Unions demand nurse pay talks after ‘inadequate’ NHS rise

The government has been urged to enter direct talks with nursing and health unions on reforming the NHS pay structure following what they describe as an ‘inadequate’ pay award for 2026/27.

The Royal College of Nursing (RCN), Unison and 12 other unions have written a letter to ministers warning that the 3.3% pay rise for NHS staff ‘is not enough’ and that health workers feel ‘angry and let down’ over the situation.

In a joint letter to health and social care secretary Wes Streeting, the unions said a 3.3% pay award fails to keep pace with the cost of living and was ‘not enough to restore what has been lost through pay erosion’.

The uplift for NHS nurses on Agenda for Change (AfC) will be imposed from April. Meanwhile, general practice nurses (GPNs) are yet to hear anything on what a pay rise might look like for 2026/27.

The government has long promised negotiations to improve the AfC pay structure, the unions said, with any increases meant to be backdated to April should a deal be reached.

Related Article: Nursing in Practice takes general practice nurse pay concerns to Parliament

‘But these talks on the pay structure were first promised more than 18 months ago, and that delay means confidence has been seriously damaged,’ they wrote.

‘For trust to be rebuilt, progress must happen quickly, and you must provide clarity on how these negotiations can improve on what staff have seen so far.’

It was revealed last month that the Department of Health and Social Care had agreed with the RCN and other unions to introduce a string of career and pay promises for NHS nurses on AfC – though this excluded most nurses working in general practice.

As part of the announcement however, plans to establish a single national nursing preceptorship to support newly registered nurses was also unveiled, and it was confirmed that this would be applicable for GPNs.

Today’s letter from health unions, of which NHS staff are encouraged to sign, once again criticises the government’s independent NHS Pay Review Body Process and highlights the stress and pressures faced by the workforce.

‘Day in, day out staff are battling understaffing, overwork and the constant worry that – despite their best efforts – patients are not getting the care they deserve,’ they wrote.

‘No one wants the NHS to succeed more than the staff who keep it running. But that requires a workforce that is properly valued and properly paid.’

RCN executive director of legal and member relations Jo Galbraith-Marten said: ‘3.3% isn’t enough and there is no excuse for government once again outsourcing responsibility for NHS pay to a failed Pay Review Body process.

‘Ministers should have negotiated with unions directly, as we requested multiple times. You simply can’t agree fair staff pay without talking to staff.’

Related Article: NHSE sets out instructions for trusts on Band 5 nurse role review

She added: ‘It’s clear that nursing staff are being failed on pay, which is why health unions are united in calling for direct talks to start swiftly on reforming the NHS pay structure.

‘All the evidence shows that the current system undervalues our highly-skilled female dominated profession and its safety critical role in today’s health service.’

Chair of the NHS unions and Unison head of health Helga Pile said: ‘For most NHS staff this will feel like a pay cut not a wage rise.

‘After years of rising pressure and falling wages, health workers expected better from this government.

‘If ministers really want the NHS to recover, they have to start by valuing the staff who keep it going.

‘There’s a lot riding on these talks. Real money on the table from government will be key.’

Related Article: NMC unveils ‘anti-racism’ principles for nursing practice and education

A Department of Health and Social Care spokesperson said: ‘This government hugely appreciates the incredible work of talented staff across our NHS, which is why we are working with the NHS Staff Council to reform the Agenda for Change pay structure and to prioritise increasing pay for graduates and the lowest paid members of staff.

‘Alongside these imminent talks, we have accepted the pay recommendation from the independent NHS Pay Review Body to deliver an above forecast inflation pay increase for the third consecutive year to 1.4 million NHS staff, including nurses, paramedics, midwives and hospital porters.

‘This pay boost will be in pay packets from April for the first time in six years, demonstrating our commitment to getting money into the pockets of NHS staff in a timely fashion.’