05 Apr An Overview of How the NHS Works and Band Wages
Ever dreamed of making a real difference in people’s lives through nursing? The UK’s National Health Service (NHS) offers a unique and rewarding environment for nurses to thrive. Whether you’re a recent graduate or an experienced nurse considering a move, this blog will guide you through the amazing world of the NHS.
If you’re a nurse planning to migrate to the UK, you might be wondering how the NHS works. The NHS stands for National Health Service and is the UK’s publically funded health system. It’s completely free for UK residents. Read on for a comprehensive guide to the workings of the NHS and the surprising shift of wages between bands.
Who funds the NHS?
Most of the NHS’s funding comes from general taxation– so taxes UK citizens pay. It also comes from NICs, national insurance contributions. A small proportion of funding (1.0 per cent of the total Department of Health and Social Care budget comes from patient charges for services such as prescriptions and dental treatment. The public spending budget comes from the Department of Health and Social Care’s budget. The Department’s spending in 2022/23 was £181.7 billion. The vast majority of this spending (94.6 per cent, or £171.8 billion) was on day-to-day items such as staff salaries and medicines. The rest is spent on facilities, like new buildings and equipment. Most of its budget is spent on the cost of staff, and mostly on primary healthcare (GPs and dentistry).
The Structure of the NHS
The NHS isn’t one giant organisation, but one large network of different organisations. It is made up of hundreds of different organisations of differing sizes, at central, national, regional, and local levels with different roles and responsibilities, and is said to be the largest employer in Europe. It’s a patchwork of organisations that often work independently of one another.
For some years now, health and care staff and leaders, have been working to bring organisations closer together to better meet our needs by working in a joined-up way.
Primary and secondary care, social care, mental health and community health services have been seeking to partner with each other in different ways. At a very local level, GP surgeries have been coming together to form primary care networks, groups of practices working together across areas called ‘neighbourhoods’. By sharing resources and working closely with other local people and services, they can provide a wider range of services than a single GP surgery.
Where RNs work in the NHS
The NHS has 4 levels: central, national, regional, and local. You’ll probably work on local levels. That could be:
- General Practitioner office: This could be your base as a nurse. You might fill a role assisting GPs (family doctors) and help with patient education: by explaining treatment and assessments. You might also help with chronic disease management. Duties could include wound care or drawing blood.
- Hospitals: If you’re a specialist nurse, you could work in a hospital, or otherwise a specialist outpatient clinic. This means providing specialist care, assisting with emergencies, and helping with inpatient care (e.g.: mental health nursing, hospice nursing).
- Mental Health Trusts: if you’re an RMN (a mental health nurse), you could work in a clinic or psychiatric ward treating the mentally ill and emotionally unstable. This work makes an enormous difference for citizens in the UK.
- Community Services: Should you be passionate about public health and providing care for the general population, consider working within community healthcare– community health or district nursing.
As you can see, there is a variety of work you can do as a nurse in the UK.
Benefits of Working for the NHS:
- Job Security: The NHS is a large employer with a consistent demand for qualified nurses.
- Career Development: Extensive training and development opportunities are available within the NHS.
- Teamwork: Emphasize the collaborative environment and strong sense of community among NHS staff.
- Making a Difference: Highlight the unique satisfaction of caring for patients and contributing to public health.
Think about working in the NHS!
Places
Health and care organisations have also been working together across larger areas called ‘places’ – often covering the same area as a local authority – where large parts of the NHS budget are spent. Here, local government, charities, residents and NHS partners can work together to understand and meet local health needs. Organisations are now coming together across even larger areas to form integrated care systems, partnerships of health and care organisations that plan and pay for health and care services.
There are around 40 integrated care systems across England and although they’ve existed for some time, the Health and Care Act gives them legal status, as well as new powers and responsibilities.
Integrated care systems
Integrated care boards decide how the NHS budget for their area is spent and develop a plan to improve people’s health, and deliver higher-quality care and better value for money. Also, integrated care partnerships bring the NHS together with other key partners, like local authorities, to develop a strategy to enable the integrated care system to improve health and wellbeing in its area.
How are these new structures funded?
Integrated care systems get most of their money from NHS England, the national body for the NHS in England, and sets the operational priorities for the health system. The Department of Health and Social Care sets out what the NHS is expected to deliver for the money it gets from the government – which comes from our taxes. It also holds budgets for other areas that impact our well-being, like public health. Throughout these new structures, local authorities play a key role; they receive money locally and from the national government, which goes towards funding a range of services that support our well-being and prevent ill health.
Levels of Care in the NHS
The NHS has different levels of care: primary, secondary, and tertiary.
Primary
Primary care is universal care provided by the community that can be directly accessed. This includes professionals like GPs, and community healthcare workers (dentists, community nurses). Primary care is commissioned by the NHS England.
Secondary
Secondary care includes more specialised care that requires referral from primary care to access, usually from a GP. Secondary care can be based in a community health setting or a hospital. Examples include paediatricians or occupational therapists. Most secondary health services will be commissioned by the local Clinical Commissioning Group (CCG).
Tertiary
Lastly, tertiary care is the most specialised level of care. These services require referral from either primary or secondary care. Tertiary healthcare will normally be based at a more distant hospital or major regional centre and may include:
- Specialist diagnostic services, such as genetics services
- Acute clinical services or specialist emergency services such as a range of paediatric surgery or children’s cancer services.
- Specialist treatment centres for children and young people with low-incidence, high-cost conditions.
Examples of these professionals include specialist nurses (cardiology, neurology, NICU) and mental health services. This is paid for by NHS England.
