The moment I opened my first pay cheque from working as an NHS junior doctor, I was shocked. 

I was 25 at the time and I’d moved to the UK from Lebanon to study medicine and then start my career. 

My total pay came to £1,800 and I couldn’t believe it. My rent was £950, plus I had to pay for bills, food, furniture, medical supplies – like scrubs and stethoscopes – and my £2,000 visa on top of that. How was I supposed to take care of myself? 

Read the full piece in Metro here

NHS staff have received a below-inflation pay rise.

This essentially means that NHS staff now have a George Cross that tells us we’re essential to the lifeblood of this country, and a paycheck that tells us that we’re not.

Over 1,500 health and social care staff have died of Covid-19 in England and Wales during the pandemic, according to ONS figures released in July last year. This number has likely risen since then. Thousands more have been absent from work for prolonged periods of time due to long Covid.

The impacts on our patients are clear: ambulance waits are at record highs, GP services are stretched, while the Royal College of Emergency has described how extended A&E wait times are translating directly into excess deaths.

Read the full piece here

Having worked under extreme pressure for the last year, should the Government’s pay rise for NHS staff not recognise this?

See the interview here

DAUK responded promptly to Robert Colvile’s misinformed opinion piece about NHS pay in The Sunday Times.

Mr Colvile states that on average, pay increased by “2.7 per cent a year” between 2012 to 2017 for NHS workers, due to a “complex system of near-automatic individual salary bump[s] every year”.
What he is referring to is a modest annual pay increase for new staff joining a ‘banded’ job within the NHS (which incidentally, excludes 10% of the workforce, including all 120,000 doctors). It occurs for the first seven years of service in recognition of increasing responsibility-then stops.
The vast majority of NHS staff have over 7 years of service, and do not receive automatic pay enhancements, meaning an experienced nurse will have suffered a relative pay cut of 9% between 2012 to 2017, without even considering the mandatory costs involved in the job.
A 1% “pay rise” is not only insulting in lieu of the sacrifice made by NHS workers, it also does little to reconcile the chasm which has emerged by wages lagging far behind inflation.

Felix Brewer – Surgical Trainee with The Doctors’ Association UK

Read the letter here

Our full response is as follows:

Response to “Welcome to the weird world of NHS pay, where a 1% rise is a lot more than it seems” by Robert Colvile

Dear Editor,

I read with interest the commentary published by Robert Colvile in the March 07 copy of The Times, and would like to respond to number of the claims made.

Firstly, let’s talk about the “pay rise”. Public sector pay is for obvious reasons, an emotive issue. For now, let’s overlook the enormous physical and psychological cost this pandemic has had on healthcare workers, the lives lost and destroyed, and just focus on pay. 

Mr Colvile states that on average, pay went up by “2.7 per cent a year” between 2012 to 2017 for NHS workers, due to a “complex system of near-automatic individual salary bump[s] every year, and the national increase on top”

Let’s look at this in more detail using a hypothetical case study for a nurse working from 2012 to 2017. 

Jeff is a nurse who graduated in 2012 and started working in the NHS. His starting salary as a Band 5 nurse is £21,176¹. For now, let’s ignore professional fees, indemnity costs and other mandatory costs required for him to just be able do his job. At the end of his 5^th year, he would be earning £25,298, factoring in pay progression and national increases². That equates to approximately 3.6% pay increase each year. 

So Jeff, a newly qualified nurse, has done relatively well over this time period.

However, this simplified scenario ignores the fact that most NHS workers in their respective pay band will already have reached the maximum pay category (achieved after 8 years of service), and no longer receive automatic pay enhancements. If Jeff, a band 5 nurse with 8 years’ experience started work in 2012 his salary would be £27,625. By 2017, his salary would be £28,462. Relative to inflation, this actually represents a pay cut of just under 9%³.

So in reality, a 1% pay rise is not only insulting in lieu of the sacrifice made by NHS workers, it also does little to reconcile the chasm which has emerged from wages lagging far behind inflation.  

The truth is that the majority of NHS workers do not get annual pay increases. Most staff have seen consecutive pay cuts over the past decade and are now 8-10% worse off than their counterparts in the private sector⁴. 

If there really is a “flood of applications” for public sector jobs, it isn’t because of pay or pensions (the latter of which also incidentally took a significant hit with the lifetime allowance freeze announced this week).   

