This year the “independent” NHS Pay Review Body agreed to the government’s demands that pay should be held down to 1% - a very poor proposal given steady inflation and years of pay freeze. (Our national negotiators told them the freeze had led to a pay drop of 9%).
None-the-less something interesting did slip out in their report on market facing pay where they noted in their best NHS  management speak: “the cost of commissioning or providing healthcare services is not the same in every part of the country
due to the impact of market forces on local costs.


The MFF [market forces factor] is included in the weighted capitation formula to allow for these unavoidable geographical variations in costs. It is also applied to PbR [payment by results] tariffs paid to
NHS providers. A key element of the overall MFF is the sMFF [staff market forces factor]…”
In English this means that it is more expensive to provide health services in some areas eg Oxfordshire - and that the  government has been providing extra funding to pay for this and a key element is the extra wages they are paying staff.
What extra pay is this? Where is it?
The Agenda for Change national pay agreement allows employers to pay an additional premium to staff in high cost areas and they have been getting the money from the government which recognises we are in a high cost area … so where has the
money been going?
This is a question that every stewards team will be asking Trust directors in their next meetings and we’ll make sure you get the answer – after all Oxford City Council recognises that a living wage in Oxford is needed and insists its lowest paid staff and contractors are paid almost £2 an hour above the minimum wage – because of high living costs.
If you want to find out more and get involved please talk to your union steward.
The full report from the NHS PRB can be seen at