Autumn Budget 2018 – What’s in it for nurses?

With the start of winter and the rapidly evolving staffing crisis in the NHS, did the budget have any gifts to give for the hard working front line staff? We look at what the Budget held for nurses and the NHS as a whole.

After speculation last week over what the Budget statement might hold for nurses and pleas from the RCN about not introducing regional pay, the Chancellor delivered his autumn statement.

So what was in it for nurses and front line staff?

In truth, not a great deal. No mention was made of pay rises or regional allowances.

The only thing suggestive of a greater income was the mention of increasing the tax free allowance to £12,500 from April 2019

For nurses, there wasn’t much to get excited about

Chancellor Philip Hammond or ‘Fiscal Phil’ as he described himself, declared that we were coming to ‘The end of austerity’ and there would be an investment of £20.5 billion for the NHS over the next 5 years with an additional £2 billion per year for expansion of mental health services across the NHS.

He talked of plucking rabbits from hats but in truth, he didn’t appear to reveal anything that would benefit the staff who run the NHS or other public services in any way.

His big reveal of the day was a ‘sneak preview’ to the soon to be released 10 year plan for the NHS.

The outline of this plan to focus on NHS Reform, reduction of waste and the support of NHS staff – as revealed by the Prime Minister in September.

He described the ’Pressing demands’ and the need to address the crisis within mental health services before announcing a comprehensive expansion of acute services that would include A&E mental health services, increased mental health ambulances, a hotline and expansion in crisis intervention.

All of which is much needed after years of underinvestment.

What the Chancellor said about the NHS

“Today I can announce that the NHS 10-year plan will include a new mental health crisis service with comprehensive mental health support available in every major A&E, a children and young people’s crisis team in every part of the country, more mental health ambulances, more safe havens in the community and a 24-hour mental health crisis hotline.

"These new services will ensure those suffering from a crisis young or old can get the help they need, ending the stigma that has forced too many to suffer in silence and ending too the tragedy of too many lives lost to suicide.”

No mention of increases in pay

There was no mention of increased salary for nursing staff or where the staff would come from to support these new services.

With Mental health nurses being particularly badly hit with the current shortage, these services may be much needed but if they haven’t got the staff to run them, then they are nothing more than another idea that is doomed to failure.

There was an additional £650 million for local authorities to be able to alleviate the winter pressures within social care in the coming year and an additional £45 million for adaptations to homes for people with disabilities.

Both of which will be welcomed by local authorities.

There had been speculation in the last week that public sector workers might be subjected to regional pay variation, but no mention was made in the Budget announced today.

London and surrounding areas already attract extra pay for cost of living allowance (which barely covers the cost of travel to work) but for many nurses in the south east, salaries are outstripped by the cost of living making the option to own their own homes prohibitive.

In his response, Jeremy Corbyn described the budget as “simply not enough,” and acknowledged the nursing vacancy rate and falling numbers of medical staff.

The RCN response to the Budget statement welcomed the investment in NHS and social care services whilst acknowledging the concerns for patient safety with the loss of so many front-line staff.

Dame Donna Kinnair, Acting Chief Executive for the RCN said in response: “The extra £650 million for social care is a step in the right direction but, in truth, those caring for vulnerable people will know that this amount barely touches the sides.

“The current funding gap for social care is estimated to be £2 billion by 2020 – we need cold hard cash to follow the forthcoming social care green paper and other future proposals.

“The Chancellor is right to recognise the importance voters and taxpayers attach to the NHS. When the 10-year plan is released later this year, the Government and NHS England must show how they will recruit the tens of thousands of extra registered nurses needed to guarantee patient safety.

“Philip Hammond is to be commended for not raising the spectre of regionalised public sector pay as rumours last week suggested. Frontline nurses and care workers defeated this six years ago as a fundamentally unfair move that exacerbates shortages, rather than fix them.”

Unfortunately, nothing from the Budget seems to have been aimed at improving the recruitment or retention of nurses into the NHS.

As a result, we are faced with the ongoing loss of good, experienced clinicians who will seek out better paid, less stressful work environments away from our hospitals and community settings.