Third of practice nurses go without pay rise for 2025/26

More than a third (34%) of nurses working in general practice have not received a pay rise for 2025/26, an exclusive Nursing in Practice survey has revealed.

Many general practice nurses (GPNs) have said they have gone without a pay rise for several years, warning that unless the situation is addressed GP practices could risk losing their nursing staff.

The findings come within a new Nursing in Practice report – General practice nurse pay: A salary survey of the profession 2026 – unveiled at our Nursing in Practice London event last week.

Based on a survey of almost 900 general practice nursing staff and informed by expert opinion, including from the Royal College of Nursing (RCN), the report focuses on GPN basic pay and salaries, annual pay uplifts, pensions, employment benefits, the additional roles reimbursement scheme and more. It follows on from our 2025 version of the salary survey and report.

The latest report adds weight to ongoing concerns around GPNs continuing to miss out on annual pay uplifts.

It found:

• A significant 34% of respondents said they had not received a pay rise for 2025/26 at the time of our survey in February 2026
• Some 61% reported they had been awarded a pay rise for 2025/26
• Of those who had received a rise, the average uplift was around 3% – coming in at less than the 4% recommended by the government in England for 2025/26
• Around a quarter of nurses either received a pay rise of either 2% or 3%.

Our findings reflect a pattern of previous years of many GPNs missing out on annual uplifts because of complicated funding mechanisms.

In January 2026, care minister Stephen Kinnock stressed that GP practices are expected to pass on government funding increases to GPNs, but acknowledged there is no contractual obligation for them to do so.

He explained that the 2025/26 GP contract had been uplifted by 8.9% and should be used to deliver a 4% pay rise for salaried and contractor GPs, as well as other salaried staff including nurses, in England.

Related Article: ‘Nursing is not just a career, it has a world of possibilities’

However, he reiterated that as GPNs are employed by independent GP contractors, the government cannot mandate pay parity with NHS nurses on Agenda for Change (AfC) contracts who are guaranteed agreed annual uplifts.

Those running GP practices often cite financial constraints that mean they cannot afford to pay GPNs in line with AfC.

Dr Sarah Jacques, co-GP lead for grassroots organisation Doctors’ Association UK, said the exclusion of practice nurses from AfC means their pay ‘sits within a very different system to hospital nursing’.

Writing for our report, she said GPNs are ‘absolutely central to the delivery of modern primary care’ and that GPs and practices ‘rely on their skill, continuity and patient relationships every day’.

However, she explained that ‘financial pressures’ present challenges for partners when it comes to practice nurse pay.

‘The reality is that practice nurse pay sits within a very different system to hospital nursing. GP practices are independent businesses operating under contract, and partners are responsible for balancing staffing costs against a fixed and often constrained funding envelope.

‘Unlike Agenda for Change roles, there is no nationally mandated pay scale or automatic uplift, which creates variability and, at times, inequity.

‘The challenge for partners is not a lack of willingness to reward staff, but the financial pressures practices are currently under.’

Dr Jacques stresses that despite the constraints, ‘the intention across general practice is clear: to retain and support valued nursing colleagues’.

For 2026/27, the government and NHS England have both reiterated that this year’s pay rise of 3.5% should be passed on to salaried general practice staff. But once again, GPNs are concerned they will miss out.

The RCN has also once again pleaded to the government to ringfence funding to ensure nurses working in general practice ‘receive the pay they deserve’.

In a foreword for our report, executive director of RCN England, Patricia Marquis, said: ‘Nursing staff are a constant presence in every general practice operation, but they continue to be left behind when it comes to pay.

‘Even when the government says they are entitled to a pay rise, too many are left without any increase at all, while the cost of living continues to increase.’

She urged the government and employers in general practice to ‘show they value their staff’, adding that ‘this starts with paying them fairly’.

Related Article: More than half of GPNs report working while feeling mentally unwell, finds survey

Many practice nurses reported in our survey that they had not received a pay rise for several years.

One GPN described missing out on annual pay rises as a ‘kick in the teeth’. ‘We feel undervalued and let down and I struggle to understand how GPs are not realising that in the very near future they will have no nursing team,’ they said.

Another added: ‘Practice nurses form the underpinning of care in general practice, but the role needs protecting with better employment terms and conditions in line with NHS staff, starting with the government ringfencing funds for annual staff pay rises.’

A nurse team lead suggested GP partners were making staff reductions to save money, meaning ‘above manageable’ workload for those remaining in post. This, coupled with ‘no pay rise in the last 18 months’, had made ‘practice nursing a very poor job’, they said.

Key findings from our report – including that nurses working in general practice are earning thousands of pounds less than those in secondary care on AfC terms – were unveiled at our Nursing in Practice London event last week.

This was followed by a keynote address from RCN chief executive and general secretary Professor Nicola Ranger who welcomed the report as an important publication.

Addressing a room of nurse attendees, Professor Ranger said she recognised that for GPNs, ‘pay is a significant issue’, with varying benefits when compared to colleagues working in the NHS on AfC.

‘I know that when it comes to your pay – and I’m absolutely delighted with the survey that Nursing in Practice did – and we hear it at the RCN, that particularly our GPNs and our community nurses and independent nurses, you are not being paid your worth and your value,’ she said.

As highlighted in the report, the RCN has called in the past for GPNs to be aligned to AfC, as well as for ringfenced funding to support general practice nursing and for a nursing seat on government negotiations.

Related Article: Practice nurses call for Agenda for Change terms and conditions to ‘feel safer’

Nursing in Practice has echoed these calls, backed by the evidence set out in the report, and has made three key recommendations.

The Department of Health and Social Care was approached for comment in relation to annual pay uplifts for GPNs.

To read the report and its findings in full, click here.

This survey was open from 9 February until 2 March 2026, collating responses using the SurveyMonkey tool. A total of 881 general practice nursing staff responded to these questions from across the UK, with the majority within England. The survey was advertised to our readers via our website and email newsletter, with a prize draw for £200 vouchers as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot.