Review Body on Doctors' and Dentists' Remuneration 2023 to 2024: Scottish evidence

D. Resources, Affordability and Pay

48. This chapter sets out the financial context including assumptions on funding available in 2023-24.

Funding growth

49. The Scottish Government announced it's 2023-24 Budget on 15 December 2022, promising to strengthen the social contract with the people of Scotland and pledging to do everything possible to shield families from the welfare cuts and austerity policies of the UK Government.

50. Health and Social Care services will receive £19 billion, the highest ever budget settlement over the next year, paving the way for sustainable public services in Scotland.

51. Health Boards across Scotland will receive a 6% boost in funding as part of the Budget – bringing their total budget to £13.7 billion, which includes over £9 billion to give staff a fair wage.

52. This Budget continues to support prevention and early intervention, as well as the provision of quality community care, providing:

• More than £1.2 billion for mental health services to provide record staff numbers that provide more varied support and services to more people than ever.
• Over £2 billion to deliver and improve primary health care services in the community, enabling dental reform and supporting crucial GP services through investment in multi-disciplinary teams and targeted assistance to support system
• £160 million to address the public health emergencies and reduce the avoidable harms associated with drugs and alcohol.
• Fully restoring the budget for life-saving procedures such as thrombectomies – which remove blood clots – despite the need to make a short term reduction to tackle the inflationary pressures faced by the whole UK.

Affordability - the funds available

53. As outlined above, NHS Boards will receive an uplift of almost 6% in 2023-24. All Boards will receive a baseline uplift of 2% along with further support for the enhanced 2022-23 pay deals and to cover recurring allocations brought forward from 2021-22. In addition, those Boards furthest from NRAC (National Resource Allocation Committee) parity will receive a share of £23.2 million, which will continue to maintain all Boards within 0.8% of parity.

Note

All figures based on 2022-23 pay award

1. Salary as per DD)01.pdf">NHS Circular: PCS(DD)2022/01,

2. Weighted average basic pay accounting for WTE for each pay point.

Pressures on funding

54. Despite our record investment in health for 2023-24, there remains significant financial challenge across health and social care. It is vital that the UK Government provides further funding to address the combined impact of Covid pressures, energy costs and inflation and to support fair pay. 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.

55. 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.

56. No Covid funding is currently included in Board baseline budgets for 2023-24 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

57. An update on public sector pay for 2023-24 was given by the Deputy First Minister in his Budget statement on 15 December. Given the uncertain inflation outlook and the need still to conclude some pay deals for the current year, Scottish Ministers did not publish a public sector pay policy alongside the 2023-24 Budget.

58. The Government will continue to collaborate with trade unions and public sector employers on fair and sustainable pay, and will look to say more on its approach for 2023-24 in the new year.

59. 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.

60. It will be for individual organisations to establish fair and sustainable 2023-24 pay levels in dialogue with their respective trade unions, to determine locally the target operating model for their workforces and to ensure workforce plans and projections are affordable in 2023-24 and in the medium term. This consideration will again reflect our commitment to no compulsory redundancy and to adoption of the real Living Wage (now £10.90 per hour).

61. Our approach reflects that employers are best placed to determine how to deliver services within available budget and we will continue to work with trade unions and employers.