How not to suck at NHS job offer negotiations
TL;DR: Don’t say yes immediately. Prepare carefully. Work out what you want. Plan the conversation. Don’t be an idiot about it.
Doesn’t Everyone Negotiate?
If you’ve not sucked at a NHS Job Interview, you may now be in the position to consider accepting a job offer. In a conversation as part of International Women’s day earlier this year, I offered into the conversation that I’d entered into negotiations for every job offer I’d had since my early 20s and some of the women in the discussion said they’d never negotiated when accepting a job offer. Further conversations I’ve had with other people reveal that they haven’t negotiated either.
So here are some personal thoughts on approaching that moment when someone makes you that job offer. One thing to remember is that I’m not a HR professional; this blog is based on my personal experience.
The first 10 or so years of my career were in the private sector, but I also observed that my colleagues in that space didn’t negotiate. I remember being in the an office with several of us doing the same job, but when the conversation turned to salaries (which we tend to avoid in Britain) I twigged I was being paid about 25% more than the person sitting across the room from me. The difference was that a) I did some modest negotiation and b) moved around jobs a bit, whereas they’d been there a long while and accepted what they’d been offered.
This example plays into the fact that, like it or not, your strongest negotiating position is when you join a new organisation, rather than when you are promoted within an existing organisation. That is annoying and unfair, but reflects the reality of every internal move I’ve made. That’s not to say that there is no scope for negotiation on an internal move, but your levers to pull are more limited. I’ll try and cover those in what follows.
Done right, this negotiation process will add to the positive impression you secured through the interview process (after all, that’s what got you the job). You’ll be seen as a professional who knows their worth, is confident to negotiate, but is able to compromise in a non-confrontational way. Done wrong, you’ll start sewing doubt into the mind of your new employer.
But this is not the moment to avoid it and avoid that potential peril. Like all the other stages that have got you this far, it is all in the preparation.
Waiting for the Call
My first piece of advice is to never accept the job when you get the call. Even if you’re absolutely certain you want to accept, please don’t! This is very tempting to do and you’ll feel you want to close down the uncertainty, particularly after the stress of the interview process.
Simply thank the caller, tell them how delighted you are to get the news and ask for a bit of time to talk it through with your family. If they start pushing you for an answer immediately, this is probably an early warning sign of the kind of person/organisation you’ll be working for. In my experience, no one has ever denied me this time, although some have reasonably asked for me to come back to them after 48 hours or after a weekend.
What do you want?
The process of negotiation is about knowing which things are your red lines and which things are you prepared to move on. You need to be realistic about what you ask for, based on the point you are in your career and the seniority of the job. The list below reflects things I’ve considered in my recent Exec roles, but the majority of them are pretty universal.
1. Salary
This is probably the main thing people think of when they think of negotiation, but this is only one aspect. The main things here is to have a sound justification for the salary point you’re proposing. My view is that you need to come straight out and state what you’d like to start on and why.
For NHS jobs, there is often very little movement in this area, but Agenda for Change does say it can be changed in “exceptional circumstances”.
1.9 Other than in exceptional circumstances, the starting salary for staff new to the NHS will be the bottom point of the band to which they have been appointed.
Source: https://www.nhsemployers.org/publications/tchandbook [accessed March 2024]
What are exceptional circumstances? I suspect different organisations view this slightly differently. I’ve certainly been involved in appointments of candidates not needing to start at the bottom of the band if they can demonstrate longer experience at that level. So think really hard about how you could demonstrate that e.g. other roles you currently do outside of your current job description, things across the ICS etc. In the Midlands Digital space for example, some colleagues lead Special Interest Groups for the Skills Development Network or do guest lectures at universities. All this can be built into your case. But remember that word exceptional and make sure you can build something credible.
For VSM jobs, I suggest doing some bench-marking of other similar jobs in the NHS. For Board-level roles, broad salary ranges are included in Trust annual reports, so it is quite easy to do your homework. Also, if you do role that is transferable into wider industry (HR, finance, legal, digital etc), then bring that wider industry bench-marking into play too. I’ve found good sources of information on the professional WhatsApp networks I’m part of. I’ve also noticed that some job recruitment sites also have some bench-marking information.
