Doctors and dentists unite on pay review process that's unfit for purpose
19 January 2023
We've set out a plan to fix a broken pay review process that is driving talent out of the NHS in every UK nation.
Last week we joined talks on pay with Health Secretary Steve Barclay. It came just hours after the Department of Health and Social Care confirmed a real-terms cut for contract values for general dental practice in England.
Alongside our colleagues at the British Medical Association, we spelled out the facts: that the pay review process is no longer fit for purpose, and it is helping push NHS services to the brink.
Together, we've detailed what needs to change.
The problems are abundantly clear. Ministers have interfered in the Review Body for Doctors' and Dentists' Remuneration (DDRB) processes as a matter of course. They've imposed public sector pay freezes and pay caps, and arbitrarily defined NHS 'affordability' each year.
It's a process that's been dogged by interminable delay, with the government routinely providing late evidence. The pay uplift for 2022/23 in England is set to be implemented 10 months late in February 2023, close to the end of the NHS financial year and backdated to April 2022. The political chaos and the resultant churn at the Department of Health and Social Care have been cited as excuses.
While only recently approved, the 4.5% pay uplift for 2022/23 in Northern Ireland won't be implemented until the end of the financial year at best, backdated to April 2022. Once again, political dysfunctionalism and budgetary pressures have impacted on dentists receiving an above-inflation uplift in a timely manner.
The 4.5% pay uplift for 2022/23 in Scotland will be implemented towards the end of this financial year, backdated to April 2022. The pay award of 4.5% for GDPs was implemented from 1 November 2022. As in previous years, it will apply to gross item of services fees and capitation and continuing care payments. As NHS dental contractors have been in receipt of both multiplier payments and bridging payments during the 2022/23 financial year, the 4.5% pay award will also be applied to both of these payments. The pay award will be included in the November 2022 paid December 2022 schedule and backdated payments will be made in the December 2022 paid January 2023 schedule.
Root and branch reform is now needed to give the DDRB real independence. It means an end to the 'remit letters' from Ministers that dictate what's affordable at the outset. It means clear and enforceable timetables for the pay review process that all parties must adhere to and powers to restore pay losses for the period where the review body has effectively had its hands tied.
"Both dentists and medics bear the scars of a failed pay review process" says BDA Chair Eddie Crouch. "Savage cuts to real incomes are the result of a system that's doled out pay caps and pay freezes to order."
Doctors and dentists working under the junior contract in England are not in the review process because of a multi-year pay deal. We are planning to ballot our hospital dental trainee members who are on the same terms as junior doctors about taking industrial action alongside BMA colleagues.
The Department of Health and Social Care says it's "misleading" to suggest the Government interferes with the operation or independence of pay review bodies. Yet at the very same time Ministers are admitting they tell the DDRB how much money is "in the pot".
We will continue to push for meaningful reform in our ongoing talks with the Health Secretary. "Current pay review processes offer textbook examples of what not to do" Eddie added.
"Every dedicated health professional requires fair and timely pay uplifts. When so many are reconsidering their future in the NHS, to do otherwise is an act of self-harm."