Pay award for Speciality and Associated Specialists (SAS) Doctors: impact assessment

Issue and action proposed

The Minister for Health and Social Services made a Written Statement on 22 July 2022 in relation to providing a pay increase for SAS (Specialty and Associated Specialists) Doctors for 2022/23.

Long term and preventative methods

As this is an annual pay rise for the SAS group of doctors and dentists, it is not anticipated this will prevent or address any longer term measures. Long term measures for this group of doctors have been addressed with implementing a new contract, that was agreed in social partnership, in 2021.

For NHS staff in Wales their annual pay is considered and announced by the Minister for Health and Social Services 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 and pay is included as part of the reform package.

As the proposal is an annual pay rise for SAS doctors and dentists, it is not intended to be preventative in the long term.

Collaboration and involvement

As part of the 2022/2023 pay rise process the Minister for Health and Social Services sought a recommendation from the independent the Review Body on Doctors’ and Dentists’ Remuneration (DDRB).

As part of the pay review process Welsh Government, along with NHS Employers and Trade unions had the ability to submit evidence for consideration by the DDRB in making their recommendation.

For the 2022/23 process, the British Medical Association, submitted evidence, based on their experience with their members, which was taken in consideration by the DDRB.

In their 50^th report for 2022/23 the DDRB made a recommendation for a 4.5 per cent increase to national salaries for SAS doctors and dentists who do not move onto the reformed contracts.

Whilst DDRB were not remitted for recommendations for those already in in multi-year deals, which includes those under the reformed 2021 contract, they strongly urged the governments to consider the unique economic and workforce context of this year, the need to protect the relative pay position of staff on multiyear deals, and the issues of recruitment, retention and motivation.

As a result of this, the Minister for Health and Social Services made the decision to pay a one off non-consolidated payment of £1,400 for those in a multiyear deal on the new (2021) Speciality and Specialist doctor and dentist contract. This decision ensured that those who have moved or are in the process of transferring to the new contract will not be discouraged to do so solely from a pay perspective given the unprecedented cost pressures on take home pay this year.

The figure of £1,400 was considered to be appropriate as this was the amount recommended by the NHSPRB for NHS staff on Agenda for Change terms and conditions. As opposed to a 4.5% unconsolidated payment given the reformed 2021 contracts had already received investment into pay with the three year pay deal.

This decision also supports Welsh Government’s policy goal to ensure the new 2021 contract benefits can be fully realised including, improved terms and conditions for doctors, leading to better services and patient experience along with addressing long standing safety and wellbeing concerns for this group of doctors. Continuing to encourage doctors to move to the 2021 contract also addresses the equality and discrimination concerns regarding the 2008 contract. The reformed 2021 contract was agreed in social partnership and all parties agreed its wider policy benefits

The Minister also considered the unintended consequence of a 4.5% pay award on the old (2008) Specialty doctor contract as this now means the old contract top salary point will be even higher than the new contract, as it is currently £296 higher.

Therefore, the Minister decided that the top salary on the 2008 contract should be frozen to maintain the integrity of the new 2021 contract and pay scales.

To mitigate the negative impact for those doctors’ current on the top pay point, it was also decided that they should receive a non-consolidated payment of 4.5% so as to mitigate any negative consequences of not having an annual pay award given the cost-of-living crisis

Costs and savings

This cost has already been accounted for within 2022/23 budgets when the pay award for all NHS staff was announced for 2022/23.

Mechanism

No legislation is required for this proposal.

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

For the 2022/2023 pay rise process the Minister for Health and Social Services sent a remit letter to the independent the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to ask for their recommendations on NHS pay.

Before the Minister issued the remit letter, she spoke with the trade union that represent SAS Doctors and dentists, the British Medical Association, to explain her intention of entering this process.

As part of the pay review process Welsh Government, along with NHS Employers and Trade Unions had the ability to submit evidence for consideration by the DDRB in making their recommendation.

One of the priorities on the pay award decision for Speciality Doctors was to not undermine movement from the 2008 to the 2021 contract to address the equality and discrimination concerns that are acknowledged in the 2008 contract

All Trade Unions had the opportunity to submit evidence to the Pay Review Bodies. Evidence submitted was then taken into consideration when arriving at recommendations.

What are the most significant impacts, positive and negative?

As the proposal is a pay rise for SAS doctors and dentists, there are no significant impacts other than providing an increase to salary. The balance of affordability and the impact pay has on recruitment and retention must also be considered.

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 proposal has no impact on the seven well-being goals as the purpose of the proposal is to implement a pay rise for SAS doctors and dentists in Wales

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

As the proposal is an annual pay rise it there are no evaluation plans in place.