Finally, Mr Colvile states that “every job [in the NHS] is then placed in one of a dozen pay bands”. This is not correct. Over 10% of the workforce, including the 122,000 doctors, are not paid according to this banding system, and instead are paid according to an entirely different set of guidelines (which incidentally also lag far behind inflation). 

1. https://www.nsft.nhs.uk/About-us/Documents/Pay_Scales_2012_Final270312.pdf
2. https://www.nhsemployers.org/-/media/Employers/Documents/Pay-and-reward/AfC-pay-bands-from-1-April-2016_FINAL.pdf
3. https://londoneconomics.co.uk/wp-content/uploads/2021/01/LE-NHS-Trade-Unions-Net-Exchequer-impact-of-increasing-AfC-pay-18-01-2021-STC.pdf
4. https://www.nuffieldtrust.org.uk/resource/chart-of-the-week-nhs-staff-pay-and-the-cost-of-living

Mr Felix Brewer

6th March 2021 FOR IMMEDIATE RELEASE

Many NHS staff finished another exhausting hospital shift this week to devastating news regarding the government’s recommendations for NHS staff pay. This represents an unconscionable affront to frontline NHS staff in all roles who have endured a year of torment working without adequate PPE, worrying about risks to their own health and mourning the death of colleagues.

It should be noted that higher pay rises (2.1%) were previously promised by the NHS Long Term Plan prior to COVID. The Chancellor vowed to give the NHS “whatever it needs” to tackle the coronavirus crisis (March 8th 2020). The latest recommendation of a pay rise of 1% therefore represents a conscious policy choice to insult NHS staff rather than that of economic reality and ignores a decade of real terms pay cuts (see figures at end of document from independent research from The Nuffield Trust and The Health Foundation) which has seen pay cut by £600 per employee over the last decade.

Dr Kaveri Jalundhwala, Vice-Chair Doctors’ Association UK said: The Prime Minister has previously told NHS staff that, “We owe you more than words can say” for their work during the COVID-19 pandemic. Now he must back up his rhetoric with action and act to pay NHS staff what they deserve after the last year of hell. If he fails to do so, it will be clear to the public that his priority is not the NHS.

A newly qualified nurse starting in 2020-21 would be earning about 3% less than one who started in 2010-11, once we account for inflation and the impact of pay freezes and caps. This is simply unacceptable. This isn’t a media story for the government to spin. This isn’t an election to score political points. These are livelihoods of exhausted NHS staff who have risked their lives to protect, treat and vaccinate the country in the midst of an unprecedented pandemic.

The Doctors’ Association challenges the government to explain to the country how it is morally or economically justifiable to cut the real-terms pay of staff that saved the life of the Prime Minister in the last year, while paying £7000 a day to management consultants for the outsourced test and trace program. Frontline staff are already shell shocked and considering if they want to keep working in the NHS after the betrayals they have experienced in the last year and previously.

This latest knife in the back may represent an insurmountable barrier to staff retainment and worsening NHS staff vacancies which already stand at over 100,000. The NHS is facing a retention crisis, and this recommendation of 1% maybe the final nail in the coffin.

