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Pressure on Government to Change NHS “Pay to Work” Rules

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Events of 2020 have made us all appreciate the work done by NHS staff more than ever. So, it’s perhaps surprising to many of us that many staff are being handed a bill from the NHS before they even set foot in a hospital. According to some reports, for many staff on lower wages, these charges can amount to as much as a full day’s wages. What is happening with these “pay to work” rules?

 

Disclosure and Barring Checks

The main costs associated with getting a job in the NHS are Disclosure and Barring Checks, also known as DBS checks. The DBS looks at an applicant’s criminal record and decides whether there are any convictions or cautions which would raise concerns about their suitability for the type of work they will be doing. There are several different levels of check, and the exact check the person will need depends on the position they will be doing.

Members of staff being employed in patient contact roles, such as porters, nurses or cleaning staff, will need an enhanced disclosure check. Back-office staff, such as those working exclusively in laboratories or in admin roles, may need a standard DBS check. Whatever the level of check, there is a fee associated with the application.

 

Don’t Employers Meet the Cost?

In most cases, employers will indeed pay the cost of a DBS check for a member of staff. This is a courtesy though, and there is no law forcing an employer to meet the cost. If they decide they’d prefer to make staff pay, then they are free to do so. Some NHS trusts, trying to save money wherever they can, decide to ask applicants to pay instead. Some may refund the charges in the applicant’s first pay packet.

During the pandemic, one of the first changes the government made was to waive the fees for all applicants working in the social care or NHS roles. This was just a temporary measure to process applicants more quickly, and fill vacancies to ensure the NHS was working at full capacity. Once the system ends, NHS trusts around the UK will be back to deciding whether to bear the cost themselves, or charge applicants to work in the NHS.

 

Overseas Applicants

The situation is even more complicated for the thousands of health professionals who arrive from overseas to work in the NHS each year. There is no point asking these people who have never lived in the UK to have a DBS check as the databases just contain UK records. Overseas applicants submit their own country’s equivalent of a DBS certificate, although this is often known as a certificate of good conduct or similar. Fees for these vary, and governments overseas have not waived the fees in the same way as the UK government has. Overseas applicants are likely to continue to have to pay the significant fees associated with applying for a DBS certificate and all of the other costs of arriving to work in the UK too.