NHS and social care financial recognition scheme: integrated impact assessment

Issue and action proposed

The Minister for Health and Social Services made a Written Statement on 17 March in relation to providing a bonus payment to NHS, Primary Care Providers and Social Care workers in Wales.  

The one-off payment of £735 is being made to recognise and reward NHS, Primary Care Providers and Social Care staff who have supported the health and social care system during the COVID-19 pandemic. This reflects the commitment of staff and recognises the impacts of the pandemic on their physical and mental health well-being in both their personal and profession al lives. It is estimated the payment will benefit  people in Wales including 103,600 social care staff, 125,000 NHS Wales staff, 2,345 deployed students and 26,000 primary care staff (including pharmacy, GP, dental and optometry staff).  NHS, Primary Care Providers and Social Care cannot always adhere to social distancing measures and are at increased risk of infection due to the numbers of people they are assisting. 

Ways of working

Long term 

This is simply a one off payment to recognise and reward NHS, Primary Care Providers and Social Care workforce. Recognising this workforce may positively impact morale, in the short and medium term. This is important during the ongoing pressures of COVID-19. 

As this is a one off payment, it is not anticipated this will prevent or address low pay in the social care sector. There are other initiatives, such as the Social Care Forum, established to look at these longer-term objectives.

For NHS staff in Wales pay is reviewed on a yearly basis following the outcome of the two NHS pay review bodies recommendations, unless multiyear contract reform deals are agreed in partnership with employers and trade unions.

Working in the NHS, Primary Care Providers and Social Care sector during the height of the COVID-19 pandemic was often challenging and at times a harrowing experience. The intention of the payment is to, at least in part, to mitigate these effects by the demonstration of appreciation, and which may aid retention in the sector at this time.

Prevention

As the proposal is simply to award NHS, Primary Care Providers and Social Care workers with a £735 payment for their contribution during COVID-19 it is not intended to be preventative in the long term.

Integration

This proposal connects and contributes to the overall public policy and public health response to the COVID-19 pandemic. It also connects with policy objectives in Health and Social Services group around the promotion of the health and well-being of people using services and taking measures that are most likely to allow individuals to achieve positive outcomes, which will be impacted by increased workforce morale. 

This proposal should also specifically connect with current COVID-19 work streams on care homes and domiciliary care, since increased morale among staff may positively impact on quality of care and reduced avoidable absences.

Collaboration and involvement

Collaborative working has enabled the proposal, in particular eligibility criteria to be developed quickly. 

For the NHS, discussions have taken place with NHS trade union and employer representatives regarding the proposals. NHS trade unions and employers have provided input into the development of the eligibility criteria and a FAQ document. 

For Primary Care, discussions have taken place with stakeholder professions; GPC Wales, British Dental Association, Community Pharmacy Wales and Optometry Wales. Comments were sought from all groups during the development of the Welsh Health Circular, FAQ document and legal directions. NHS Shared Service Partnership have worked closely with us on the development of this scheme including eligibility criteria and process for completing the application and processing payment. 

For social care a working group of external stakeholders who represent care workers, care providers and local authorities (commissioners) was established, meeting a number of times as the proposal was developed. This has comprised representatives from GMB, Unison, RCN, Care Forum Wales and Association of Directors of Social Services Cymru (ADSSC). Representatives of the Welsh Local Government Association and Welsh Local Authority Treasurers have also been involved. It has been possible through these meetings to build on the feedback from the previous bonus scheme for social care staff and assess lessons learned. This also applies to care providers and local authorities who will be administering the scheme on behalf of Welsh Government. 

Impact

The positive impact of the proposal is to recognise and reward NHS, Primary Care Providers and Social Care workers for their contribution during COVID-19 with a bonus payment of £735.

The main argument against this policy is the risk that the scheme will draw challenge from those who are not included for payment and that other key workers outside of those eligible will not receive the payment. NHS, Primary Care Providers and Social Care workers have throughout the pandemic worked in an environment which continues to be extremely stressful and demanding. For many workers this includes them being at a higher risk of infection than other key workers as in some cases as they have to provide care and treatment to infectious people in our response to the virus and keeping Wales safe. 

Costs 

The total estimated cost of the scheme is approximately £232m (£99.3m social care and £133m NHS and primary care). This cost has already been accounted for within 2020/21 budgets.

Mechanism

No legislation is required for this proposal for NHS Directly employed staff and social care staff.

For Primary Care Providers the Primary Care (NHS Covid-19 Bonus Payment Scheme) Directions 2021 will enable payment to be made to Primary Care Providers and their employees.

Eligibility criteria for NHS staff

Eligibility for social care staff 

For NHS directly employed staff, payment will be administered through the NHS payroll.  For Primary Care Providers, payment will be administered by NHS Wales Shared Services Partnership. For social care, local authorities will administer the scheme of behalf of Welsh Government. Eligible Cafcass staff will be paid through Welsh Government payroll.

How have people most likely to be affected by the proposal been involved in developing it?

For NHS staff, we have been in contact with NHS trade unions and NHS Wales employers in the development of the eligibility criteria and a supplementary FAQ document. For Primary Care Providers, we have been in contact with trade unions for each of the four contractor’s areas; Dentistry, General Medical Services, Optometry and Pharmacy on the development of application forms, Welsh Health Circular and FAQ document.

For social care a working group of external stakeholders who represent care workers, care providers and local authorities (commissioners) was established. This has comprised representatives from GMB, Unison, RCN, Care Forum Wales and Association of Directors of Social Services Cymru (ADSSC). The group have met to discuss and develop the detail of the proposal, with a particular focus on the eligibility criteria.

What are the most significant impacts, positive and negative?

The intention of the scheme is to reward NHS, Primary Care Providers and Social Care workers who were employed during the height of the pandemic with a bonus payment to recognise their work. As this is the sole purpose of the policy there are not anticipated to be any significant negative impacts. Some negativity may arise from the proposal on the basis it has not been extended to other key workers.

However, NHS, Primary Care Providers and Social Care workers have throughout the pandemic worked in an environment which continues to be extremely stressful and demanding. For many workers this includes them being at a higher risk of infection than other key workers as in some cases as they have to provide care and treatment to infectious people in our response to the virus and keeping Wales safe. 

In light of the impacts identified, how will the proposal: 

• maximise contribution to our well-being objectives and the seven well-being goals; and/or
• avoid, reduce or mitigate any negative impacts?

The main purpose of the proposal is to deliver a financial reward to eligible NHS, Primary Care Providers and Social Care workers. This is anticipated to be received positively and indirectly promote the well-being goals of those in receipt of health and care support by increasing staff morale through demonstration of their being valued by Welsh Government. 

How will the impact of the proposal be monitored and evaluated as it progresses and when it concludes?

The scheme is monitored for the uptake of payments against the anticipated numbers of eligible staff. The scheme has a clear appeals process for primary care and social care staff which ensures people have access to a process to review their eligibility for payment. The Welsh Government Appeals Panel has decision making powers delegated by Welsh Ministers.