Four years after reforms were introduced and in the teeth of union opposition, more than 100 NHS trusts are considering a move away from national bargaining and the introduction of peformance pay for an increasing number of staff.
Industrial Relations Services, which surveyed 180 trusts, believes 1995 will be a critical year for the future pay prospects of about a million staff in the health service.
Three-quarters of the trusts said that fewer than one in five of their employees were on local terms and conditions. But researchers also found that most trusts in England had "action plans" for the development of in-house pay by the October 1994 deadline set by the Department of Health.
About half of the trusts with locally-determined salaries have already introduced some performance-related element.
As the independent pay review bodies consider their recommendations for nurses and medical staff in 1995, IRS found that despite the absence of government funding, the "vast majority" of trusts paid nurses and medical staff the 3 per cent rise the bodiesrecommended last year.
In many cases the rise was funded locally by increasing the workload and changing the "skill mix" of nursing staff - which means employing people with lower qualifications.Reuse content