The Society of Radiographers is the professional body and trade union for all those working in diagnostic imaging and radiotherapy. The Society of Radiographers (SoR) represents more than 34,000 members, most of whom work in the NHS across all four nations, at all grades across clinical imaging and radiotherapy.
The SoR welcomes the opportunity to submit evidence to the Pay Review Body (PRB) for the 2025-26 pay round. We recognise that the evidence round has started earlier in an effort to support members receiving an increase as close as possible to the increment date of 1 April 2025. Paying people an increase on time is important for the credibility of any pay system and can also, in the long run, help stabilise industrial relations by providing a stronger framework in which wider discussions about pay structures and systems can take place.
However, this change in timetable does create some challenges this year regarding presenting our evidence. Firstly, we are in effect submitting evidence twice in the same year, and some of the data sources we traditionally use have not yet been updated or re-aligned with the new timetable. We strive to use the latest available workforce data, but it is possible that more up-to-date data may need to be provided before we give our oral evidence early in 2025.
Secondly, we are conscious that, at time of writing, the various joint workstreams that arose from the 2023-24 pay award are only just finalising reports and we have no information as to the new government’s response to any consequent recommendations. Our evidence reflects to some degree what we anticipate the recommendations will be and what we think the reaction from government will be, including where we think the recommendations are too limited to make the impact needed for our members.
Overall, we would say that a key lesson from these working groups has been how difficult it has been to get the three keys groups – employers, unions and professional associations, and the DHSC – into a space where consensus about practical changes can emerge. This has been reflected equally in the Social Partnership Forum (SPF) during the same period, where progress towards addressing even agreed key concerns, such as bullying and harassment in the workplace, has been extremely limited.
Since the change of government, there has been more positive discussion across the range of joint forums, with a welcome upturn in the DHSC’s willingness to actively engage in work towards change. However, these are early days in what requires a significant and sustained culture shift. We welcome the additional investment in the NHS announced in the budget, but also recognise this can only credibly be seen as a first instalment on repairing the 20% funding gap between the UK and EU15 spending on health and social care, referenced in our previous PRB evidencei. We are also awaiting the outcomes of the public consultation on the future of the NHS and consequent revisions in the 10-year workforce plan.
We remain completely opposed to splitting Agenda for Change (AfC), and in particular the idea of a separate pay spine for nurses. No AfC professional works in isolation. Even though nine out of 10 patients on a treatment pathway will be supported by a radiographer, and while addressing shortages of radiographers could be central to tackling the waiting-list crisis, we do not think radiography is more important than other professions. There are already within the AfC arrangements to target recruitment and retention initiatives for key groups (such as greater use of Annex 20, which is largely limited to midwives at present). Strong recommendations from the PRB in support of appropriate targeting would be welcomed – alongside calls for adequate funding to recruit enough staff to sustain safe working practices, greater access to flexible working, space for career development and incentives at key points in careers for radiographers.
However, we’d expect you to say these could be extended to all professions without demolishing AfC structures. Indeed, with so much change and the government finally recognising the need to move from short termism towards longer-term planning, maintaining a stable, common pay and reward structure to safely encompass reform of practice is even more critical than ever. We urge the PRB to specifically recommend that AfC should not be broken up.
However, we also acknowledge in our evidence the growing frustration of NHS staff regarding their pay and reward, which has fallen significantly behind the rest of the economy since 2008. This frustration was at the root of the industrial action during 2023, and remains evident in our discussions with members and representatives. One area where this can be seen is the pressure for revision of job profiles and job evaluation. We are in no doubt that we have members whose jobs have significantly changed, not least as a result of new technologies and advanced and enhanced practice across all areas of radiography. This will continue to happen if ambitions for early diagnosis and wider scanning programmes to support early detection and prevention are met over the coming years.
At the same time, the job-evaluation process has not been consistently well-managed or sustained. We can point to examples where people with almost identical roles are banded differently in different trusts, as a result of the degree of proactivity or resistance to requests for revalorisation from their local employer. However, we are equally concerned that efforts to address this are neither used to sidetrack the more important priority of addressing fair pay rates and the consequences of pay restoration across grades, nor used as an extension of a Nurses First agenda. Job evaluation can and must be addressed, preferably in parallel to a longer-term review of pay rates and bands. But it must not be used to play off one group of staff against the others. This is a critical point in the evolution of the NHS, and the PRB should use its voice to specifically caution against parties becoming side tracked by division.
Against this backdrop of potential for change and reform, we urge the PRB to take the opportunity to recommend:
- a significant above-inflation pay award for 2025-26 for all NHS staff, to begin restoring comparative pay rates against the UK economy as a whole.
- using the PRB remit to address equal pay, recognising and amplifying the equal-pay challenges evident in the NHS – the UK’s biggest employer.
- targeted recommendations in key areas to support recruitment and retention initiatives, while also helping to establish a supporting environment for longer-term reform.
- a comprehensive joint review of the current pay and reward structures to better support the aims of the Long Term Workforce Plan (LTWP) and to accelerate pay restoration. We suggest the outcomes from this should be implemented as they are agreed, and completed in full to support the 2028-29 pay round and beyond.
- a full review of job profiles and role boundaries to recognise changes to working practices and professional roles across AfC, but not in lieu of whole-band pay restoration.
- adequate funding for sustainable modernisation of the AfC system, to be guaranteed within the 10-year plan.
- modernisation of the role of the PRB as a genuinely independent body that reviews the impact of pay and reward strategies against the benchmark of continued progress and assessment of the LTWP, including adjustments for changes in known demand, and where progress happens more quickly or more slowly than anticipated in the plan.
Our evidence expands on the reasoning behind each of our proposed recommendations.