Finding a cure? Pay in England's National Health Service

This paper explores the consequences of the introduction by National Health Service (NHS) trusts (i.e. hospitals) of their own pay systems. It is based on case studies of ten NHS trusts and involved 73 interview sessions with a variety of stakeholders and the examination of employment data and performance indicators. The research revealed the tensions and countervailing forces inherent in NHS pay: the tension between national and local pay; the tension between simplification and the need to address the different requirements of the many occupational groups in the NHS; the tension between performance pay and feelings of equity; and the tension between equal pay and the traditional pay determination arrangements. These findings are discussed in the context of the proposed new NHS pay system.