At the end of July a long-awaited pay increase for more than a million NHS staff – worth 6.5%, on average, over the next three years - finally began to land in pay packets. The complex deal followed months of negotiations and was accepted by 13 of the 14 unions representing NHS staff.
While there has been some confusion recently among certain NHS staff about when the various stages of the pay increases would be paid, the move has been widely welcomed as a boost to recruiting and retaining staff and follows years of austerity.
This is clearly a positive and well-deserved development for the health service’s hardworking staff, however its impact will be felt much wider and less favourably across other sectors.
As the national charity for hospice and palliative care, we are very concerned about the knock-on effect that this will have on charitable hospices in England.
The Government has indicated it will allow non-NHS providers in England - that are providing NHS services and that employ staff on an Agenda for Change contract - to access part of the additional £800million that is being made available to the NHS this year to fund the pay award.
Agenda for Change is the NHS-wide system that allocates posts to set pay bands and seeks to provide better links between pay and career progression. It also harmonises terms and conditions of service such as annual leave and sick pay.
However, only those organisations that match Agenda for Change terms and conditions exactly will be able to access the extra funding.
This puts hospices at an immediate disadvantage as most use NHS terms and conditions as a guide for their local pay policies, rather than matching their terms and policies exactly.
To have any hope of recruiting and retaining staff, hospices will have little choice other than following the pay rises for the NHS. Without extra funding, many hospices will be left severely out of pocket as a result.
Hospice UK - together with the charities Together for Short Lives and Marie Curie - are calling on the Government to provide support for hospices to reduce the impact of the award on hospice recruitment and retention as a matter of urgency.
We estimate that the changes resulting from the NHS pay deal will mean that the 200 charitable hospices around the country will have to spend an extra £100million over the next three years. To put that in to context, this amount is equivalent to just 2% of the three-year funding that the Government has put aside to fund the increase for staff working in the NHS, but is a huge stretch for charitable hospices.
This development comes at a time when many charitable hospices are struggling financially and, like most other charities, are operating in a tough fundraising climate.
Some hospices have substantial deficits, such as North Devon Hospice which last year spoke out about how rising demand for its care was not being matched by donations and NHS funding. Other hospices have seen funding from the NHS drastically cut, as happened recently with Peace Hospice in Watford when this was reduced by £163,000 part way through the year.
In this context the impact of the NHS pay award will put hospices’ stretched resources under even greater strain. Furthermore, hospices are currently facing major workforce challenges, especially in recruiting and retaining staff with the specialist skills for supporting people with terminal and life-limiting conditions.
If no financial support from the Government is made available to hospices so they can accommodate the pay increase, many may be forced to cut vital services. We are acutely aware that these are straitened times for everyone but the lack of financial support from the Government for hospices is short-sighted.
Without hospices the NHS would be even more stretched. Charitable hospices across the UK support more than 200,000 people each year. In addition, hospices work closely in partnership with the NHS, especially with hospitals, to ensure that people approaching the end of life are cared for in the place that will best meet their needs.
These partnerships help to meet people’s end of life care needs more effectively, as well as relieving pressures on hospital beds.
Hospice UK is calling on the Government to make sure that what is a positive step for NHS staff does not have a major negative impact on charitable hospices.