You’ll also want to take into consideration if this role will require additional travel costs or other expenses. When I took one role, I did extensive calculations of train vs car and other arrangements to check that the additional travel of the new role was actually not costing me money, which helped me work out my red line of absolute minimum salary.
Once you’ve done all that, draw up three numbers:
a) Salary you can’t go below without declining the offer (your red line)
b) Salary point you’d be happy to be pushed down to
c) Salary point that you’re going to start your negotiations using.
Having said all that, going back to what I said at the start of this section, many NHS organisations will not have any movement in this space, and even less scope when you’re making an internal move, so then you need to consider what other things would augment the offer…
2. Working Pattern
Will the new role require you to travel further and incur more travel costs or parking fees? Are there days when you have personal commitments in an evening/early morning that mean that it would be beneficial to work from home that day (assuming your job can indeed be worked from home). Will your new role require a longer commute than your current role?
This is also the time to consider term-time only working, school drop off, caring arrangements, compressed hours, 9-day-fortnights etc. Remember, this is your most powerful negotiating moment, so use it!
Again, this is about building a case. It helps to explain a bit why you think the working pattern you’re suggesting works for you, but most importantly, can you make it work for your employer? Can you demonstrate that you’ve performed to a high level working in this pattern in your previous role? Would your current line manager concur with this view? Would they be prepared to write you a statement along those lines?
3. Leave
Most basic thing is to declare any leave you already have booked and check your new organisation/role will honour that. There should be absolutely no problem with any organisation honouring pre-booked holiday and any challenges to this should be a strong warning sign that should cause you to question if this is a great employer to be joining.
This might also be the time to try and negotiate some additional days leave, particularly if there is no movement on the salary. Again, Agenda for Change is quite strict in this situation, but this is about building a case. Some employers make allowances for volunteering days that may be taken into account. In my case, the first NHS organisation I joined, kindly recognised some (but not all) of my previous years of public-sector experience outside of the NHS when calculating my leave entitlement.
4. Professional Development
Is there any professional development that you’re already signed up for, or was agreed as part of your last appraisal? Do you want to continue that in this new role?
Are there any development needs you’d want in this new role? What might they be? Make sure they are realistic and fully support your new role, rather than just something you fancy. This is a good time to get those agreed before you’re embedded in the organisation and so busy you can’t see the wood for the trees.
5. Visits/Chats with other people?
Are there any things that still are lingering doubts about the new role that are show-stoppers? You’ll have a chance to arrange visits during your notice period, but are there any things you want to confirm before you’d be prepared to say yes? This could be wanting to go and visit the environment, meet some of your potential new colleagues for coffee, talk to the person leaving the role. All of these are possible and valid, you just need to be honest about why you want to do it, be clear why it MUST be done before accepting the offer and be prepared to close off these visits/calls very quickly.
6. Salary Sacrifice Items
Adding this as this was a big one for me. The costs of transferring my car to a different salary sacrifice scheme were massive, so I needed to make sure that I could continue the same arrangements. Check if you have any salary sacrifice elements that need declaring.
7. Equipment/Tech
Are there particular things that you need as part of your job, or are not standard issue equipment, e.g. high-specification laptop or standing-desk. This is the moment to add those.
8. Reasonable Adjustments
You may have had this conversation already, but every organisation has the responsibility to make reasonable adjustments to support disabled staff. I think this is the time to have that discussion. Although there is a legal basis to this, my suggestion is that if you build it into your package of negotiation, it is part of the overall picture of what you’re agreeing in joining/moving.
