as agreed under the Agenda for Change framework. 


The Francis report into the failings at Mid Staffordshire NHS Foundation Trust emphasised the importance of having an organisational culture that promotes high-quality care. Many research studies have shown that the more positive experiences of staff within an NHS trust, the better the outcomes for that trust, both in terms of patient care and financial performance – in particular, making savings through improving patient outcomes and staff sickness absence rates. 


We also argued that maternity units are facing unprecedented challenges, with units understaffed and staff overworked. There has not only been a reduction in training, but in band 7 posts too, so there are fewer opportunities for talented midwives to progress and less leadership on the unit. Staff are not feeling valued, there are high levels of bullying, harassment and abuse, and perceptions of discrimination – particularly in London trusts. Staff are redeployed to other areas of work to cover essential services and units rely on bank and agency staff. 


Improving staff engagement cannot only improve a trust’s financial performance through savings on litigation costs and sickness absence rates, but it has a direct impact on client outcomes. Midwives and MSWs have never been so challenged in their ability to provide high-quality and safe care. 


Despite submitting strong evidence to the PRB, NHS Employers, the Foundation Trust Network and the DH have all included evidence arguing that NHS employees should be given a pay freeze for the next year. NHS Employers added to this by stating that, in their view, the changes to Agenda for Change that were agreed earlier in 2013 are ‘only a start’ to changing terms and conditions. Despite saying that the NHS staff are their ‘greatest asset’, the DH said that the 1% that the government has made available for pay would be best spent ‘modernising the national pay frameworks to ensure there is a better balance between pay, performance and productivity, rather than time served’. The Foundation Trust Network argues that there should be no pay award next year, but there should be ‘significant changes to pay, terms and conditions’. 


Hopefully, as we (and the other NHS trade unions) have presented strong evidence to the PRB, they will award the 1% uplift as originally promised. However, what is clear is that the government and employers have not lost their zeal for cutting pay, terms and conditions in the NHS. 


To read the RCM’s evidence to the PRB, visit: rcm.org.uk/college/support-at-work/pay


Amy Leversidge
RCM employment relations advisor





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