Vital NHS services face cutbacks as government excludes thousands of workers from pay deal

Exclusive: Government refusal to increase pay of some healthcare workers risks creating ‘two tier’ system, service leaders warn

Vital NHS services could be cut as a result of pay deal row (Getty/iStock)

End-of-life care and other vital health services face cutbacks or rationing after thousands of staff were excluded from a new government pay deal, it has been warned.

The government has confirmed that staff working in outsourced services are not included in the NHS pay deal, meaning their employers will have to fund any pay rise themselves.

For some organisations, this could amount to millions.

Healthcare leaders have written to the health secretary saying that NHS services run by social enterprises, local authorities and the voluntary sector will be forced into reducing their workload or hiring fewer staff as a result.

The pay deal means NHS workers will get an uplift of 5 per cent along with two one-off payments for 2022-23, with the government previously indicating it would fund the uplift.

But tens of thousands of staff providing community services, end-of-life care, and prison healthcare and mental health support could be left out, as they are not directly employed by the NHS.

A letter from the leaders of the NHS Confederation, NHS Providers, the Local Government Authority and the Association of Directors of Public Health to health secretary Steve Barclay warns that organisations may be forced to stop recruiting new staff and reduce the level of service they provide in order to match the pay rise for NHS-employed staff. The letter was also co-signed by The Independent Health Care Provider Network, and Social Enterprise UK.

“If unaddressed, an inequitable, two-tier system will be inadvertently created, impacting staff and creating significant risks and concerns,” the letter states.

“Without central funding to cover the uplift, many non-statutory providers will struggle to cover these increased costs and retain staff to sustain critical services. Likewise, unfunded pay uplifts will increase financial pressures for NHS trusts employing Agenda for Change staff delivering public health contracts.

“Impacted organisations have told us that the uplift represents significant sums, and if unfunded, along with inflationary pressures, will result in a reduction in service provision and vacancy freezes. They are therefore having to consider the potential impact on patient services and the viability of their organisations.”

Crystal Oldman, chief executive of the Queen’s Nursing Institute, which represents community nurses, warned that community services would be “disproportionately” affected.

“It’s absolutely appalling and isn’t what was promised,” she said. “Social enterprises and community interest companies who deliver NHS contracts in the community pay their staff equally to the NHS.

“So inevitably, and quite rightly, they will raise the salaries ... that will mean that they have less money for services ... and they’ll have less money for the staff that they need to recruit.”

The Department of Health and Social Care was approached for comment.

This story was updated to include all signatories of the letter to the Secretary of State.