9. Other Arrangements
Do you take part in some local/regional/national things that are beyond your job description, that you would like to continue? These things need to align to your new job, so you’ll have to make sure that works. This could be your role on a regional/national committee related to your role, it could be that a conference regularly asks you to speak, it could be that you do a couple of sessions a year guest lecturing at a university or college. As a result, you might be asking to claim for travel or accommodation in relation to those roles. It is important to declare these things and make them part of your negotiation. Generally, these things are easy for an employer to agree to, and it is important to have some things on the list that are easier than others, but I feel it is critical to declare them at this point, rather than revealing them a few weeks into the job, which could be seen (unwittingly) as disingenuous.
10. Contentious Stuff
And now into things that will be on the margins of many people’s experience, including mine. My advice is to tread carefully here.
One of the things expected/included in Executive/Senior roles is doing Gold On Call (aka Strategic On Call). I’m happy to do this, but am aware of some people negotiating not do do this. How acceptable this is will depend on the culture and norms of the organisation.
I am aware of people who have not managed to get where they needed to be on salary, but have used their bench-marking and other data to negotiate a Recruitment and Retention allowance. According to NHS Confederation:
Recruitment and Retention Payment (RRP) — are additions to the pay of a post or group of similar posts where market pressures would otherwise prevent the employer from being able to recruit or retain staff in sufficient numbers at the normal salary for jobs of that weight.
Source: NHS Confed [accessed March 2024]
So in the first instance, your new organisation will have needed to recognise your new role as being one that qualifies for RRP, so it is worth asking if you think it could be.
11. Executive Role Things..
One essential thing for me was to be able to continue my Executive coaching arrangement. My strong recommendation to anyone going into an Exec role, particularly for the first time is to have an Exec coach and ask for it as part of your negotiations. This should be a person who gives the right balance or support and challenge and is able to align the coaching they give you to the organisational aims. Don’t be surprised if your line manager wants to meet them — in fact, you should encourage it.
12. Feedback
Finally, you might also want to ask for feedback, even if you got the job. This is is an important element of understanding the gaps that your new employer/line manager sees in you and also gives you some concrete development areas to get in your first set of objectives.
Approaching the Conversation
You’ll need to make sure you’re talking to someone who can make decisions. This ought to be your new line manager if at all possible.
My suggestion is to write all these things down in a numbered list, along with your supporting narrative. You need to approach this conversation carefully — you want your new employer to come away with the impression that you are simply a person who knows their worth, is flexible in their expectations and deals with negotiations in a professional and non-confrontational way. The last thing you need is them to think you’re a pain in the backside already.
So in the first instance, I’d suggest carefully writing a script, something along the lines of:
- I’m absolutely delighted to get the job offer and so are my loved ones. Thank you for giving me the time to consider the offer.
- There are a few things I’d like to discuss as part of the offer, can I go through them now?
- Go down your list in turn, super-professionally, explaining each one in turn
- Seek understanding of what are the next steps to the things you’ve raised
- Reinforce how pleased you are about the role, and how you know you’ll be able to make a great contribution
- Still don’t accept the job
The Conversation
As you go down your list, don’t expect them to respond in detail to any item at that point on the call, just give them an opportunity to ask questions. Some may do, but often your new line manager will need to check things out with HR, their boss, or finance or all three.
Follow up the conversation with an email that sets out which things you’ve discussed, and if any were accepted on the call. I’d phrase those things as “it is my understanding that we accepted this on the call”, to avoid any assumptions. Don’t add anything into the negotiation during this back and forward that you didn’t declare during the first conversation.
The Close
It may be that your conversation initiates quite a few backwards and forwards conversations or email exchanges. Hopefully that will be swift and you’re able to get to a point where both parties are happy.
At some point you’ll need to close the negotiations. My strong suggestion here is that you get what you’ve agreed in your contract, or if the contract is the broadly the same for all employees, then you have an additional side letter or at the very least an email summarising the final agreements. This is important, as after all your negotiation with your new line manager, you don’t want to have those things agreed evaporate or be questioned if the person you agreed it with leaves.
At this point, you can now accept the job.
Next Steps
Once you have a signed contract, all you need to do is hand in your notice and start planning to not suck at your first 100 days in the new job…
