A decent pay rise for all staff is the only reasonable response to the pressure and trauma of working in the NHS during the pandemic, and essential to avoid a staffing crisis in the year ahead, MiP tells the NHS Pay Review Body. 

NHS staff, including managers, need a significant pay rise this year if the NHS is to tackle the staff shortages, exhaustion and stress which pose “an imminent and real threat to system function”, according to MiP’s 2021 evidence to the NHS Pay Review Body (PRB).  

The evidence was based on a survey of 828 MiP members carried out in March, which found that more than two thirds had seriously considered leaving the NHS during the last year, while 37% wanted to leave “as soon as possible”. 

Eighty per cent said a significant, above-inflation pay rise would make them more likely to stay in the NHS, while 92% said it would make their staff less likely to leave.

“An insult”

Some members described the government’s proposed 1% pay increase as an “insult” that had made staff feel “worthless”, while one member said that NHS workers had been “treated like canon fodder” during the pandemic. 

Commenting on the survey, MiP chief executive Jon Restell said: “Loss of time with their families, huge amounts of unpaid overtime, and exhaustion, stress and traumatic experiences during the pandemic are among the reasons managers believe staff deserve a significant pay rise above inflation this year.” 

He pointed to an MiP survey during the first wave of the pandemic which found that 60% of members were working five hours or more of unpaid overtime every week, with a quarter working more than 20 hours.

“A significant pay rise is important for our members as recognition of their efforts, not only in keeping the NHS functioning during the pandemic, but also in managing the constant upheaval in the NHS in recent years—and in the months to come,” Restell added.

The survey also shows that managers are “gravely concerned” for their staff, MiP said. “They do not feel that anything other than a significant pay rise could properly reward the work they have witnessed from their staff over the past twelve months. They are also concerned that a sense of not feeling valued by a pay award will amplify feelings of burnout and stress, creating further conditions for leaving the service.”

“Mass exodus” feared

One MiP member said employers need to show “some level of recognition and reward for a heavy year which has taken its toll on the team, both psychologically and physically.” Another said “the country has got through the pandemic on the backs of NHS staff”, adding that “clapping doesn’t feed my children.” 

MiP’s evidence warns that a “mass exodus” of NHS staff after the pandemic is “a distinct and perhaps even likely possibility”, and could leave some parts of the health system “on the brink of collapse”. 

Around half of members said there were recruitment and retention problems among managers in their organisation and over 70% said they were experiencing difficulties recruiting other staff. At the same time, over 60% of respondents said their staff were more likely to be looking for jobs outside the NHS than before the pandemic.

One member said staff “were desperately hoping that all the clapping and the rainbows would mean something material to them”, but news of the government’s 1% offer had given them “no choice” but to leave the NHS. 

Particularly alarming, said MiP, is the high proportion of managers and other staff who were now considering retirement. More than half of MiP members (51%) said they were considering bringing forward their own retirement, while 42% said staff they manage were thinking on the same lines.

“If staff leave the NHS [for other jobs] there is at least a possibility they will return, but if staff retire in huge numbers then they are likely to be lost to the system forever,” MiP warns the PRB.

Support for families

MiP’s evidence also argues that a pay rise for NHS staff would provide important support for many families hit by the economic impact of the pandemic. 

MiP says “the outcomes for many private sector staff during the pandemic has been poor” and many NHS staff, including MiP members, have been directly affected: “Many NHS staff live in households where one or more adults has lost a job or been furloughed, and the economic pressure on them as the main breadwinner has therefore increased.”

The survey found that for 40% of respondents, their NHS salary was now a larger proportion of their total household income than 12 months ago—in most cases because the earnings of other household members had fallen.

“A pay rise for NHS staff will not only give an opportunity to pump money back into local economies, allowing NHS organisations to act as anchor institutions in their local areas, it will also directly assist workers who have lost their jobs within the private sector,” MiP’s evidence says.

The results of MiP’s survey were reported extensively in the Independent on 16 April. In an interview with the newspaper, MiP chief executive Jon Restell said: “We don’t want an exodus of experienced people leaving just when we need that experience to guide the system through the next two to three years.

“You can’t keep putting pressure, accountability and responsibility on people and expect them to endlessly soak it up,” he added. “This survey tells us that we’ve reached a moment where people may be not ready for that anymore.”

Your say on pay: some written responses to our survey

• 1% is an insult, it’s says that you and your teams are not worth it.”
  
• “My team and myself have all been transferred across the county to help in ITU then emergency theatres, putting our own safety at significant risk. I have seen several of my own colleagues die of covid and I am exhausted.”
• “I have no idea yet what the long term impact will be of witnessing so much death and trauma and 1% feels particularly insulting given how many of our people are suffering for their commitment to the NHS and our communities.”
  
• “A member of my team spent several nights sleeping in his car until he could arrange alternative accommodation, because he didn’t want to risk infecting his elderly parents. That dedication is worth a clap and 1%?”
  
• “I have never worked so intensely over such a long period of time (60+ hours each week sometimes 10-11 consecutive days). The physical and mental health toll can never be compensated.”
  
• “Staff have been treated like canon fodder. If I didn’t need the money I would’ve resigned, which is soul destroying because I used to love my job but now it fills me with dread and I’m permanently exhausted.”
  
• “A pay rise would mean that all the thousands of extra unpaid hours I have done for the NHS since 2005 would be finally recognised and valued. I am so sick and tired of being treated like I’m worthless.”

Key findings from MiP’s 2021 Pay Survey

Andrew Neel/Unsplash

• 80% said a significant pay rise would make them more likely to keep working in the NHS
• 92% said it would make their staff more likely to stay
• 60% were dissatisfied with their own pay
• 65% said they were paid less than similar jobs in the private sector
• 46% said there were recruitment difficulties for managers in Bands 8 and 9 in their organisation
• 51% reported retention difficulties
• 71% said their organisations were struggling to recruit other staff and 63% were experiencing retention problems
• 68% had seriously considered leaving the NHS in the last 12 months
• 37% wanted to leave “as soon as possible”
• 51% were considering bringing forward their retirement
• 61% said staff were more likely to leave the NHS than before the pandemic
• Only 58% would recommend a career in NHS management to friends and family

Source: MiP Pay Survey, March 2021