The UK's largest health union is to ballot members on whether they are prepared to accept an improved NHS pay offer.
Nurses in England are still being offered a staggered 2.5% pay deal, but all those in pay bands 5 to 8a will be given £38 towards professional fees.
The agreement will also help low-paid staff in pay bands 1 and 2 who will be guaranteed a £400 bonus.
Unison lead negotiator Mike Jackson said: "The package on offer is a complex one, and will mean different things to different NHS staff depending on where they live.
"This is still a below-inflation deal for most, but it is the best offer we are likely to achieve through negotiations, and we will be balloting our members over whether they wish to accept it."
In addition to the improved pay offer, unions, employers and the government have agreed to enter into talks, prior to the next pay round, to consider improvements to the Agenda for Change pay structure and its terms and conditions.
Health Secretary Alan Johnson said: "I have pledged to listen to front line NHS staff and work with them to provide a health service that meets everyone's needs.
"This offer preserves the tough line on public sector pay which we have had to take this year, but I believe that it will help low paid staff on the first rung of the career ladder, not only through improved pay, but also through help with training."
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Is an additional pay bonus enough? Do you think this offer is acceptable? (Please supply your comment, name and location in the feedback box below. Your details will not be published if you so request.)
Your comments: (Terms and conditions apply)
"I agree wholeheartedly with the comment from the practice nurse. I work for a single-handed GP and I have been informed that there is no money for any pay increase. I did protest but 25p per hour was the final result! I also cover his mornings when he is on leave - about 8 weeks each year so he saves money by not paying a locum all day. I shall soon give up but I do enjoy, for the most part, seeing patients. I feel trapped!" - Name and address supplied
"This offer is a joke and the bonus will feed my family for two days. I have been qualified for 20 years and deeply regret entering the nursing profession. I would never wish for my children to enter the NHS. THis shows how low the morale of myself and many of my colleagues has become. I would love to change career but obviously I am trapped due to financial outgoings. Despite nursing for 20years I still rent my home and have not had a holiday for 6 years. Also I have just received my latest invoice from the MNC, shocking" - Name and address supplied
"Withdraw the funding we supply to the Labour party if they cannot see fit to give staff a decent pay rise" - Name and address supplied
"Why have the army been given 10%? They put their lives in danger and do a difficult job, but NHS workers at every level save lives as well as help patients during their stay in hospital, so why is there such a big difference in wage increases? Well I think that someone up there thinks that health workers are just idiots" - Mr Smith, London
"Here we go again. I feel used and abused. Are we professionals? We are not treated as such. Agenda for Change is a waste of time, only good for the politicians and managers. It gives them something to do, poor things" - Name and address supplied
"Absolutely not, it's an insulting offer" - Name and address supplied
"Not only is it awful the way we are treated, it takes the biscuit when we still have not received any pay increase whatsoever" - Laura, paediatric nurse, Coventry
"As a practice nurse, employed by my GP, I have been informed that there is no money to give anyone a pay rise. While I still believe the national offer is, once again, too low, I'd actually be glad to get anything" - Name and address supplied
"No. The 2.5% was already an insult. It is obvious what value our so-called bosses place on frontline workers. It's a disgrace to keep expecting higher standards and qualifications and an increased workload for a paltry 2.5% which will be staggered. We are taking on more and more of the work traditionally done by doctors and receive no recognition or reward" - Name and address supplied
"I think that it is about time that nurses got their fingers out and stuck up for themselves. I think this 2.5% and updated pay offer is an insult. Nurses have a difficult enough job and are just looking for their pay to reflect their responsibility" - Gillian Cunningham, Addiction nurse, Glasgow
"The offer is not acceptable. Not only are we having to endure, yet again, conflict over a pay rise in line with inflation, despite meeting targets asked of us and saving as much as we can, but we are also in the midst of "skill mix" reviews, which for the band I am on will mean I will have to be reintervied for my own job. Mr Johnson is already showing signs and symptoms of being every bit as useless as Patsy [Patricia Hewitt]. No wonder nurses are leaving the profession. Very sad times indeed, and it could all be avoided" - Name and address supplied
"I think nurses deserve more, we are doing more of the doctor's work and generally not paid for it. This is a better offer but once again we have slipped behind for so long. As a nurse qualified for 35 years I have seen a great deal of change, not for the best sadly" - Name and address supplied
"The worthy principles of Agenda For Change were abused from the beginning by health boards who have used it to balance their budgets. Staff have been slotted into pre-arranged bands, regardless of what skills, knowledge and efforts are required to do their jobs, to suit the money available. So why the big show otherwise, at a huge cost? So it can be claimed that it was done in partnership with employees and unions. As a union activist, I was horrified to witness the "talking down" of front line jobs to suit a national profile that bears no resemblence to what is expected and required of a post. Conversely, the "talking up" of other posts to maintain existing status and hierarchies was incredible. I saw job descriptions being reviewed again and again until a panel agreed with what had been predetermined. Disgracefully, many of our union representatives are involved in this charade, taking partnership working to a new low. Of course staff at operational level are aware of budget requirements, but the cynical manipulation of, for instance, band thresholds to keep a majority of dedicated staff in many areas trapped in a band well below what they actually merit is an injustice. The doers in the NHS have been sacrificed to disproportionately hugely reward those who claim they tell us what to do. Now we're faced with an insulting pay rise and it appears half hearted representatives who expect us to be grateful for the crumbs they may pick up" - Name and address supplied
"No, nurses in all parts of the UK with the exception of England are getting 2.5 %. Why can't we get the full amount which is still below inflation. Nurses are still being treated as 2nd class workers instead of professionals, especially in England. Why should there be a national discrepancy?" - Name and address supplied
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