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Workforce Update October 2021

Welcome to this month’s UK Workforce Update

Through these regular updates we will share with you some of the key developments in different areas of health and care policy, all through publicly available resources.

Pay and conditions

After the government accepted the pay recommendations made by the NHS Pay Review Body and the Review Body on Doctor’ and Dentists Remuneration (DDRB) many nurses, paramedics, consultants and dentists in England will receive a 3% pay rise backdated to April 2021. This does not apply to junior doctors who are currently covered by a pre-existing long-term pay deal. Meanwhile, NHS Scotland has awarded an average of 4% to staff on Agenda for Change.

In response to this, The Nuffield Trust states that the pay agreement lacks transparency on whether it reflects the extraordinary efforts of health staff during the COVID-19 pandemic. This echoes concerns communicated by the BMA as it announced that senior doctors will no longer engage with the DDRB. Some organisations, like UNISON, are running an indicative ballot on the proposals. Concerns have also been raised regarding workplace resources as General Practitioners respond to Public Accounts Committee’s (PAC) inquiry on supporting patients during lockdown.

The Health Foundation's response highlighted that NHS pay has risen by 1.6% over the last decade, lower than the Retail Price Index (RPI) rate of inflation, currently at 4.8%. The IFS’ most recent inflation projections can be found here. RCN data show that the cumulative effect of this has meant that staff have experienced a 13.2% real term drop in earnings since 2010. These figures do not include the unpaid overtime which is reported annually in the NHS staff survey.

In this bulletin, we also include the NHS Pension Scheme’s report on proposed changes for April 2022, as well as OECD salary index, where the UK ranks 16th for average nurse pay. Luxembourg and Iceland pay its healthcare staff the most, with nurses receiving an average £76,908 and £61,295 respectively.

Staff Shortages

The WHO predict there will be an 18 million global shortfall of health staff by 2030, including 9 million nurses and midwives. There are currently 38,952 (10.3%) registered nurse vacancies across NHS England. NHS Scotland have 4,845 (7.1%) nursing and midwifery vacant posts, whilst Northern Ireland have a nursing and midwifery vacancy rate of 11.4%. At time of writing, data from Wales is yet to be published.

The UK has fewer practising registered nurses and physicians than many other high-income countries with 30% of physicians and 15% nurses working in the UK being trained overseas. The state of the adult social care sector and workforce’ report has just been released for England, which discusses how retention may look for the allied health professions. Meanwhile, the Lancet has written a Health Policy paper which argues that UK workforce planning mechanisms are not currently fit for purpose.

Produced by Natalie Elliott, Heather McAdam, Arrash Yassaee



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