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Fair pay in the NHS

Find out how we’re fighting for pay reform 

We're done fighting for scraps. It's time to break away from a pay cycle that devalues nursing.  

For years, governments and health care systems across the UK have undervalued nursing. While you've taken on more responsibility, your pay has fallen in real terms.

You've sent a resounding message in recent pay consultations that you want lasting change, and we've told governments they have a small window to act.

See what we're demanding and how to stay up to date and involved. 

Pay reform in the NHS: the first steps towards change

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Equal pay progression after training

Midwives and paramedics benefit from career progression after their preceptorship. Nurses must have this opportunity too. 

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Payment for every hour worked

Unpaid work and reduced bank rates are serious issues in the NHS. Nursing staff must be paid fairly for this 'invisible' work. 

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Job evaluation that works

Our profession has evolved, but job descriptions haven't kept up. New nursing role profiles must be implemented now with full funding.

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Timely, above-inflation awards

Every year, pay awards must meet or exceed the cost of living and prevent further real-terms losses for nursing staff. 

Annual pay awards alone are not enough 

The systemic undervaluing of nursing won’t be addressed by annual cost-of-living awards alone. We're fighting for bigger change to turn our profession around and ensure we are properly valued for the work we do.

That means long-overdue structural reform of NHS pay in every country of the UK. This includes using Annex 20 for band 5-6 career progression and ensuring all nursing roles are evaluated against new nursing job profiles with full government funding. 

Nursing pay around the UK and Crown dependencies

England

What's happened so far?

Our members voted in record numbers to tell us that the government's NHS pay award of 3.6% is simply not enough.

What's happening now?

While we’ll continue to push for the pay award you deserve year on year, we recognise that no cost-of-living award will ever be enough to reform a broken pay structure that undervalues nursing.

We've been meeting with government ministers, seeking the investment the nursing workforce urgently needs. We’ve told them they have a short window to do so to avoid escalation into a formal dispute.

We've joined 13 other health unions to call on the Westminster government to urgently begin promised direct talks on NHS pay reform and future pay awards.  

Northern Ireland

What's happened so far?

We consulted members on the recommended award in summer 2025. They told us that even if funding were made available, 3.6% would not be enough.

What's happening now?

We're in formal dispute with the Northern Ireland Executive and HSC employers over the lack of a 2025-26 pay award for HSC nursing staff.

Despite the Northern Ireland Health Minister saying he wants to pay HSC nursing staff the recommended 3.6% pay award that NHS nursing staff in Wales and England have received, no funding has been made available by the Northern Ireland Executive.

Scotland

What's happened so far?

We consulted our members in Scotland who accepted the Scottish government’s NHS pay offer of 4.25% for 2025-26 and 3.75% for 2026-27. The offer also included an inflation guarantee to ensure the increase in pay each year is a minimum of one percentage point higher than average Consumer Price Index (CPI) inflation.

What's happening now?

While an annual cost-of-living increase has been agreed for 2025-26 and 2026-27, we continue to push for structural reform of Agenda for Change terms and conditions agreed in the previous 2023-24 pay deal. We've seen significant success with the review of band 5 nursing roles, but we need more members to apply to have their role reviewed and the decision-making process to speed up. We're also pressing health boards to ensure all members receive the protected time for learning they are now contractually entitled to.

We've been clear with Scottish government and the health boards that the full 1.5 hour reduction in the working week must be implemented on 1 April 2026. Looking ahead, we expect the new Scottish government, elected in May, to commit to entering direct negotiations with the RCN and other health trade unions as quickly as possible to enable us to reach a pay settlement in advance of 1 April 2027. 

Wales

What's happened so far?

Our members voted in record numbers to tell us that the government's NHS pay award of 3.6% is simply not enough.

What's happening now?

We’ve told government ministers they have a short window to reach agreement on investment in the nursing workforce, or risk escalation to a formal dispute.

Crown dependencies

What's happened so far?

Jersey

Members accepted a three-year deal of pay increases beginning in 2024 and extending until 2026. The current pay offer is: 2024 – A pay increase of 8% (consolidated) 2025 – A guarantee of RPI + 1% (RPI as at September 2024) 2026 – A guarantee of RPI + 1% (RPI as at September 2025).

Guernsey

Members accepted a one-year pay offer that will uplift all pay and allowances by 5% from 1 January 2025. 

Isle of Man

In November 2024, members employed by Manx Care voted to reject a 4% pay uplift with effect from 1 April 2024. 70% of those who voted in a subsequent indicative ballot said they would consider strike action.

What's happening now?

Jersey

Pay negotiations for 2027 and beyond will begin again in 2026.

Guernsey

Pay negotiations for 2026 and beyond will start later this year.

Isle of Man

We're continuing discussions with Manx Care. Members have already been awarded and paid 4% but a final offer still needs to be agreed for 2024/25. No offer has been made for 2025/26 that we can ask members to vote on.

Strikes: are they on the horizon?

We've been crystal clear: government ministers must reach agreement on investment in the nursing workforce. If they fall short, we could escalate the vital issue of nursing pay by raising a formal dispute and asking you to vote in an industrial action ballot.

This is already happening in Greater Glasgow and Clyde, where some district nurses have been denied proper job evaluation by their health board. Members have told us they would be willing to take strike action.

Make sure we have all the essential details for you to take part in upcoming ballots by updating your record with us.

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