Key messages

Trusts have told us it is critical for staff throughout the NHS to receive a meaningful, real terms pay increase in 2021/22. A significant majority (82%) of respondents to our survey this year called for a pay uplift of at least a 3%, with only 14% saying it should be 2% or less.

• the coronavirus pandemic has impacted trust views on pay awards as we draw to the close of the current three-year deal. Over the past nine months, trust leaders have consistently emphasised the need to recognise and reward the efforts of staff who have gone above and beyond to protect the public and continue to provide COVID and non-COVID care

• it is essential that pay awards are fully funded by the government and affordable for trusts to administer for all eligible staff. Affordability of pay rises has presented a key financial and operational challenge for trusts in recent years, due to flaws in the broader design of the three-year pay settlement

• the government needs to ensure funding is made available to specifically cover uplifts for Agenda for Change staff working in local authority commissioned NHS services. Given an inconsistent approach over the past three years, there is very little confidence among community trusts that central funds will be allocated to solve this issue in 2021/22

• workload and burnout concerns have multiplied as a result of COVID, with trust leaders consistently telling us of their fear for the wellbeing of their staff, and over the future state of the workforce if large numbers decide to leave the service after the worst of the pandemic is over

• the workforce is overstretched with high rates of sickness contributing to an immediate operational concern: on 6 January, almost 100,000 NHS staff were absent from work across England with almost 50% linked to COVID-19 related sickness or self-isolation. There is an obvious correlation between persistent workforce gaps prior to the pandemic and a service that is now being forced to reduce its offering to patients in some areas

• the pandemic has made it clearer than ever that the NHS needs a fully funded, agreed, workforce plan that gives the NHS the increases in long term workforce numbers and financial support for existing staff it so desperately requires

• within this the government must be more ambitious when it comes to restoring funding for CPD. 88% of HR directors said more funding for CPD was important, with current investment below the levels of 2014/15 prior to cuts

• there is more trusts can and must do to improve pay, progression and the overall working lives of ethnic minority staff who are disproportionately employed within the lower bands of the AfC framework. The PRB must also carefully consider the impact of new pay recommendations and other workforce recommendations on Black, Asian and minority ethnic staff.