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 2023/24 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 2023/24 pay round is commencing against the backdrop of what is likely to be the most widespread industrial action in the NHS' history, in response to the 2022/23 award and increasing pressures on staff
• 67% of HR directors responding to our pay survey favour a percentage uplift over a lump sumpay award, but there is support for the principle of the progressive nature of the 2022/23 award in its targeting towards lower paid staff
• Respondents to our pay survey are clear that as a minimum, AfC staff should be awarded a 5% uplift in 2023/24, with only one respondent supporting an award below this figure. 35% of respondents supported an uplift of between 6-9%, while 19% supported an uplift of 10% or more. At the time of our last survey in December 2021, 28% of respondents supported an uplift of 5% or more, compared to 83% this year – an increase of 55%
• 62% of survey respondents were very (33%) or somewhat supportive (29%) of exploring targeted pay initiatives for AfC staff groups with specific workforce shortages. However, respondents also suggested recruitment and retention premia could be explored as a more appropriate intervention
• 96% of respondents agreed that increased pension flexibilities for all staff are very important (74%) or important (22%). 92% of respondents further agreed that government reform of pension taxation regulations is also very important (73%) or important (19%)
• We continue to reject the narrative of a 'direct trade off' between increased pay and more staff. These are interdependent factors, as fair pay helps to attract high quality staff and support their retention
• We ask that the PRB makes an explicit recommendation for government to commit to fully funding the pay uplifts it decides to award NHS staff, rather than funding the award from existing NHS budgets
• We ask that the PRB makes specific reference to the issue of pay award funding for NHS staff on local authority contracts in its report to government
• We ask the PRB to explicitly consider the interplay of pension contribution rate changes, backdating of pension contributions, and increases to both the national and real living wage in their recommendations for NHS pay awards
• 88% of respondents to our pay survey agreed that delays to the announcement of the pay award affects backdated pension contributions negating the value of the award for staff
• We are prepared to submit supplementary evidence should further significant changes arise between now and the announcement of the review body's recommendation.