Career levels in the NHS
The NHS showcases a variety of career levels for healthcare professionals, called bands. Each band comes with a respective pay scale, increasing each year or band you move into. Pay factors will include years of experience, clinical specialisms, duties included as part of the post, and how the role will fit into the overall hierarchy of the Trust.
Band 1
These workers are entry-level and require very basic knowledge, usually solely GCSEs (math, English, etc.) They undertake a limited number of straightforward tasks under direct supervision. They could be any new starter to work in the Health sector and usually rapidly progress to Band 2. For example, a cadet, domestic support worker, housekeeping assistant, driver and nursery assistant.
Salary
These workers’ salary starts at £22,383.
Band 2
Band 2 healthcare workers require basic factual knowledge of a field of work. They may carry out clinical, technical, scientific or administrative duties according to established protocols procedures, or systems of work. For instance, a support worker, emergency care assistant, HCA (healthcare assistant), clinical coding officer, estate officer and occupational therapy worker.
Salary
Depending on years of experience, wages start at £22,383.
Band 3
People working at band 3 need knowledge of facts, principles, processes and general concepts in a field of work. They contribute to service development and self-work. They usually have more responsibility than workers in band 2 but are still supervised. An example could be an emergency care assistant, trainee clinical coder, estates officer and occupational therapy support worker.
Salary
After working for 2 years, you can expect to make anywhere from £22,816 to £24,336.
Band 4
Band 4 professionals require facts and knowledge at a broad knowledge and theory at a broad level within their work. Their work is guided by standard operating procedures, protocols, or systems of work. However, they may be permitted to make judgments, plan activities, or contribute to service development. They could even supervise some staff. An example of this worker could be an associate practitioner, audio-visual technician, pharmacy technician, dental nurse and theatre support worker.
Salary
Band 4 workers’ salary ranges from £25,147 for under 3 years of experience, and £27,596 for more than 3 years of experience.
Band 5
The higher you climb the career ladder, the more specialised knowledge you’ll need. This is definitely the case with Band 5 workers, who require comprehensive, specialised, factual and theoretical knowledge within a field of work and an awareness of the boundaries of that knowledge. They should be able to solve problems creatively, make judgments that require critical thinking and interpretation, and actively contribute to the development of services and themselves. One example of a band 5 worker is a newly qualified RN or any other newly qualified clinician.
If you’re a qualified nurse with a bit of experience, Proximity Healthcare can place you in a healthcare facility that provides you with a flexible schedule and positive work environment through nurse agency work. The best part? We’re based all over the UK. We take pride in our especially helpful, kind, and intelligent staff. They genuinely care about your future and are ready to hold your hand for the entirety of your agency work journey. That’s what makes Proximity Healthcare different from every other employment agency.
It’s why we’re one of the UK’s best: we care and will keep your head above water.
Salary
It depends. Salaries vary depending on the amount of experience. Under 2 years of experience, you’ll make £28,407. At 2 to 4 years’ experience, you could make around £30,639. And after 4 years, expect £34,581.
Band 6
Band 6 workers have responsibilities and leadership roles within the NHS. They’re usually specialists in their field and require a critical understanding of detailed theoretical and practical knowledge. Think of a practitioner, school nurse, experienced paramedic, clinical psychology trainee and biomedical scientist, for instance.
Salary
Band 6 healthcare workers from £35,392 (under 2 years experience) to £37,350 (after 2-4 years), or even £42,618 after 5 years.
Band 7
These workers have a critical awareness of knowledge in their field, most often specialised. They might additionally interface between other fields, too. They are innovative and have a responsibility for developing and changing practices and/or services in a complex and unpredictable environment. Sounds like a nurse practitioner (NP), communications manager, high-intensity therapist and advanced speech and language therapist.
Salary
The higher up the ladder you’ve climbed, the more you make. Under 2 years’ experience, you’ll receive £43,742. After 5 or more years: £50,056.
Band 8
Nearing the top of the ladder, these pioneers serve at the forefront of specialised knowledge. They are leaders with considerable responsibility, and the ability to research and analyse complex processes. Like fairy godmothers of the NHS. They could have considerable clinical and/or management responsibilities, be accountable for service delivery or have a leading education or commissioning role.
There’s band A and band B within level 8.
Salary
Band A, B, C and D have different salaries.
- Band 8A: Less than 5 years experience: £50,952. And more than 5 years’ experience? £57,349.
- Band 8B: If you have fewer than 5 years’ experience, you can ask for at least £58,972. And after it’s been 5 years, ask for £68,525. That’s a pretty decent salary, right?
- Band 8C: Below 5 years of service, you can request £70,417. After 5 years, you could request £81,138.
- Band 8D: If you have less than 5 years of experience, expect £83,571, and up to £96,376 after 5 years.
Examples of band 8A workers: are consultant prosthetists/orthotists, project and programme managers, modern matron (nursing) and nurse consultants (mental health nursing).
Examples of band 8B workers: strategic management, head of education and training, clinical physiology service manager and head orthoptist.
Examples of Band 8C workers: head of human resources, consultant clinical scientist (molecular genetics/cytogenetics) and consultant paramedic.
Examples of Band 8D workers: consultant psychologist (8c-8d), estates manager, chief nurse and chief finance manager.
Band 9
The highest band workers, band 9, require the most specialised knowledge and serve at the most advanced frontier of the field of work, and the interface between fields. They will have responsibility for the development and delivery of a service to a population, at the highest level of the organisation. Cast your mind towards a podiatric consultant (surgery), chief finance manager and director of estates and facilities.
Salary
Lastly, Band 9 salaries start at £99,891 below 5 years of experience and skyrocket to £114,949 after 5 years.
You now have a thorough understanding of the NHS and its respective bands. Want to work in the NHS? Contact Proximity Healthcare for nurse agency work near you!