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NHS haemorrhaging one third of new PAM graduates

5 July 2005 - 9:10am

PT'A' staff side evidence to PRB shows Government pledges to help tackle the crisis in the NHS by increasing numbers of PAMs are seriously threatened by the numbers of new graduates who are leaving the service as fast as they can.

Released on behalf of the NHS PROFESSIONS ALLIED TO MEDICINE - Staff Side Secretariat, representing: art therapists, chiropodists, dietitians, occupational therapists, orthoptists, physiotherapists, radiographers, support staff.

Government pledges to help tackle the crisis in the NHS by increasing numbers of PAMs are seriously threatened by the numbers of new graduates who are leaving the service as fast as they can.

The Government is planning an extra 6,500 therapists by 2004, and a massive 59 per cent more physiotherapists by 2009.

However, more than a third of PAM graduates are quitting their NHS jobs within their first 12 months of work. Professions affected are art therapists, chiropodists, dietitians, occupational therapists, orthoptists, physiotherapists and radiographers.

The shocking facts are highlighted in the PAM PT'A' staff side evidence to the Pay Review Body, responsible for making recommendations to the Government regarding pay.

Garry Newman, PT'A' Staff Side Secretary, said: 'We have warned for a number of years that it is no longer safe to assume that students graduating with a relevant PAM degree will automatically move into the NHS, or indeed, into clinical employment within that profession. 

'We had evidence last year that 32% of new graduate entrants to the NHS remained in post for less than 12 months.  More recent anecdotal evidence shows that the trend for PAM graduates who choose not to go into clinical work after graduation is gathering momentum.'

No-one knows exactly where each PAM goes to, but physiotherapists and occupational therapists have the highest vacancy rates in the NHS ñ even higher than nurses. A survey last year revealed that, nationally, 74% of trusts have special difficulties in recruiting physiotherapists, 70% struggle to recruit occupational therapists, and 44% have the same problems with radiographers1.

The numbers entering training for the PAM professions have increased from 4,690 in 1996, to 6,600 this year, and are projected to increase to 10,430 by 2003 in order to meet the Government's ambitious targets to increasing the number of therapists working in the NHS by 2004.

However, Mr Newman warns that merely increasing training places at university will not tackle the problem. He said: 'We welcome the increase in training places, but there is little point investing in training places only to lose people within months of graduation. There are increasing numbers of graduates who see their degree as a highly saleable commodity in the wider market place. Unfortunately the starting salary for a PAM is far below the national average, and therapists are increasingly being forced to abandon the careers they trained for in order to pay back student loans and make ends meet. It is clear from our survey results, in this and previous years, that the PAMs starting salary is not sufficient to attract and retain even adequate numbers of graduates into NHS employment.'

The unions are calling on the Government to remove the bottom two increments of the PAM starter grades in order to close the gap between a PAM starting salary and the national average for a graduate. Currently a new PAM graduate can expect to earn a salary of just £15,920. This compares to £16,038 for a teacher, £17,238 for a university lecturer, £18,057 for a probation officer and £25,221 for a police officer.

Mr Newman said: 'Removing the bottom two increments for a PAM would give a starting salary of £17,125 ñ closer to the national average for a graduate, though still below it.

'At the moment, even amongst those graduates who choose to take up clinical work upon qualification, increasing numbers are opting to work as locums immediately on leaving university.  The reason for this is primarily because students can earn more money working as a locum and they feel that this will enable them to pay off their student loans more quickly.

'Our organisations are very concerned about newly qualified staff working as locums in this way.  Recent graduates need a period of stability after qualifying, in which to work under close supervision whilst consolidating their skills.  This will not be available if newly qualified staff work in locum positions, as employers will simply require them to treat patients single-handedly, without supervision.'

A further concern is the growing number of PAM staff who opt to work in the private sector ñ either straight from university of after a very short period of NHS employment.

Mr Newman said: 'Both of these scenarios result in a reduction in the number of permanent staff available for NHS employment.

'Health minister Lord Philip Hunt has said that 'members of these professions are central to the modernisation programme we have set in train'. 2 

'The Government's focus on rehabilitation and public health mean that the demand for PAM services will increase significantly, while the recruitment and retention problems facing the PAM professions continue to worsen.  This is one way in which the Government could begin to tackle the problem and we urge the Pay Review Body to recommend that they do so before it is too late.'


1 Office of Manpower Economics' Workforce survey, 2000
2 Lord Hunt of Kings Heath OBE, Parliamentary Under Secretary of State for Health. Foreword to Meeting the Challenge: A Strategy for the Allied Health Professionals, November 2000, November 2000

Notes to editors:
For further information contact Raquel Simpson on 0207 306 6628.

The professions allied to medicine (PAMs) are arts therapists, chiropodists, dietitians, occupational therapists, orthoptists, physiotherapists, radiographers and support staff in the NHS. 



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