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EDITIONS
NHS in crisis Monday, 17 January, 2000, 11:16 GMT
NHS pay and staffing at a glance
Cash
Pay is a constant issue in the health service
The NHS employs more than 600,000 doctors and nurses, but the service is in the grip of a recruitment and retention crisis.

More doctors and nurses are needed, but not enough want to work for the NHS. Many of those who do want to leave.

Nurses

Nurse salaries are based on scales within certain grades, and rise within that bracket according to experience and length of service.

Salaries will also vary depending on additional qualifications or an ability to specialise in a particular field of medicine.

Since December 1998, when the second stage of that year's pay award was implemented, pay scales for fully-qualified nurses have been:

  • Staff nurse (grade D): 14,400 to 15,905
  • Senior staff nurse (grade E): 15,395 to 17,830
  • Junior sister, ward sister, school nurse GP practice nurse (grade F): 17,075 to 20,925
  • Ward manager (grade G): 20,145 to 23,300
  • Nurses with specialist roles, ward managers with extra roles (grade H): 22,505 to 25,735
  • Senior nurses with responsibilities across a hospital trust (grade I): 24,920 to 28,240.

Nurses in London get paid slightly more, a

General practitioners

GP
GPs aim to earn just over 50,000
Pay for doctors varies depending on where they work and at which stage of their career they are at.

GPs are self-employed, and work for the NHS on an independent contractor basis.

Rather than a salary, they have an "average intended net remuneration". This is how much they should expect to earn after paying expenses such as staff costs and surgery rent. The government sets this figure following recommendations from the Doctors and Dentists Review Body.

It is net of business expenses, not income tax.

From December 1998 the average intended net remuneration for a GP was 52,600.

They can earn bonus payments if they meet public health targets such as immunising a certain proportion of the people on their practice list.

However, many GPs can make more than this by taking on additional duties, such as additional on-call shifts or working as a police surgeon.

Others make less because they have a flexible working pattern or practise in an area with fewer opportunities to boost income.

Senior hospital doctors Hospital doctors are salaried, but they can opt to be employed part-time by the NHS and use the rest of their week practising privately.

There are different grades of hospital doctor depending on how much training they have received. Consultants, associate specialists and staff grade doctors are out of training and in the "career grades".

As of December 1998, career grade doctors have been paid on the following scales:

Consultants are paid up to 61,605, so-called associate specialists and staff grade doctors less.

Consultants can double their salaries if they are given distinction, or merit, awards.

Discretionary points are awarded by NHS trusts, which must distribute a certain number each year. A consultant with the maximum number of points can see his or her salary rise by approximately 10,000 pounds

Merit awards are given for "outstanding contribution" to NHS services. They are awarded by a body of doctors called the Advisory Committee on Distinction Awards.

Although the system is currently under review with a view to including lay people in the selction process, a consultant already earning 59,040 can have his or her salary increased by between 24,000 and 46,000 pounds.

Junior hospital doctors

Junior doctors, or doctors in training, are split into house officers and registrars.

House officers are fresh out of medical school and will learn general medicine, before becoming specialist registrars, who have chosen a field in which they aim to become a consultant.

As of December 1998, junior doctors have been paid on the following scales:

  • House officer:16,710
  • Senior house officer: 20,845 to 27,845
  • Specialist registrar (replacing the registrar and senior registrar grades): 23.300 to 33,965

Junior doctors also get paid "additional duty hours" - an hourly rate that is paid when the working week exceeds 40 hours.

Sources: Staffing levels from the NHS Executive, Scottish Office, Welsh Office and Department of Health and Social Services in Northern Ireland. Pay scales from Department of Health and British Medical Association.

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