*Updated 17 April*
This fact sheet sets out the Department of Health and Social Care's position on industrial action by NHS staff.
Statement on junior doctor strike impact data - issued 17 April
Health and Social Care Secretary Steve Barclay said:
"It's deeply disappointing that hundreds of thousands of appointments and procedures had to be cancelled last week as a result of some junior doctors taking strike action. This walkout clearly had an impact on many patients as well as hampering our efforts to cut NHS waiting lists.
"We remain ready to start formal talks with the BMA as soon as the union pauses its strikes and moves significantly from its unrealistic position of demanding a 35% pay increase - which would result in some junior doctors receiving a pay rise of £20,000.
"Thank you to all the staff who have worked tirelessly to cover for striking junior doctors during this period."
Statement on Unison members accepting pay offer - issued 14 April
A government spokesperson said:
"The decision by members of Unison, the largest NHS union, to accept the pay offer recommended by their leadership demonstrates that it is a fair and reasonable proposal that can bring this dispute to an end.
"Under the offer, an Agenda for Change employee at the Band 6 entry point - such as a physiotherapist, paramedic or a midwife - will receive over £5,100 across last year and this year, with over £2,000 in bonus payments arriving as a lump sum in pay cheques by summer.
"Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this generous offer secures their support."
Statement on RCN ballot results - issued 14 April
A government spokesperson said:
"It is hugely disappointing that the Royal College of Nursing membership has rejected the pay deal recommended by their leadership. Following constructive discussions, all parties agreed this was a fair and generous offer which is demonstrated by Unison, representing the largest share of the NHS workforce, choosing to accept it.
"The fact that the Royal College of Nursing has announced an escalation in strike action with no derogations, based on a vote from the minority of the nursing workforce, will be hugely concerning for patients.
"Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this generous offer secures their support."
Contents
- Agenda for Change pay offer
- Junior doctors
1. Agenda for Change pay offer
What are the next steps now?
- Hundreds of thousands of Agenda for Change staff continue to vote in ballots for other unions over the next two weeks and we hope this fair and reasonable offer secures their support - as it has with Unison, the largest NHS union.
- We will set out next steps after the NHS Staff Council meeting once the overall results are formally fed back to the government.
What is the offer that's been negotiated?
The fair offer that has been discussed with Agenda for Change unions includes steps on pay as well as measures to improve working conditions. The offer covers:
- A one-off award of 2% for 2022/2023 on top of at least £1,400 already received for this year. The one-off 2% award is worth between £405 and £2,189 depending on their pay band.
- A one-off NHS Backlog Bonus worth between £1,250 and £1,600 depending on how much experience staff have and their pay band. The average nurse in pay band 5 with at least four years of experience, for example, would receive £1,350.
- A 5% pay rise for 2023/2024, worth at least £1,065. In addition, the lowest paid staff will see their pay matched to the top of band 2, resulting in a pay uplift of 10.4%, or £2,113.
- Non-pay reforms to make the NHS a better place to work. This includes a drive to tackle violence against staff, measures building on existing safe staffing arrangements, amendments to terms and conditions to support NHS staff to develop their careers through apprenticeships, and a consultation to make the suspension of the pension 'retire and return' rules introduced during the pandemic permanent.
What would this offer actually look like for staff?
- For example, a newly qualified nurse would see their salary go up by more than £2,750 over two years from 2021/22 to 2023/24. On top of this they would also receive over £1,890 in one-off payments for the financial year 2022/23.
- A band 6 paramedic with less than two years' experience would see their salary go up by more than £3,000 over two years from 2021/22 to 2023/24. They would also receive over £2,020 in one-off payments for the financial year 2022/23.
How will this offer be paid for?
- We are absolutely committed to ensuring the NHS has the funding it needs to deliver for patients. There will be no impact on frontline services or quality of care that patients receive as a result of this offer.
- DHSC is working with the Treasury to ensure the department has the money it needs to fully fund this pay offer.
- There is already funding available for up to a 3.5% pay increase within DHSC's existing budgets - funding on top of that will come from a combination of reprioritisation and additional funding, which is new money for DHSC.
How much is the total offer worth?
