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NHS pay and performance

There are some fundamental problems with this short-sighted and damaging approach: (1) There is already a mechanism to control pay in the NHS: by not progressing the pay of poor performers – it just requires performance management processes to be implemented properly through Agenda for Change. Poor performers shouldn’t receive incremental rises, but EVERYONE should be entitled to cost of living increases.

(2) This system of rewarding only people at the ‘top’ of the scale introduces inequity and opacity into a pay system that was developed to address those very problems. Only giving pay increases to those at the top of the scale could easily introduce unequal pay for men and women (breaching the Equality Act) and will make progression and appointments harder and more difficult to assess for fairness. Pay will start to reflect ‘years in the job’ rather than experience, seniority, expertise, value to the organisation, professional development, etc – a fundamentally unfair and often illegal approach.

(3) Pay is already shockingly out of kilter with the private sector for certain roles. I have three degrees (including an MBA with distinction from a respected business school) and earn approximately half the same as my peers in equivalent roles in the private sector. I accept this, because I value working in and contributing to the NHS – but it’s a pretty demoralising blow when you can’t even expect to receive cost of living increases anymore, chipping away slowly at the already comparatively low salary we do get.

(4) To imply that this is an exercise to save jobs is both misleading and upsetting given the huge upheaval that NHS staff have faced in recent years. Not only ARE redundancies still happening in force but alternative pay controls are being implemented insidiously – through ‘restructuring’ and or ‘regrading’ people’s jobs and paying them less. This reduces the cost of redundancies but makes people work in lower banded positions, feeling demoralised and devalued to be stripped of their status and achievements. Being given a job that is one or two grades below the grade you have worked hard to achieve is not a good outcome for many staff, and many I speak to would actually prefer to be made redundant that suffer the indignity of losing their job for a lesser one, and becoming labelled less valuable in the job market as a consequence.

The government needs to think again – this approach does not benefit anyone.

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