We welcome the opportunity to submit evidence to the NHS Pay Review Body (PRB) on behalf of NHS trusts and foundation trusts, to inform the 2022/23 pay round. The key messages from our submission, based on a number of information sources including our survey of trust HR directors, are as follows:

• The majority of HR directors responding to our survey support a pay award of at least 3% for 2022/23, with a significant proportion (28%) supporting an uplift of 5% or more. This year’s results show an upswing in support for a higher pay award compared to last year’s survey, given the context of rising inflation and cost of living.
  
  
• Trusts are running at full capacity, with extensive and sustained operational pressure caused by COVID-19 infections, winter pressures, a nationwide vaccination campaign and a significant backlog in care. Trust leaders are concerned about the level of burnout across their workforce.
  
  
• Trust leaders are concerned about the possibility of partially funded pay uplifts, as trusts will have to make up any shortfall from existing budgets which have been allocated to ensuring service delivery. This would have operational impacts which will affect patients directly.
  
  
• We continue to reject the concept of a “direct trade-off” between more funding for pay or staff numbers. These are interdependent factors, as fair pay helps to attract high quality staff and support their retention.
  
  
• 71% of respondents to our survey support targeted pay initiatives for AfC staff groups experiencing particular workforce gaps, an increase of 7% compared to last year. The possibility of a pay premia for staff groups which the NHS is struggling to recruit to should be explored in this pay round.
  
  
• Some trust leaders feel that the current Agenda for Change pay and progression structure is too rigid, based on length of service over ability. This has an effect on retention across all staff groups, with colleagues moving between organisations to accelerate their pay progression.
  
  
• The delays to the announcement of pay awards each year have a negative impact on staff morale, increase uncertainty for staff and make trust financial planning more complicated. There is a specific recruitment and retention case for higher pay awards this year, given rising inflation, a National Insurance increase, and proposed changes to staff pension contribution rates predominantly affecting lower and middle banded NHS staff.
  
  
• Flexibility can be built into the service both through the fuller utilisation of new roles, and the provision of flexible working options for staff. A fully costed and funded national workforce plan is needed to realise this, to build resilience into the system and to plan sustainably for future demand

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