to think NHS Staff have got amazing terms and conditions?

[backoffice]

I've left the NHS to go back to the private sector after 15 years. I've been reflecting a lot on my time in the NHS and something in particular that has struck me time and again are the great terms and conditions that really get people stuck in the service, so they can't leave.

In my organisation over 1/3 of staff were Band 7 or above (40-45k). Many had been in the service for many years. Statistically almost half of NHS staff are earning over 31k (band 6 or above).

The pension accrual at this level is the equivalent of an additional £15-20k contributions on top of the salary if you were buying on the open market (I'm assuming around 1k p.a. for a Band 7 into the defined benefits scheme). So that's around 1/2 NHS staff with a package of around 50k.

These benefits are really significant - especially outside of London or other cities. And staff who perform very poorly cannot really be removed from the service - the unions are very strong and the processes are huge. I managed out one person but it ended up with a criminal case - i.e. the person committed a crime and I was still struggling to get rid of them.

I needed to leave the NHS for my mental health - the whole service is so traumatised - but the financial benefits of working there far, far outweigh anything in the private sector. Most staff are, I think, basically trapped. AIBU?

I'm band 6 so on 32k, but I'm a highly trained advanced nurse practitioner and can prescribe etc. Most of the nurses on my old unit were band 5, so between 25k and 30k but that's after 3 years of uni and a lot of training. The worst paid are actually non trained HCAs who will be on 18k (actually 18005) who take blood, do observations, feed patients, bathe patients, talk to them etc.

The back bone of the ward is a good hca who you'd trust with your life; I have to be sure my hcas know what a bad set of obs looks like and will tell me if they think anything is 'off' they also stock up so we have everything to hand to do our jobs properly. They are the ones who deserve a proper pay rise.

I really feel for them at the moment working 40+ hours a week back breaking work for less than 9.20 an hour, we've had a massive amount of hcas leave our trust recently because they can get more in Tesco and people in Tesco don't spit at you

If pay and conditions were so good, there wouldn’t be a chronic and ongoing shortage of clinical staff.

Honestly it matters not whether you pay the same, more or less than the private sector or whether the package is excellent or really poor. It only matters whether it’s good enough to attract adequate staff and it clearly isn’t.

A good number of newly qualified nurses and midwives never practice at all. Why would they, they owe the NHS nothing when it fails to support their training and uses them as unpaid labour for three years.
Qualified staff meanwhile leave in droves, those who remain reduce hours or go off sick. Many take early retirement. Some come back and work bank and agency shifts, it would have been so much cheaper to keep those staff.

Pay is just one aspect of this but it does matter. Staff are less likely to jump ship when the pay is too good to lose. Despite what you say clearly few feel trapped by the pay because there is a constant, ongoing loss of staff

The NHS has a retention crisis currently, so presumably many people don't feel trapped.

I think perhaps you have this whole thing 'arse about face'

Conditions in the NHS are not fabulous ...

Conditions in private industry suck ... big time fucking suck

(I spose I could post a long piece about how much better things are - generally speaking - in the EU but cant be arsed dealing with the Sovereignty/Borders/Refugees/illegal immigrants shit that would be posted in response).

We really should all get decent terms and conditions ...

@Onandoff I don't know where you get that idea from. Our ward receptionist is the most important person on the ward. She's indispensable. She's only a band 2. If we are short of nurses we just get another. We really struggle without our receptionist!

Ward clerks have a massive responsibility.

Receptionist, responsible for the care and security of files, having to message and contact relatives, consultants, physios, SALT, discharge teams and keep an eye on wandering patients who may be confused and aggressive.

They have to book follow up appointments, admit and discharge patients, print out letters and information and keep on top of a never ending pile of paperwork and requests from staff.

That job is full on from the get go.

A few high earners will be bumping up the average for all the porters etc

Exactly this. Consultants are on well in excess of £100k, they bump the average up massively.

I agree re T&Cs but actually the pension is a bit shit, but then newer private pensions are also a bit shit. Holidays and parental leave are good as is paid sick leave etc.

My DH is top of his scale on about £25k though so pay can be pretty poor. A lot of staff have never worked in private sector so don't really have anything to compare it to.

@Hoowhoowho
Honestly it matters not whether you pay the same, more or less than the private sector or whether the package is excellent or really poor. It only matters whether it’s good enough to attract adequate staff and it clearly isn’t

Same thing could be said for teachers, though etc. Teaching has a crazy staff turnover, something like 50% quit in the first five years. The issue is, the public sector offers the salary and gets the resultant quality which The Public is prepared to pay/vote for.

