Resolution: NHS Pay Review Body (PRB)

This resolution passed. 

The Pay Review Body system in the NHS dates from 1983, with the creation of the Nurses’ and Allied Professions’ Review Body (NAPRB) which covered nurses, midwives and health visitors. 

The creation of this body was a response to a series of long-running industrial disputes in the NHS. There was a repeating ‘stop-go’ cycle of pay changes under the Whitley Council – nurses’ pay would fall back over a few years in comparison to other groups followed by a one-off catch-up exercise in response to staff shortages and industrial conflict. Between 1968 and 1980, there were four ‘catch-up’ exercises or Commissions which made recommendations to bring nurses’ pay up to a level judged fair (Buchan, 2012).  

The NAPRB was restructured to form the NHS Pay Review Body (PRB). By 2007 the PRB coverage had expanded to all other NHS staff, except doctors, dentists and very senior managers.   

The NHS PRB can be understood as one institution within a ‘nested structure’ of NHS pay, terms and conditions, with the social partners owning each part of a national and interdependent system which includes the Staff Council, the Agenda for Change (AfC) pay framework and the NHS Job Evaluation System. This national system is in turn embedded in local recognition, partnership and bargaining structures within NHS workplaces.  

Within this ‘nested structure’ the PRB makes recommendations on pay awards for all NHS (AfC) staff to the UK governments. The recommendation is based on the consideration of evidence from trade unions, employers and governments. Governments are not bound by the PRB recommendations and can decide to reject, implement fully or in part. 

Collective bargaining over other issues, including terms and conditions, takes place within other NHS structures, meaning there is a separation of decision making between pay and other terms and conditions of employment.  

The NHS PRB terms of reference set out its overarching objectives (NHS Pay Review Body, 2007). In each pay round, these are supplemented with a remit letter from the UK Secretary of State for Health and Social Care emphasising which factors it should focus on as well as any specific constraints on the issues the PRB is to consider. The relevant health minister in the devolved governments also submits a remit letter to the PRB. The Welsh government’s remit letter heavily focused on affordability and the need to increase UK funding.  

Since 2021, the Scottish government has not sent a remit letter to the NHS PRB, instead negotiating with the health trade unions in Scotland via the Scottish Terms and Conditions Committee.   

The NHS PRB has eight members. The Chair is appointed by the Prime Minister, while the other members are appointed by the Secretary of State. The appointment process is regulated by the Commissioner for Public Appointments. PRB members have a range of backgrounds and expertise including people resourcing, remuneration experts, economists and former trade unionists.  

References 

Buchan J (2012) James Buchan speculates on when the pay freeze is likely to thaw, Nursing Standard, 26(40), p. 28

NHS Pay Review Body (2007) Terms of Reference. Available at: https://www.gov.uk/government/organisations/nhs-pay-review-body/about/terms-of-reference (Accessed 15 March 2023)>

 NHS Pay Review Body (no date) About us. Available at: https://www.gov.uk/government/organisations/nhs-pay-review-body/about (Accessed 15 March 2023)