Nurses are furious after being awarded a pay deal less than doctors as workers are balloted over strike action.
The Government has announced a pay rise of 4% for doctors and 3.6% for other NHS staff in England, insisting it is offering a real terms pay increase for the second year in a row.
Health Secretary Wes Streeting said the government “was never going to be able to fully reverse a decade and a half of neglect in under a year”. The Royal College of Nursing called it “a grotesque decision to again favour doctor colleagues for higher increases than nursing and the rest of the NHS”.
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The Consumer Price Index (CPI) is the measure of inflation used by the Government and is currently at 3.5%. Unions prefer to reference the Retail Price Index (RPI) is a broader measure that includes owner-occupied housing costs like mortgage interest payments and is currently 4.5%.
Professor Nicola Ranger, General Secretary of the Royal College of Nursing, said: "This pay award is entirely swallowed up by inflation and does nothing to change the status quo - where nursing is not valued, too few enter it and too many quit. It is a grotesque decision to again favour doctor colleagues for higher increases than nursing and the rest of the NHS. Starting salaries for nursing staff remain too low.
"Nursing staff have suffered 15 years of pay erosion and this award is symptomatic of a broken system which erodes our pay each year and keeps nursing staff weighted to the bottom. Now, hundreds of thousands of our members in the NHS will be given a vote on this award. They will ultimately decide if it is enough and whether they feel valued."
The college led its members into the biggest strike in the RCN’s history in December 2022, when around 100,000 nurses walked out in a dispute over pay. However the leadership recommended members accept a 5% pay rise for 2023/24, plus a lump sum of at least £1,655, at a time of soaring double-digit inflation. Members voted to reject the deal by 54% to 46% but then a second RCN ballot to continue strikes failed to meet the legal turnout threshold of 50%.
In contrast the British Medical Association’s resident doctors - formerly known as junior doctors - remained out on strike right up until the 2024 and eventually received a 22.3% pay rise over two years including 2023/24 and 2024/25.
Resident doctors had already started a ballot for strike action before Thursday’s pay announcement which will give them a 4% rise plus a consolidated payment of £750. The British Medical Association (BMA) called on Health Secretary Wes Streeting to enter direct negotiations to "avert strike action".
Professor Philip Banfield, BMA chairman of council, said: "The Health Secretary can avert strike action by negotiating with us and agreeing a route to full pay restoration. Doctors' pay is still around a quarter less than it was in real-terms 16 years ago and today's 'award' delays pay restoration even more, without a government plan or reassurance to correct this erosion of what a doctor is worth. No-one wants a return to scenes of doctors on picket lines - we'd rather be in , in GP practices or in the community seeing patients, improving the health of the public - but today's actions from the Government have sadly made this look far more likely."
Mr Streeting said that the Government would not be able to "fully reverse a decade-and-a-half of neglect in under a year". He said: "These are thoroughly deserved pay rises for all our hard-working nurses, doctors and other NHS staff," he said in a statement. We inherited a broken health service with extremely low morale after years of pay erosion and poor industrial relations.
"Which is why, despite the difficult financial situation the nation faces, we are backing our health workers with above-inflation pay rises for the second year in a row. This Government was never going to be able to fully reverse a decade-and-a-half of neglect in under a year, but this year's pay increases - and last year's - represent significant progress in making sure that NHS staff are properly recognised for the outstanding work they do."
The Government accepted Pay Review Bodies’ headline pay recommendations for NHS staff. This will be 4% for consultants, specialty doctors, specialists and GPs, with dentists also receiving a contract uplift of this rate.
Most NHS are on the main ‘Agenda for Change’ contract including nurses, health visitors, midwives, ambulance staff, porters and cleaners and will receive 3.6%. The Government says this will mean the starting salary of a nurse will have gone up by around £4,000 over three years from £27,055 in 2022/2023 to £31,050 this year.
The Government accepted the pay awards which were the recommendations from pay review bodies which take submissions from unions, the NHS and government.
UNISON head of health Helga Pile said: “The absurd pay review body process has led to two different awards for employees. But the NHS is one team and should be treated that way. Nurses, porters, paramedics, healthcare assistants, cleaners and other workers on Agenda for Change contracts will feel less valued than their doctor colleagues. That will generate more discontent from an already demoralised workforce. So long as coffee shops, and parcel delivery firms pay more than the NHS, staff will go on leaving.
The union is balloting tens of thousands of NHS and ambulance workers between now and July 17. GMB national secretary Rachel Harrison said: "GMB has been notified of the 2025/26 pay award for NHS workers. We're pleased dedicated NHS staff will get their pay rise closer to their anniversary date than they have in previous years. The decision on whether this pay award is acceptable is for GMB members to decide."
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