Millions in the UK are already living hand to mouth/unable to get optheir own house, and so those people will not entertain the idea of further tax increases. Meanwhile no Political Party now has the balls to only raise taxes on high earners ( well, Corbyn was entertaining a small top rate increase, raising the top rate from 45%-50% or something, for which he was labelled a communist and told that everyone making 50k+ would Flee the Country rather than pay an extra grand or so in annual income tax to pay for schools with better teachers/ smaller class sizes/ hospital beds / non burned out staff etc)

Most people in the public sector don’t realise the value of their pension. It is a massive benefit but if you’re a 23 year old nurse with high cost of living, you’re probably not going to be valuing the prospect of the pension if you’re struggling day to day.

But… it really is massive and would cost a fortune to replicate with a private pot.

I've said this for year, every few months there will be some campaign that nurses are underpaid and must be paid more. My two standard responses to this are:

1)There pay is on par with other similar professions (teacher, solicitor etc).

2. If you don't like to pay don't do it, no one is making you.

If you don't like to pay don't do it, no one is making you

Which is why NHS staff are leaving in droves and there’s such a high vacancy rate. People are voting with their feet.

@Bunnycat101

Most people in the public sector don’t realise the value of their pension. It is a massive benefit but if you’re a 23 year old nurse with high cost of living, you’re probably not going to be valuing the prospect of the pension if you’re struggling day to day.

But… it really is massive and would cost a fortune to replicate with a private pot.

Having a high value pension pot is no good when you are struggling to pay your rent, bills, eat and travel to work.

I'm surprised it's difficult to get rid of incompetent staff in the NHS. I work in education and the government have made it extremely easy for head teachers to get rid of poor teachers or manage out staff that they simply don't like. Our unions are still strong in lots of respects but powerless against staff being unfairly bullied or managed out of schools.

@Hoowhoowho Speaking to friends who work for the NHS, they leave because it's a bureaucratic, box ticking, woke hell hole.

A strange misconception that the grass is greener being a smaller factor.

It's also possibly a self fulfilling fallacy, the media endlessly claims nurses are under paid/under valued, despite the obvious.

My DH is a band 7 nurse manager on just under £48k (Scotland).

He has most of his MSc and manages about 30 staff - he doesn't have time to do patient care now as he's too busy with recruitment/incidents/management/planning which is enormously stressful. His phone starts ringing at 7am and doesn't stop until 6pm, despite his hours of work being 9-5.

He's been in the NHS for 25 years and works very, very hard for his money. He will absolutely deserve his pension.

It's hard to get rid of Drs as they stand very firm and support each other however incompetent. Nurses and other staff, not so much...

In mental health it’s very hard to progress past B5 unless you’re in an undesirable area that struggles to retain staff (my experience anyway). At B6 you have a lot of people to supervise, regular students, juniors and agency staff. To reach B7 you have to want to go into management. There were very few B7s in the places I worked. Most B7s had reached it by taking jobs they didn’t want (eg crisis team which usually has plenty of vacancies) then using it as a stepping stone.

It’s different in physical. But I know many MH nurses and allied professionals who have been a B5 for over a decade, simply because there aren’t any B6 vacancies in their area. The top of B5 is about £1,650 take home pay a month for 37.5 hrs so it doesn’t go far. Many MH professionals leave the NHS as jobs notoriously don’t fit with school hours, and if their partner is the higher earner it’s not worth paying for wraparound and holiday care on that salary.

I'm nhs admin and can't qualify for the car leasing scheme due to salary. Not all admin are band 6/7

@supermoonrising it is more nuance than that.

The government actually found the tax take went up when they reduced the top band of tax to 45% in 2013.

On the other hand Brown was slated for abolishing the 10% tax rate in 2007 even though the personal allowance was eventually raised.

I was a band four for seven years in mental health. I had to leave. We were under staffed significantly. I was having to make decisions above my pay grade. No one cared. Management gave not one f* and were never there when the shit hit the fan.

I work for myself now and I’ve never regretted it. Just the timing with Covid! That has hit my business… but I can now sleep at night without worrying constantly! Priceless.

Just the area I worked in however and probably not a review of services elsewhere.

Good management is everything!!

the great terms and conditions that really get people stuck in the service, so they can't leave.

But they can leave, they don't want to. Because they know as much as they moan about the NHS they will be worse off with a private for profit employer.

All this talk of demanding pay rises and strikes: well it is easy to demand pay rises when it is public money.

People are socialists with other people's money but capitalists when it comes to their own.

Moaning about the overtime...I've never had paid overtime in my life.

If it was that great, compared to comparable professions both in the public and private sector, there wouldn't be a retention crisis. Opinions on this matter not one jot, it only matters in the NHS can manage to be adequately staffed with its current pay and conditions offering. In some roles I'm supposing it can, but in lots of essential roles it most certainly cannot, so you can't really come to the conclusion that the offering is good enough.

NHS worker here. It sounds promising. But as a b7 mixing my clinical with management of a busy team means I have not worked my 37.5hrs a week since obtaining the post. I take work home. Respond to emails at Al hours on average working 55hrs a week. Really, for what I do, the 3 degrees, the student debt, the wage is appalling compared to those who work in private pharma etc