A swift announcement on pay must be a priority for the new Government

By Alice Sorby, Director for Employment Relations on 10 July 2024

In his first speech as the new Secretary of State for Health and Social Care Wes Streeting said the NHS was 'broken' and that it will take a team effort to turn it around. There is no NHS without its staff and addressing the retention crisis has to be a priority for the new government. In his blog at the end of last week Stuart Bonar the RCM's Public Affairs Advisor gave a whistle stop tour of the commitments that Labour had made in their manifesto and how we want to work with them on delivering those promises.

I want to talk in a bit more detail now about what we want to see to improve your working lives. Firstly, the Pay Review Body (PRB) report, your pay rise is already over three months late, a swift announcement must be a priority. Year after year you face months of delays to a pay rise which is due on 1 April – the same date every year. We need to get the timetable back on track for future years and that means engaging us and the other NHS trade unions to improve a process that many have lost faith in.

While decent headline pay is key to keeping midwives and MSWs in the NHS and to making the NHS an attractive place to work there are also many structural issues in the Agenda for Change pay system that need addressing. This includes small gaps between pay bands particularly at Band 7-8a (with just £896 between bands) and at 2-3. Underpinning the pay system is the NHS Job Evaluation Scheme it ensures equal pay for work of equal value – meaning that you get paid fairly for the job that you do. Job evaluation is also important to addressing wider pay discrimination, gender, ethnicity and disability pay gaps. For it to work properly though it needs effective local application, this means job descriptions are regularly reviewed and updated and job matched. Job matching needs to be done in partnership by a panel of management and staff-side representatives. Years of underfunding means that we need to see investment at a national level in infrastructure and capacity building.

Something we have been talking about for some time now is the amount of unpaid extra hours that midwives and MSWs do, propping up maternity services with unpaid labour. According to an RCM poll during one week in March midwives and maternity support workers (MSWs) in England, worked 118,181 extra unpaid hours to keep services running safely. The most recent NHS Staff Survey showed almost 80 percent (78.9%) of midwives work additional unpaid hours. Regularly working above contractual hours impacts health, safety and wellbeing and can lead to burnout but with current staffing pressures these extra hours are common, and they should be paid as per the Handbook.

Flexible working for midwives and MSWs means a change to the culture of rigid shift lengths and unpredictable patterns with the introduction of innovative shift patterns and the ability to fix shifts/ensure a predictable working pattern. It also means an end to the inappropriate use of on-calls to cover for shortages in acute settings, we have seen in some areas the imposition of on-calls on non-working days and during periods of annual leave. This is the antithesis of the flexibility (or stability) that midwives and MSWs need at work.

This is not an exhaustive list of all that needs to change, rather it's a recap of some of the issues we have been raising for some time and will continue to do so until we see the change that’s needed. If any of this resonates with you and you would like to share your experience, please let me know. The RCM is your union, and we want your voices to be the ones that are heard by those in power’.