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?

Terms are reasonable.

Working conditions are shit. Chronically understaffed with no let up on workload.

Pension is v expensive and I can't retire until late 60's. No where near the deal my older colleagues have.

Pay is stagnant, no decent rise since I qualified. Pay does not reflect the responsibility, workload and expectations. Let alone the unpaid overtime and lack of breaks (also unpaid).

For comparison, dh far outearns me. His t&c are similar minus sickpay. More flexibility, same holidays, company vehicle and fuel card etc. Plus, his qualifications were done and paid for on the job. I have numerous qualifications plus a yearly fee to stay on the nmc register.

Top b6 midwife currently working her notice period.

Plenty of capitalists demand pay rises. They demand them by quitting and moving onto better paid jobs if better paying jobs are available. Or if they're a contractor say, they offer their services at a certain fee and if they don't get the appropriateness fee they don't do the work. I don't really get your argument about capitalism and socialism, as literally everyone "demands" a pay rises if they can and the market allows. I guess that's one of the reasons why the NHS struggles recruit and retain nurses and the like, similarly qualified people choose different careers with (to them) more appealing pay and terms and conditions. If they don't, how do explain the difficulty in recruitment and retention? Last time I checked we weren't a communist country, our employment markets are still market driven, even in the public sector.

My adult DS applied for a job in our large local hospital, an admin role but advised it was high pressured and "efficiency is key"

I encouraged this, based on the rhetoric above about job security, good terms and conditions, pension, holiday etc.

It was his first job and he was naive, I didn't even think that he may not actually be working for the NHS. He was so thrilled to be offered the job with only a Zoom interview.

Three other in, turns out the company that employs him is based in the USA. HR is only accessible online and responses to queries are automated replies. Minimum wage unless specific targets are met. He has the minimum holiday (bank holidays come out of it) No sick pay at all. Toilet breaks are timed. Pay is directly related to performance (hitting the top hourly rate is only possible if you work like a machine, don't stop to use the toilet, talk to colleagues or make a drink) Culture is bullying, humiliation in front of colleagues if targets are missed (targets are for speed of inputting, amount of papers shredded per day etc)

I feel terrible that I encouraged this, I thought working in an office in a large NHS hospital would be a good step on the career ladder, reality is he would be better off at McDonald's.

Call me cynical, but in the context of underfunding and denigrating the NHS in order to justify privatising it bit by bit, I read this as feeding into a wider narrative being created to chip away at public confidence inthe NHS.

I worked for an outsourcing company that had many staff TUPE'd from the former British Rail.

Their Salary/Conditions were way better than people who joined this company directly, these people really were trapped because they new they could never get another job with the same pay/conditions.

I'm a HCA in NHS so band 2. Taking observations, personal cares, bloods, ECG's, catheters, yet I'm paid the same as the catering staff who plonk food on the patients table and leave it so they can't reach, or will even press the buzzer for the patient so that us HCA'S go move the table with food on over the patients bed.
I don't quite get how HCA'S with all that responsibility, that could actually put peoples lives at risks if a mistake is made can be paid on the same scale as someone handing out food and mopping floors.

@whoopsnomore agreed. Many of my GP colleagues think there is a structured political campaign.

People in both private and public sector don’t understand the differences between the defined benefit pensions (public sector) and defined contribution pensions used in private sector.

In the NHS, the employee will be paying in around 8% and the employer around 24%. The employer figure is significantly more than most private sector employers pay.

The key though is what you get out. £27k salary a year in NHS boosts the yearly pension by £500 per year. Lots of people hear that and aren’t impressed. But what they don’t realise is the cost of buying that in terms of a defined contribution ones in pot…..it would require contributions to the pension pot of about £15-20k…..and very few people add that to their pensions each year and certainly not those earning £27k.

This difference in pension provision is VAST.
Someone who earns £27k and works 40 years will have £20k pension. That assumes no inflation or pay rises….but because these will exist, the pension will be far higher.

Someone needs over £500k in their pension pot to generate this. The average pension has about £70k in their pot when they retire.

The sick pay, death in service pay and holiday pay are also very good. There will also be compassionate leave and other flexibilities, including ability to work part-time and flexibly in some jobs.

