NHS Pay FAQs

RCN members who are employed by the NHS in England have received the result of the strike ballot for the NHS in England by email. If a member does not have an email address on their MyRCN record, a letter will be sent to them providing the result. As this ballot was aggregated, only one overall report is provided relating to the entirety of the England ballot. There is only one single result in respect of this ballot. 

This statutory ballot took place on an aggregated basis.

This means that the threshold that we needed to meet – 50% of members voting and the majority of them voting for strike action – applied to the entire voting membership. Therefore, there is one result from this ballot for all RCN members employed by the NHS in England.

Over 120,000 of you voted. Draconian strike laws mean that over 140,000 ballot papers needed to be returned in the post and as a result we do not have the mandate to take more strike action at this time.

This was unlike the strike ballot carried out in 2022, when the same threshold applied to each NHS employer, which meant that we achieved a mandate to strike at some employers but not others.    

To get the government back to negotiations, we needed to show even greater strength than we have to date. In this strike ballot we sought a country-wide mandate that would have allowed an even larger strike than RCN members have managed until now.

Our result shows that thousands of members are ready to vote in a ballot just like this, despite the stakes being much higher. The fight for fair pay and safe staffing has never been contingent on striking, and despite this result we will build on the power we’ve built in this campaign to achieve the change that each member deserves. 

Nursing staff working in every setting and employer deserve fair pay. The RCN will continue to campaign for fair pay in all of settings, both in and outside the NHS. Members will hear more soon on new campaign activity and how members can take practical steps in their workplace to apply pressure and secure meaningful changes to job descriptions, roles and consequently levels of pay.

Alongside the government's pay offer, in a separate letter to the RCN, the Health Secretary committed to consider whether a separate pay spine for nursing should be established to address specific challenges faced by nursing staff. The government has confirmed its position has not changed. The RCN is clear that too many nurses are stuck at pay bands that do not reflect the responsibility and complexity of their roles. Additionally, our work through the NHS Staff Council on nursing job profiles and ongoing work on job evaluation remains a high priority.  

Members working on Agenda for Change terms and conditions in the NHS in England will not be balloted again about the 2022/23 or 2023/24 pay offer. Members will always be consulted on substantial changes to their pay, terms and conditions.

The law requires a strike ballot to be conducted by post. Every effort has been made by the RCN and our independent scrutineer, Civica Election Services, to send a ballot paper to any member who was eligible to vote as of 11.59pm on 14 May. This also includes members who requested a replacement ballot paper. Once ballot papers have been posted by Civica Election Services, the RCN and they no longer have control over the ballot paper’s arrival or return. The RCN is clear that the stringent law that requires statutory ballots to be conducted by post are designed to limit our ability to achieve strike mandates.

It has also been the case that some members who reported their ballot paper did not arrive were in fact not eligible for a vote on this occasion based on their current employer; the data held on their RCN membership record about their accurate place of work; or membership status, such as being in payment ‘arrears’.

To have been eligible to vote, members must have been:

• Employed in the NHS on an Agenda for Change contract AND
• Have ensured their MyRCN record showed they are employed in the NHS before 11:59pm on 14 May 2023
• Have become an RCN member before 11:59pm on 14 May 2023
• Have been up to date with membership payments as of 11:59pm on 14 May 2023  

No. The RCN’s first strike mandate, which applied at certain employers across England, expired on 1 May 2023. The ballot that has just been conducted was to provide a new mandate to strike at every employer where RCN members are employed. in England. This ballot was ‘aggregated’, meaning it would have given us a mandate to strike everywhere or nowhere in England. As the legal threshold required to take strike action was not met, the RCN cannot take lawful strike action anywhere in England.

As an RCN member, you should attend work as normal when another union is organising industrial action. We also recommend that you:

• don’t take on any work outside of your professional remit on the days of industrial action
• don’t cover the work of colleagues taking industrial action, if that work falls outside your contract or remit
• don’t take on any voluntary overtime work to cover the work of those taking industrial action.
• avoid taking any bank or agency work to cover the work of those involved in the industrial action.

For full guidelines, read our publication on industrial action by other unions.

NHS Employers have confirmed that the additional payments for the previous pay year (2022/23) will be paid as a non-consolidated lump sum, and the new salary rates for this year (2023/24) will take effect from 1 April 2023. 

Eligible staff can expect to receive the additional 2022/23 payment and the new 2023/24 pay rates (including back pay to 1 April) as part of their pay in June.

You can find more information about how the offer will be implemented in the NHS Employers FAQs.

We understand that bank workers and some of those employed in NHS funded organisations with Agenda for Change terms and conditions have been told they will not receive the non-consolidated lump sums and/or the consolidated uplift for 23/24 as it is not being centrally funded. The RCN is continuing to engage with the government and employer organisations regarding this issue. If you have received a ballot to vote in the current strike ballot, please vote and return your ballot today to show how strong the voice of nursing is. 

The government and NHS employers unilaterally decided that only those directly employed in the NHS as of 31 March 2023 are eligible to receive the payments. This was not agreed by the RCN. We appreciate this is frustrating for those who left shortly before that date. The government and employers have confirmed they are not willing to move this date or take account of individual circumstances.

No. The government and NHS employers decided unilaterally not to provide the funding to enable independent employers delivering NHS services to pay the non-consolidated element of pay award. This RCN remains committed to demanding fair pay for nursing, wherever you work.

The RCN is clear that the non-pay elements of the offer – including a policy framework for safe staffing, and a separate pay spine for nursing – must be kept and built upon in future negotiations.

