Thousands of NHS contractors face missing out on this month’s health service pay rise despite working on the same terms as staff.

More than one million NHS staff in England began to receive pay rises this week after months of strikes, but employees working for social enterprises contracted to work in primary care, mental health, charities and other health sectors are not yet eligible as the Government is not providing funding for them.

NHS Providers, which represents trusts, told i the disparity is “fundamentally unfair”.

Nurses, radiographers, 999 call handlers, midwives, security guards and cleaners are among those who will receive the pay rise, backdated to April. The move could see some nurses’ salaries go up by more than £2,750 over two years.

They will also receive a one-off “NHS backlog bonus” which Health Secretary Steve Barclay said “recognises the sustained pressure facing the NHS following the pandemic” and the “extraordinary effort” of staff to help cut waiting lists.

However, Royal College of Nursing members rejected the pay rise and the union is balloting members to ask if they want to return to the picket lines. The result is expected shortly after the ballot closes on 23 June.

Social enterprise leaders have also criticised ministers for leaving them out of the new deal.

Providers in the community often deliver vital NHS services with NHS contracted staff – who work under the same terms and conditions as those on the Agenda for Change deal – playing an equally vital role that has not been recognised with a pay rise, health leaders say.

Saffron Cordery, deputy chief executive of NHS Providers, said: “There’s a huge question mark over how the pay rise will be funded for staff of, for example, social enterprise or voluntary providers delivering vital NHS services in the community.

“These staff may end up missing out on the pay uplift which would be fundamentally unfair and damaging to the morale of frontline staff delivering these services. Without full funding of the pay uplift by the government there are risks of cuts to services to cover this, which will hit patients.”

Peter Holbrook, chief executive of Social Enterprise UK, said: “Social enterprises are a crucial part of the NHS family, delivering over a billion pounds of services and employing many thousands of staff while reinvesting any profits in communities. Health Secretary Steve Barclay recently said that he would implement the NHS pay deal for all staff on Agenda for Change – but he has yet to come up with the money, putting these organisations and their staff in an impossible position.

“Social enterprises work by reinvesting any profits into the community, so the companies who employ the staff do not have money in reserve to cover the costs of the new pay deal themselves. We still expect the department to take urgent steps to solve this – as they did previously in 2018 – before staff, services and patients are adversely affected.”

Some health leaders are warning of a “two-tier system” unless all health staff are recognised fairly.

Matthew Taylor, chief executive of the NHS Confederation, called for the pay uplift to be fully funded for all staff. “The NHS is more than just hospitals, consisting of a range of vital services patients rely on including mental health care, primary care, district nurses and therapists, all of which are contracted indirectly,” he said.

“The current arrangement for central funding might see staff at these services miss out and risks the creation of an inequitable, two-tier system for different staff. Providers are currently facing the unenviable choice between finding additional savings – likely through cuts to services – to fund the rise, or not implement the raise and risk staff leaving, leaving patients worse off.

“A similar oversight was made with the pay rise in 2018, but the government eventually solved this by agreeing to cover it via central budgets. We urge the government to review its position and agree to fund the pay award for all staff on AfC terms and conditions, including those on local authority contracts.”

The Department for Health and Social Care said: “NHS funding to social enterprises, community interest companies, charities and other similar services will be uplifted through their usual funding routes.”

However, there was no further clarification if this included social enterprise staff contracted to work for the NHS.

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