Social Enterprise UK is extremely concerned at the proposed funding route for the NHS pay deal.  The majority of social enterprises providing NHS services follow the NHS pay framework, Agenda for Change, offering the same terms and conditions as their peers in NHS Trusts, and are represented on the NHS Staff Council.  As a result, they expected to be treated in an equal manner and to automatically receive an uplift to funding via contracts with commissioners, alongside all other providers of NHS contracts.  However, we have learned from the DHSC that the plan is to fund onlyNHS Trusts and Foundation Trusts to pay the uplift directly to them.  This is likely to have a catastrophic effect on social enterprises providing NHS services.

All nurses and other health care workers providing NHS services should be treated the same, whoever their employer, so that a gap in pay does not result in workers being drawn away from primary, community and social care services, negatively impacting on patient care.

Our concerns are summarised below:

  • At a time where NHS services are at risk due to vacancies it seems curious to only offer some staff a pay rise.  We are attempting to retain and recruit nurses, not to lose them.  There is a real risk that a gap in pay means health staff being drawn away from community and social care services.
  • If the pay rise is unfunded the majority of social enterprises are unlikely to be financially viable for the long term. They operate on margins usually of less than 2% and so could not absorb the increased staffing costs.  Unlike NHS bodies social enterprises cannot run at a deficit.
  • As most social enterprises operate community services we envisage real disruption to local services and systems, and therefore to patients.
  • Local health care systems will lose the additional social value that has been provided.
  • Contracts held by NHS trusts will receive additional funding whilst others (held by non NHS organisations will not). Is this state aid? It appears anti-competitive.
  • Most perversely of all should we see the failure of organisations then the staff will be absorbed into NHS organisations who will then pay them the uplifted salaries – so the pay rises will be funded by Treasury.
  • The resulting discrepancy in funding for pay is leading to uncertainty for the tens of thousands of nurses, physiotherapists and health care assistants working at social enterprises delivering front line care to our communities.

Lord Victor Adebowale – Chair of Social Enterprise UK and Board Member of NHS England