Intended for healthcare professionals


NHS pay cap is barrier to recruitment and retention, unions warn

BMJ 2017; 357 doi: (Published 19 June 2017) Cite this as: BMJ 2017;357:j2965
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

The public sector pay cap is preventing the best people from being recruited and retained by the NHS, health unions have warned.

In a letter sent to prime minister Theresa May on 19 June, 16 organisations representing NHS and public sector staff warned that the pay cap had forced professionals out of their jobs.1 “Those who stay are overstretched and under pressure to do ever more with less,” the letter said.

The news comes after England’s health secretary Jeremy Hunt said that he had “sympathy” for calls to increase NHS pay and that he would put the case for lifting the cap on pay rises to the Treasury.2

The cap, which was introduced in 2010, has limited NHS staff to 1% pay rises or below. NHS doctors’ pay is determined by the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The DDRB has been told by the Treasury that overall pay awards should be within the 1% cap, and its recommendation for 2016-17 was for a 1% pay rise for doctors, in line with the Treasury’s recommendation.3

In their letter the organisations, which include the BMA and the Royal College of Nursing, warned that the “longstanding cap stands in the way of recruiting and retaining the best in healthcare.”

“It is having a profound and detrimental effect on standards of care at a time when the NHS is short of staff across every discipline,” the letter said. “This is alongside an uncertain future for EU nationals working in health and care.”

The signatories called on the government to change its policy. “Government should remove the pay cap and tackle the real term loss of earnings so the NHS can retain and attract staff, resolve the workforce shortage, and ensure safe patient care,” the letter said.

Speaking at the NHS Confederation’s annual conference in Liverpool on 15 June, the health secretary was asked about calls to lift the current cap on public sector pay.3

“I have a great deal of sympathy for the case that nurses, among others, have made on the issue of pay,” Hunt said in response. “They do an absolutely brilliant job. We need to factor in that there is an enormous amount of goodwill and an enormous amount of time given free of charge because people care about their jobs and they see it not as a job but as a vocation.”

Hunt said that decisions on pay rises in the health service were outside his remit as health secretary. “We have a budget that we have to live within, and public sector pay is a matter for the chancellor,” he said.

But he said that he would put the case for lifting the pay cap to the chancellor. “I have had a very constructive letter from Janet Davies, head of the Royal College of Nursing, since I came back into office,” he said. “I will be meeting with her, and I will make sure that our conversation is reflected back to the chancellor before he makes that decision.”


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