Doctors’ Association UK 1-2-1 The Barracks Lancashire, LA1 4XQ press@dauk.org www.dauk.org 6th March 2021 FOR IMMEDIATE RELEASE DOCTORS’ ASSOCIATION UK condemns Govt recommendations regarding pay for NHS staff Many NHS staff finished another exhausting hospital shift this week to devastating news regarding the government’s recommendations for NHS staff pay. This represents an unconscionable affront to frontline NHS staff in all roles who have endured a year of torment working without adequate PPE, worrying about risks to their own health and mourning the death of colleagues. It should be noted that higher pay rises (2.1%) were previously promised by the NHS Long Term Plan prior to COVID. The Chancellor vowed to give the NHS “whatever it needs” to tackle the coronavirus crisis (March 8th 2020). The latest recommendation of a pay rise of 1% therefore represents a conscious policy choice to insult NHS staff rather than that of economic reality and ignores a decade of real terms pay cuts (see figures at end of document from independent research from The Nuffield Trust and The Health Foundation) which has seen pay cut by £600 per employee over the last decade. Dr Kaveri Jalundhwala, Vice-Chair Doctors’ Association UK said: The Prime Minister has previously told NHS staff that, “We owe you more than words can say” for their work during the COVID-19 pandemic. Now he must back up his rhetoric with action and act to pay NHS staff what they deserve after the last year of hell. If he fails to do so, it will be clear to the public that his priority is not the NHS. A newly qualified nurse starting in 2020-21 would be earning about 3% less than one who started in 2010-11, once we account for inflation and the impact of pay freezes and caps. This is simply unacceptable. This isn’t a media story for the government to spin. This isn’t an election to score political points. These are livelihoods of exhausted NHS staff who have risked their lives to protect, treat and vaccinate the country in the midst of an unprecedented pandemic. The Doctors’ Association challenges the government to explain to the country how it is morally or economically justifiable to cut the real-terms pay of staff that saved the life of the Prime Registered office: The Doctors’ Association UK, 1-2-1 The Barracks, Lancashire, LA1 4XQ. Company no.: 11562124, Registered in England & Wales Minister in the last year, while paying £7000 a day to management consultants for the outsourced test and trace program. Frontline staff are already shell shocked and considering if they want to keep working in the NHS after the betrayals they have experienced in the last year and previously. This latest knife in the back may represent an insurmountable barrier to staff retainment and worsening NHS staff vacancies which already stand at over 100,000. The NHS is facing a retention crisis, and this recommendation of 1% maybe the final inail in the coffin. Registered office: The Doctors’ Association UK, 1-2-1 The Barracks, Lancashire, LA1 4XQ. Company no.: 11562124, Registered in England & Wales CONTACT Press@dauk.org 1The Doctors’ Association UK (DAUK) is a professional association for UK doctors. Run by frontline NHS doctors, DAUK campaigns for patients and the NHS as well as advocating for the medical profession.

I didn’t join medicine for the money, in fact quite the opposite. But during the the past 10 years, junior doctors have faced pay cuts by as much as 30 per cent in real terms. During the same period, our honourable MPs have voted to give themselves no less than eight pay rises.

Most “junior doctors” earn less than tube drivers, self-employed plumbers and construction workers, among many others. Compared to professionals such as city bankers and lawyers, it the difference is even starker.

When you picture a junior doctor, you probably think of someone in the first year out of medical school. In reality it’s any doctor who’s not yet a GP or consultant, which takes years of work. Specialties such as psychiatry and surgery require a minimum of 8 to 10 years after graduating and passing annual assessments and exams.

For other specialities, it’s closer to 15 years, and many are still termed “junior doctors” into their late 30s and 40s – especially if training is done part time, or doctors change specialty.

A survey of members of the Royal College of Nursing (RCN) across the NHS and independent sectors – released in June last year – found that 36 per cent of respondents were thinking of leaving the profession. Of those thinking of leaving, 61 per cent cited pay as a factor. A different survey, released in December, found that 30 per cent of nurses asked planned on leaving the profession within 12 months thanks to the impact of the Covid-19 pandemic. Many had visited food banks, while 39 per cent had skipped meals to feed their family or save money.

The RCN has set up a £35m industrial action fund to support its members through a loss of earning should they decide to strike over this. NHS staff generally don’t like talking about money, but a 1 per cent pay increase for NHS staff is pretty appalling when you consider this actually means a real-terms rise of potentially just £3.50 a week.

Almost all the medics I know in the UK say they wouldn’t recommend the profession to their children. Yet, in countries where doctors are paid better – being a doctor is still something to aspire to. The NHS hospitals, mental health services and community providers are currently faces a shortfall of 84,000 full-time equivalent (FTE ) staff.

Burnt out frontline workers are retiring early, going off sick, or emigrating to countries where they will enjoy a better quality of life. My cousin, who is also a junior doctor, earns almost 600 per cent of my salary in another country. We graduated the same year and work the same hours.

It’s time to recognise and value the contribution made by NHS staff. Between March and December last year, more than 850 health and social care workers died of Covid-19 in England and Wales, yet staff continue to do their jobs to the best of their ability.

In recognition of the efforts of thousands of migrant workers within the NHS, The Doctors’ Association UK today launched “Overseas NHS Workers Day”, to celebrate the contributions of those who have propped up our health service during the pandemic, and to raise awareness of the issues they face.

Fairer pay for all NHS staff would be a starting point in view of the sacrifice made by so many during the pandemic.

The author is using a pseudonym. He is a GP trainee