None of this is saying it’s undeserved for the job itself isn’t bloody hard. It’s just a comment in the terms and conditions of employment.

Civil servants, teachers, fire workers, etc all have similar pension provision which is excellent in relation to the private sector.

People generally have very poor knowledge about pensions in all sectors. Those in the public sector don’t realise how good their pensions are. Those in the private sector often don’t realise how poor theirs are, or the amounts they would need to put into them to have anything like the pension someone in a fairly low paid public sector job could generate.

People also don’t realise how valuable some of the other terms are…such as death in service, or index linking of pensions.

Like @DobbyIsAFreeElf, I have a hard time understanding the discrepancies between the different jobs, even at the same level.

Band 2 cleaners are on the same band as me - while I work in a clean environment, in layers of protective clothing, sterilizing and cleaning pharmaceutical production rooms, setting up the next day's production lines, they're in polo shirts, doing regular cleaning.

HCAs have tough routines and are paid the same as the cleaners and catering staff

Ward clerks are also Band 2, but do so much more than the average admin assistant.

Health records clerks are no in charge of clinics, instead of just collecting, replacing and picking files for clinics and wards.

The unfairness of some of the pay bands creates resentment.

Blossomtoes - most consultants are not on 100K +

Starting salary is 82K and will take 15 yrs to get to 100K for the majority

That is after 6/7 yrs med school 10+ yrs of specialist training and few higher degrees thrown in. Most are in the range of a Band 8d manager to put it in context. Our band 8d manager is 34!

@Zilla1 yes, there's the "social Care " Plan which was supposedly ready 2 years ago, now about to be announced and funded by a 2% NI increase.

Which will provoke upset as it affects younger and lower paid people than a tax rise.

Then the government say "ah well the NHS is such a drain we could make it more efficient by ..."
Then sell off and "outsource" more of it to their paymasters and the US financed Big Business...who then employ people like PP's son on exploitative contracts...

Well this capitalist got a 20% pay cut for 3 months in the pandemic and a suspension of pay rises that year.

Then the company posted their accounts which showed record profits from the money they saved in cutting all our wages. There is nothing we can do about that!!!!

It's a common misconception that in private employers you can demand and get payrises or vote with your feet. It isn't always that simple.

Qualified as nurse 30 years ago. Been top B6 for 8 years with no chance of b7 job in very specialist clinical area where I work and even management style jobs are very few and far between . Work in rural part of country so no relevant jobs in private sector and no chance of career progression as no relevant post qualification courses to apply for ( even if there were , it's unlikely study leave would be granted in current climate
When my cohort qualified we were warned there would a large number of nurses retiring with insufficient numbers to replace them...since then situation has just become worse each year with even more unfilled posts ...it's a similar situation with Drs and other clinical posts
I'll hopefully be retiring in next 3-4 years ( I have a chronic long term illness and would love to be able to retire sooner )
I have 3 dcs and none of them have gone into Nursing/Medical careers
My dds bf is already on £80k/ per annum (aged 25 ) as an IT consultant - outside London, in private sector with a very good pension/employment package

I don't understand, why isn't in that simple to leave your job and getter a better one, if the market allows? That's a big if, there has to be better paying jobs out there that might recruit you, if there isn't, you can't demand a pay rise. Nurses can "demand" a pay rise because there isn't enough nurses willing to work for the current terms and conditions. If there aren't enough, it's because the people who could be nurses, are employed doing something else that, in their opinion, have more favourable pay and terms and conditions. Just because the employment market hasn't worked for you specifically, doesn't mean that the rules of that market don't apply generally.

DobbyIsAFreeElf I agree HCAs are underpaid for what they often do. Every time I’ve been in or visited someone in hospital it is the HCAs/support workers that make a big difference to patient experience and care.

The NHS is a monopsony...it is close to being a sole employer of medical staff. This, along with the fact that employer is the state, means wages are held down, in relation to more competitive labour markets, where employees have more choices about who to work for.

Yes, people in the medical sector could leave it and go and work in another sector. That assumes workers have flexibility both geographically and occupationally to do so. There are lots of eye might not be impossible to overcome but they exist.

