Doctors' and dentists' remuneration (DDRB) review body - 2022-2023 pay round: evidence
Written evidence submitted to the review body on Doctors’ and Dentists’ Remuneration (DDRB) by the Scottish Government for the 2022 to 2023 pay round.
D. Resources, Affordability and Pay
Introduction
38. This chapter sets out the financial context including assumptions on funding available in 2022-23.
Funding growth
39. The Scottish Government announced it's 2022-23 Budget on 9 December 2021. It was set out as a transitional budget, paving the way for a full resource spending review in May 2022, and taking the next steps to deliver the Health and Social Care commitments outlined in the Programme for Government.
40. The Budget sets out record funding of £18 billion for the Health and Social Care Portfolio, supporting the remobilisation of services, as well as delivery of priorities relating to prevention and early intervention.
41. The budget provides new investment in excess of £1 billion for health and social care, with over £600 million provided to support our health services, and £400 million for social care and integration. This funding supports our frontline services by providing:
- £12.4 billion investment in our frontline health boards, representing additional investment of £387 million (3.2%) – delivering the first increase to ensure frontline funding that directly supports patient services increases by at least £2.5 billion by 2026-27.
- £554 million investment in health infrastructure – supporting continued delivery of our NHS Recovery Plan by increasing capacity and treatments through expansion of our network of National Treatment Centres.
- Over £1.6 billion in social care integration. This investment in social care and integration lays the groundwork for our National Care Service.
- Funding of £147.6 million to address the twin public health emergencies of drugs deaths and the harms from alcohol – including £61 million specifically to address the national tragedy of drugs deaths as part of our commitment to invest £250 million over the lifetime of this Parliament.
- In excess of £1.2 billion for mental health services and taking forward our commitment to ensure mental health funding increases by 25% over this Parliament
42. The public health measures required to respond to the threat and uncertainty of COVID-19 remain a key consideration in our planning, and we await the outcome of further detail that was promised in the UK Government's Spending Review to support our plans.
Affordability - the funds available
43. As outlined above, there will be additional investment of £387 million (3.2%) to frontline health boards. All Boards will receive a baseline uplift of 2% along with further support for increased employer national insurance costs arising from the UK Health and Social Care Levy. In addition, those Boards furthest from NRAC (National Resource Allocation Committee) parity will receive a share of £28.6 million, which will continue to maintain all Boards within 0.8% of parity.
44. In terms of pay, initial funding has been allocated to Boards in line with the Scottish Public Sector Pay Policy for planning purposes.
45. In addition to the funding above, a total of £845.9 million will be invested in improving patient outcomes in 2022-23, as set out below:
| Improving Patient Outcomes | 2021-22 Investment in reform (£m) Restated | 2022-23 Investment in reform (£m) | Increase for 2022-23 (£m) |
|---|---|---|---|
| Primary Care | 250.0 | 262.5 | 12.5 |
| Waiting Times | 196.0 | 232.1 | 36.1 |
| Mental Health | 231.1 | 246.0 | 14.9 |
| Trauma Networks | 37.8 | 44.3 | 6.5 |
| Drugs Deaths | 61.0 | 61.0 | 0 |
| Total | 775.9 | 845.9 | 70.0 |
46. When combining the £70 million increase in investment set out above with the increase of £317.4 million in baseline funding for frontline NHS Boards, the total additional funding for frontline NHS Boards will amount to £387.4 million (3.2 per cent) in 2022-23.
47. The Scottish Government will further increase its package of investment in social care and integration to over £1.6 billion, laying the groundwork for our National Care Service. The Health and Social Care Portfolio will transfer additional funding of £554 million to Local Government to support social care and integration - this funding will help to retain care workers and support better pay and conditions; local government will be required to deliver a £10.50 minimum hourly rate for adult social care workers in commissioned services, in line with the public sector pay policy.
48. The medical and dental paybill is itemised by the following groups, as per the below:
| Staff Group | 2020-21 Estimated Paybill (£m)* | 20-21 Average Basic Pay (£000)1 |
|---|---|---|
| Foundation Years (FY1, FY2) | 103 | 28.4 |
| Specialty Training (SpR, StR, etc) | 383.1 | 38.5 |
| Consultant | 969.5 | 100.9 |
| Specialty Doctor | 74.5 | 67.7 |
| Associate Specialist | 23.8 | 94.2 |
| Other | 167 | 70.2 |
| Total | 1,720.8 |
* Figures based on 2020-21 pay award
1 Salary as per NHS Circular: PCS(DD)2020/2
Pressures on funding
49. The additional funding outlined above is directed to support frontline services however, with 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.
50. 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.
51. The Covid pandemic continues to present the most significant challenge to Health and Care services and we await the outcome of further detail that was promised in the UK Government's Spending Review to support our public health measures including vaccinations and Test and Protect.
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