- The deal represents around £2.7 billion for the non-consolidated elements in 2022/23 and around £1.3 billion for the consolidated element in 2023/24. This is on top of the c. £2.6 billion already available within DHSC's existing budget for pay awards up to 3.5%
Will this offer fuel inflation?
- The government firmly believes this is a fair deal which gives all Agenda for Change staff a fair and proportionate pay rise, at a time when people across the country are facing cost of living pressures and there are multiple demands on the public finances.
- It protects the Prime Minister's promise to halve inflation as a one off payment for the financial year of 2022/23 does not create a future inflationary pressure, and the award for rthis year is broadly in line with pay growth in the wider economy, and so won't drive significant growth in private sector pay.
2. Junior doctors
What is the BMA asking for and how much would this cost?
- The BMA is asking for full restoration of junior doctors' pay to levels equivalent to 2008/2009 based on RPI inflation to April 2022.
- Meeting this demand would require an average pay award of around 35% in 22/23 (including the existing Junior Doctor pay award for this year).
- To restore real terms pay to 2008/09 levels on this basis would cost over £2 billion on top of the existing 22/23 award. This is over 1.3% of the total NHS budget (£152.6bn for 22/23)
How much do junior doctors get paid?
- A junior doctor starting training in Foundation Year 1 received full-time basic pay of £29,384 in 22/23. On average, Foundation Year 1 Doctors have additional earnings worth around 31% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctor of around£38,000 in 22/23.
- A junior doctor progressing into Foundation Year 2 received full-time basic pay of £34,012 in 22/23. On average, Foundation Year 2 Doctors have additional earnings worth around 35% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctor of around £46,000 in 22/23.
- A junior doctor progressing into specialty training can expect to have received a starting basic pay of £40,257 in 22/23. On average, doctors in specialty training have additional earnings worth around 36% of basic pay covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings for a full-time doctors of around £55,000 in 22/23.
- The maximum basic pay as a junior doctor depends on the specialty they train in, but once they are qualified, they have opportunity for career advancement into roles in the consultant, Specialty and Associate Specialist, or general practice workforces, potentially earning significantly more.
- Junior doctors who are also members of the NHS Pension Scheme receive a pension contribution worth 20% of their salary.
- Many will progress to become consultants. On average, consultants have additional earnings worth around 31% of basic pay, covering additional programmed activities, clinical excellence awards and on-call payments This is expected to take average earnings per person to around £128,000 in 2022/23.
Are some junior doctors paid £14 an hour?
- This rate refers only to the basic pay rate for Foundation Year 1 doctors in their first year following graduation from medical school. It does not include any additional earnings - enhanced rates are payable for night work and additional supplements for those regularly working at weekends.
- On average Foundation Year 1 doctors have additional earnings worth around 31% of basic pay. This is expected to take average earnings for a full-time doctor to around £38,000 in 2022/23
Details on the multi-year pay deal
- Junior doctors were in a multi-year pay and contract reform deal, between 2019/20 and 2022/23.
- The junior doctor pay and contract reform deal has seen all pay points increase by a cumulative 8.2% between 2019/20 - 2022/23.
- We have asked the DDRB for recommendations for 23/24.
- This deal:
- provided the most experienced junior doctors with a higher pay band, recognising that they are often taking decisions and delivering care at near-consultant level. This meant they received a cumulative increase of 24% over the four years. All junior doctors that reach the highest pay point as part of their specialty training will benefit from this.
- increased allowances for those working the most frequently at weekends.
- increased rates of pay for night shifts. Shifts between midnight and 4am are paid an additional 37% of the hourly basic rate.
- created a permanent allowance of £1,000 a year - on top of their usual pay - for junior doctors who work less than full time to recognise the additional costs they face.
- Our door remains open to the BMA for constructive conversations, as we have had with other health unions, to find a realistic way forward.
Is the BMA's claim that the majority of junior doctors are looking to leave the NHS accurate?
- The NHS Staff Survey 2022 indicated that over 79.4% of junior doctors are not considering leaving their organisation (50.9%) or if they left would be most likely to move to a different NHS trust or organisation (28.5%).
- We are committed to making the NHS the best place to work and the NHS will publish a long-term workforce plan in Spring to recruit and retain more staff.