It is also true that recruitment and retention are difficult, but also that some of the positive terms and conditions the staff have (not the same as working conditions ...some people seem to muddle the two) are likely to get worse as government seeks to reduce the pension bill.

Lots remain in the public sector despite some of the horrible working conditions that people mention on this thread, because the terms of employment (not necessarily pay, but things like pension and holidays) have been pretty good. These are likely to eroded over time....which will no doubt make recruitment even more difficult.

But then we have to remember that usually the NHS is a secure job. With so many workers being in zero hour contracts in other areas, and having no pension provision or security of employer, the NHS starts to look not quite so bad.

People used to talk about jobs in supermarkets being easy to get. But now there is a multiple stage application process for most jobs which offer employment security and benefits.

In lots of ways, it is a polarising labour market.

@ejhhhhh

I don't understand, why isn't in that simple to leave your job and getter a better one, if the market allows? That's a big if, there has to be better paying jobs out there that might recruit you, if there isn't, you can't demand a pay rise. Nurses can "demand" a pay rise because there isn't enough nurses willing to work for the current terms and conditions. If there aren't enough, it's because the people who could be nurses, are employed doing something else that, in their opinion, have more favourable pay and terms and conditions. Just because the employment market hasn't worked for you specifically, doesn't mean that the rules of that market don't apply generally.

It often doesn't. Niche area of law. Firms aren't hiring in it. Have made redundancies.

Isn't that simple to.leave I mean. 2 of my solicitor friends lost their jobs in the pandemic. Different areas of law

Aside from my post above.

I totally agree our band 2 and 3 staff have it even more shit. Poor pay and massive expectations.

Maternity services where I work would not function without them.

They deserve a huge rise. No decent t&c will ever compensate for the huge amount they do on such a poor wage.

So their skills are not in demand, they can't "demand" a pay rise. The skills of nurses are in demand, so they can. I did say that you can demand a pay rise if the market allows. Evidently in that particular area of law, the market does not.

I get what you are saying when you factor in holidays and how well staff are treated you won't find another employer where you essentially can never be sacked for dreadful behavior.
Sounds heaven doesn't it. It's not. Higher bands are under massive pressure constantly to do more with less year after year with quite tough questions from corporate if you don't hit targets.
You have to perversely love the job. If you've only in it for the money the stress would drive you to an early grave very quickly.
Oh and the general public proclaim to love the NHS but also think nobody is the NHS deserves a pay rise because they have a job. Never mind that during austerity measures there was no pay rise for years. Yet there was in the private sector.

@bogoffmda

Blossomtoes - most consultants are not on 100K +

Starting salary is 82K and will take 15 yrs to get to 100K for the majority

That is after 6/7 yrs med school 10+ yrs of specialist training and few higher degrees thrown in. Most are in the range of a Band 8d manager to put it in context. Our band 8d manager is 34!

You’re forgetting those lovely juicy clinical excellence awards. It’s a very rare consultant who isn’t on £100k three or four years in.

One of my parentst is a nurse and would agree fully with @Onandoff

The % of qualified nursing staff on band 6 or above is much smaller. Every ward I worked on either had 1 band 7 and 1 band 6, or just 1 band 7 and no 6. My own role (no longer ward based) was downgraded from a 7 to a 6 about 4 year ago. Pretty naffed off considering you have to complete 2 degrees to do my role. I also work far in excess of my paid hours. I have 34 years of experience. Including G grade, then band 7 ward management experience. I have friends and relatives doing jobs which don't require 1 degree, never mind 2, have less responsibility, and do no unpaid work, and get paid more than me. Can you tell what I'm going to vote? 🤣😭It's not conditions that keep me in the NHS it's the fact that I went into nursing with the intention of it being my life long career, and I would feel defeated to walk away

Blossom toes - you obviously have a beef with doctors pay.

to put it into context 128 consultants in my dept ( anaesthesia) 20% are on over 100K.
Ignore 2020-21 where over time payments were the only thing keeping people fro dying as we were so stretched.

Get your facts right and don't allow your bitterness to show.

The minority get a CEA - I have 1 point worth about £2k - I developed and run a unique specialist service and wrote 8 papers over 4 years to get, on top of all clinicial work, oncall and admin.