Will Raising Nurses’ Pay Be Enough For The NHS To Meet Its Long-Term Workforce Plan?

"Nursing salaries need to match or be higher than equivalent jobs in the wider economy for more people to be attracted to joining the NHS, according to the IFS."

Analysis by the Institute for Fiscal Studies (IFS) says the NHS will only meet its staffing targets if salaries are sufficiently raised as to attract and retain staff.

NHS England’s long-term workforce plan was published in June this year. It laid out how the health service was planning to deal with the severe staffing shortages that are restricting the capacity of the health service to operate effectively.

The workforce plan anticipates the NHS increasing the number of staff employed permanently from 1.4 million in 2021-22 to around 2.2 million in 2036-37. This includes an expected 180,000 nurses joining the NHS over the coming years.

Worryingly though, the most recent NHS Staff Survey found that nearly a third of current staff (32%) often considered leaving their job.

Do you think the expectation of 180,000 nurses joining the NHS in the next few years is realistic, and if so, will so many nurses have left that those newly joining nurses won’t end up adding to the workforce, but merely replacing those who have left?

The IFS also cautioned in its report that unless the workforce plan took into consideration large increases in the NHS pay bill resulting from raised wages, ’difficult fiscal decisions’ would need to be taken in future spending reviews.

The report claimed that ‘if the NHS is going to expand its workforce by more than half, it will need a strategy for attracting workers into the sector (and subsequently retaining them). That is almost certain to require real-terms wage increases, and highly likely to require pay increases that match – or perhaps even exceed – economy-wide earnings growth,’.

With a higher wage bill, do you think that NHS managers will be able extract more funding from the government, or will they end up having to redistribute budgets from other areas? And if so, what effect will this have on already insurmountable patient waiting lists?

RCN general secretary Pat Cullen said in response to the IFS research:

‘It is vital that the government makes the NHS a good workplace that will attract the best people. And fair pay is a fundamental part of this – otherwise we’ll see nurses continue to leave in their droves.'

‘Failing to provide the investment that the workforce plan needs will put the entire plan in danger of collapse’ she warned, adding that ‘The funding must not come at the expense of frontline services.’

Following on from this, in October 2023, the Public Accounts Committee (PAC) of the House of Commons delivered a stern warning to the government about its ongoing failure to clarify how the long-term workforce plan would be funded.

The long-term workforce plan contained a commitment to £2.4bn of investment, which would cover the first five years of the fifteen-year plan. However, no detail about when and how this money would be released was specified in the plan, nor was there any information on how the final decade of the plan would be funded.

The PAC report cautioned that: “The plan does not include any estimate of total additional running costs for the significant increase in workers it has identified, such as salaries for an extra 260,000 to 360,000 staff. There is no information available on either the scale or source of how staff costs in future years will be met.”

If the funding isn’t to come from frontline services, do you think that there will be any will within the NHS or government to look at the politically uncomfortable option of cutting roles that don’t directly contribute to the frontline clinical effectiveness of the health service?

A spokesperson for the Department of Health and Social Care said: ‘We are backing the plan with more than £2.4 billion over the next five years. Decisions about spending review periods beyond this will be announced in the usual way, but this demonstrates our commitment to delivering the whole plan.’

As of October 2023 however, there is no national long-term social care workforce plan. Could it be argued that by only focusing on the NHS workforce, government ministers are not looking at the whole problem, and consequently the plan will not have the full transformative effect it might otherwise have had?

Please let us know what you think in the comments.