Review Body on Doctors' and Dentists' Remuneration (DDRB): written evidence - 2024-2025 pay round

C. Resources, Affordability and Pay

34. This chapter sets out the financial context including assumptions on funding available in 2024-25.

Funding growth

35. The Scottish Government announced it’s 2024-25 Budget on 19 December 2023 - giving Health and Social Care over £19.5bn, a real terms uplift in the face of UK Government austerity

36. Despite this investment, the system is under extreme pressure as a result of the ongoing impacts of Covid, Brexit and inflation, and UK Government spending decisions – hard choices, greater efficiencies and savings will need to be made.

37. Health Boards across Scotland will receive an almost 3% uplift in funding as part of the Budget – bringing their total budget to £14.2 billion, which includes over £10 billion to support NHS staff.

38. This Budget continues to support prevention and early intervention which is critical to addressing system challenges:

• Over £2.1 billion for primary care to improve preventative care in the community, supporting the development of multidisciplinary teams in general practice, sustaining NHS dental care through enhanced fees and continuing free eye examinations.
• Over £1.3 billion for mental health services, with £290.2 million direct investment – more than doubled since 2020/21 – enabling record numbers of staff in providing more varied support and services to a larger number of people than ever before.
• Sustaining increased funding to address the twin public health emergencies of drugs deaths and the harms from alcohol by maintaining our commitment to provide an additional £250 million in funding over the life of this parliament to address the drugs death emergency.
• Protecting those most at risk with increased investment of over 55% for our routine childhood and adult vaccination programmes.

Affordability - the funds available

39. As outlined above, NHS Boards will receive an uplift of almost 3% in 2024-25 including funding to support the 2023-24 pay deals. In addition, those Boards furthest from NRAC (National Resource Allocation Committee) parity will receive a share of £31.1 million, which will continue to maintain all Boards within 0.6% of parity.

Note

1. Sourced from NES pay bill file 2022/23 from Scottish Workforce Information Standard System (SWISS).

2. Salary as per NHS Circular for 2023-24 pay award: PCS(DD)2023/01, https://www.sehd.scot.nhs.uk/pcs/PCS2023(DD)01.pdf

3. Weighted average basic pay salary for 2023-24 pay award, accounting for WTE for each pay point assuming the same WTE as 22/23. Does not account for any banding supplements.

The estimated paybill suggests that the paybill of current year (2023-24) would increase by about £163 million, assuming all work patterns and WTE do not change.

Pressures on funding

40. It is vital the UK Government faces up to the pressures across health and social care and provides adequate funding to address the cost crisis that is hampering service recovery, and to support fair pay for health and social care workers. The additional funding outlined above is directed to support frontline services however, with the costs crisis, people living longer, and the increased cost of new technology and drugs, this means that the NHS will continue to face budgetary pressures that require both investment and reform of services.

41. The Scottish Government expects all Health Boards to take reasonable steps to live within their means and make best use of the available resources as part of a balanced approach to finance and performance.

42. No Covid funding is currently included in Board baseline budgets for 2024-25 but we recognise that additional funding will be required to support vaccinations staffing and delivery, Test & Protect activities; and additional PPE requirements.

Public Sector Pay

43. An update on public sector pay for 2024-25 was given by the Deputy First Minister in her Budget statement on 19 December. Given the ongoing fiscal challenges and uncertainty over UK Government funding and inflation levels, Scottish Ministers did not publish a public sector pay policy alongside the 2024-25 Budget.

44. The next phase of public sector pay work will focus on working with Scottish Government’s Trade Union partners to deliver reforms to put our public sector workforce on a sustainable footing. We intend to set out the pay metrics for 2024‑25 following the Spring UK Budget scheduled for 6 March 2024. This is in keeping in line with the approach we took for 2023-24 and will allow time for further engagement with our Trade Union partners on the reforms necessary to put our public sector workforce on a sustainable footing.

45. The Budget stressed that going forward, pay and workforce must, more than ever, be explicitly linked to both fiscal sustainability and to reform to secure the delivery of effective public services over the medium term.