Thousands of staff contracted by the NHS could miss out on the recently negotiated pay rise that more than one million health workers will start to receive today – despite working under the same terms and conditions.

Staff working for social enterprises contracted to work in primary care, mental health, charities and other health sectors are not yet eligible for the pay rise that could see some nurses’ salaries go up by more than £2,750 over two years.

Eligible staff, including nurses, paramedics, 999 call handlers, midwives, security guards and cleaners, will receive the pay rise, backdated to April.

They will also receive a one-off “NHS backlog bonus” which the health secretary says “recognises the sustained pressure facing the NHS following the pandemic” and the “extraordinary effort” of staff to help cut waiting lists.

But social enterprise leaders argue NHS contracted staff – who work under the same terms and conditions as those on the Agenda for Change deal – have played an equally vital role that has not been recognised with a pay rise.

The Department of Health and Social Care (DHSC), however, is not providing the funding to pay them the increase.

Peter Holbrook CBE, chief executive of Social Enterprise UK, said: “Social enterprises are a crucial part of the NHS family, delivering over a billion pounds of services and employing many thousands of staff while reinvesting any profits in communities.

“Health Secretary Steve Barclay recently said that he would implement the NHS pay deal for all staff on Agenda for Change – but he has yet to come up with the money, putting these organisations and their staff in an impossible position.

“Social enterprises work by reinvesting any profits into the community, so the companies who employ the staff do not have money in reserve to cover the costs of the new pay deal themselves.

“We still expect the department to take urgent steps to solve this – as they did previously in 2018 – before staff, services and patients are adversely affected.”

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Some health leaders are warning of a “two tier system” unless all health staff are recognised fairly.

Matthew Taylor, chief executive of the NHS Confederation, said: “While the 2023 pay uplift has been welcomed and may with help with retention issues, it must be fully funded for all staff.

“The NHS is more than just hospitals, consisting of a range of vital services patients rely on including mental health care, primary care, district nurses and therapists, all of which are contracted indirectly.

“The current arrangement for central funding might see staff at these services miss out and risks the creation of an inequitable, two-tier system for different staff.

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“Providers are currently facing the unenviable choice between finding additional savings – likely through cuts to services – to fund the rise, or not implement the raise and risk staff leaving, leaving patients worse off.

“A similar oversight was made with the pay rise in 2018, but the government eventually solved this by agreeing to cover it via central budgets.

“We urge the government to review its position and agree to fund the pay award for all staff on AfC terms and conditions, including those on local authority contracts.”

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The DHSC told Sky News: “All eligible Agenda for Change staff will receive the 23/24 consolidated pay award.”

A spokesperson added: “NHS funding to social enterprises, community interest companies, charities and other similar services will be uplifted through their usual funding routes.”

There was no further clarification if this included social enterprise staff contracted to work for the NHS.

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