The gruelling effects of the pandemic and cost-of-living crisis have accelerated the need to review the approach to nurses' pay after a decade of a fall in their average earnings, according to a new report. A study by the Health Foundation found that between 2011 and 2021, NHS nurses' average basic earnings fell by 5% in real terms, after accounting for consumer price inflation.
The government-imposed seven-year public sector pay cap to 2017 led to a "significant" drop in nurses' pay compared with overall average earnings across the wider economy, the charity said. Nurses' average earnings fell by 1.2% a year in real terms between 2010 and 2017, while economy-wide employees' average earnings fell by 0.6% a year in real terms over the same period, the report said.
The foundation said if the NHS Pay Review Body accepted the Government's request to cap any pay increase for 2022/23 at 3%, a further "significant real-terms reduction" in nurses' pay would be the likely outcome.
James Buchan, senior fellow at the Health Foundation, said: "The NHS has long suffered from chronic nursing shortages. With many nurses burnt out after working on the Covid front line, and all now facing increased cost-of-living challenges, it's vital that nurses feel valued and their hard work is fairly recognised when this year's pay settlement is implemented by government.
"We also need to take a longer term perspective that reflects changes in the external environment and changing trends in the labour market to ensure that NHS pay can be used most effectively as part of an overall workforce strategy. That is why we are arguing for the need to shift to a three-year pay cycle and review the current system to ensure it is not discriminatory, and for there to be a more targeted approach to any pay enhancements or flexibilities.
"While the NHS faces challenging funding prospects, a real-terms pay cut this year would not contribute to retaining and motivating current staff. NHS services can only recover if there are sufficient motivated staff in place."
Royal College of Nursing general secretary Pat Cullen said: "After hearing this hard-hitting and independent analysis, it is hard to see how ministers and an independent Pay Review Body could disagree with a word of it. The report is external verification of our positions and the level of pay award we are calling for from governments.
"It shows the profession has seen real-terms pay cuts over the last decade and now inflation is expected to hit double digits, leaving some to choose between heating and eating. At present, the UK Government is ignoring the worrying trend of leavers outstripping student intake - action is needed now to ensure nursing is an appealing education and career path.
"Anything other than an above-inflation pay rise will leave staff worse off, risk an exodus of staff and put patient care at risk."
Unions believe the pay review body has made its recommendation to the Government, so a decision on this year's award is expected soon.