If you provide NHS care but are not directly employed by the NHS, have a dynamic Agenda for Change contract, or are a member of bank staff who has been denied all or part of the NHS pay award you can use these letters to query the implementation of the pay award with your employer.

If you work for a Social Enterprise or CIC delivering NHS care, you can also encourage your MP to speak with the Secretary of State regarding inconsistent implementation and funding of the NHS pay award.

Employers have local discretion to pay the award if they choose. If you employer has chosen not to pay the award and your career break was to facilitate caring responsibilities, we can assess your case to assess the potential for unlawful discrimination. Please contact RCND for advice and support.

Employers are entitled to deduct pay when you take strike action. In addition, staff required to work on a public holiday are entitled to equivalent time to be taken off in lieu. However, you are only entitled to time off in lieu if you work on a bank holiday. Therefore, if you participated in strike action, your employee is entitled to deduct pay and you would not be entitled to any time off in lieu. 

No. The NHS pay award only applies to staff directly employed by the NHS on Agenda for Change terms and conditions. GP nurses are generally employed by the GP practice they work for therefore, most GP nurses are not directly employed by the NHS and will not automatically receive the pay award.

A small number of GP nurses are directly employed by the NHS on Agenda for Change terms and conditions and if this is the case, you should receive the pay award. 

This depends on how you were transferred:

• 'Static' transferees will not receive the pay award because the terms of your transfer effectively freeze your pay and conditions at the point of your transfer. This means that you do not automatically benefit from subsequent pay awards.
• 'Dynamic' transferees should receive the pay award because your terms and conditions should continue to mirror those in the NHS. However, the government has not yet committed to fully fund their pay offer and the RCN is pressing government to make the necessary funds available.

If you are unsure of your transfer status you can check your contract of employment or speak to your local HR officer.

Your pay is determined by your employer and not by the NHS pay review body or the recent NHS pay negotiations. However, we know that many independent health and care employers use NHS pay as a benchmark in setting pay and increases in NHS pay often lead to increases in pay in other parts of the health and care sector. We've always called for pay parity between the NHS and every other setting and we continue to support non-NHS members in seeking appropriate recognition in their pay and working conditions for the complex expert care they deliver.

Members who are employed on Agenda for Change terms by an NHS employer with whom we are in dispute. NHS Employers for the purposes of industrial strike action are those organisations listed in Annex 1 to the NHS terms and Conditions of Service handbook.  

NHS Professionals is not an NHS Employer because the organisation is not listed in Annex 1. 

Yes. You have legal protection from unfair dismissal if you’re participating in official and lawful strike action.  

Nursing staff in Northern Ireland went on strike in 2019.

Members who are employed at a particular workplace. The Code of Practice on picketing recommends that 6 people form an official picket line at any one time.

If you do not form part of a picket line, you can support those who are in other ways, for example by providing food and drink.

Please refer to annex B of the RCN Industrial Action Handbook. 

No. You can only strike if you are on duty on a strike day. But you can support your colleagues and the cause in other ways. For example, you could provide food and drink for those on a picket line, post about strike action on social media and speak to colleagues about being an RCN member. 

No. You can only strike if you are on duty on a strike day. But you can support your colleagues and the cause in other ways, if you feel well enough. For example, you could provide food and drink for those on a picket line, post about strike action on social media and speak to colleagues about being an RCN member.

You will be able to strike if:

• your employment with an NHS employer has started and
• you are scheduled to be at work on a day when strike action is called. 

You will be able to strike if:

• you are an RCN student member or apprentice and
• you are directly employed by an NHS employer and
• you are on Agenda for Change terms and conditions.

This may include bank contracts. However, please check your bank contract. You must be employed by an NHS employer on Agenda for Change terms and conditions, and not an internal pay or bank system that differs from the NHS terms and conditions.

You will be able to take industrial strike action if your employment with an NHS employer has commenced and you are rostered to be at work on a day when strike action is called.

Every member is entitled to take industrial strike action following a lawful and successful ballot, and if called upon to do so by the RCN.

No. You can only strike if you are on duty on a strike day. However, you can support your colleagues and the cause in other ways. For example, you can provide food and drink for those on a picket line, post on social media about strike action and speak to colleagues about being an RCN member. 

Non-RCN members taking part in RCN industrial action 

Members from other unions may decide to strike on the days of RCN strike action. But this is not an official request from the RCN, and any consequences that may follow will be a matter for the individuals concerned.

RCN members taking part in industrial action organised by another union 

As an RCN member, you should attend work as normal when another union is organising industrial action. We also recommend that you:

• don’t take on any work outside of your professional remit on the days of industrial action
• don’t cover the work of colleagues taking industrial action, if that work falls outside your contract or remit
• don’t take on any voluntary overtime work to cover the work of those taking industrial action. 
• avoid taking any bank or agency work to cover the work of those involved in the industrial action. 

Yes, provided the ballot at your workplace has met the required legal thresholds.

No. Members can vote for strike action but taking part on a specific strike day is a decision for individual members. Voting ‘yes’ in the strike ballot increases the pressure on the government to fund fair pay for nursing staff.   

Members can only be on strike if they are on the rota for the day(s) of action. If members have multiple workplaces that are called to strike on the same day, members should support the picket activity at the workplace they were due to be at that day. 

We welcome public support for strike action. Only those members who are employed where strike action is taking place can formally participate in a picket line. However, you will be able support pickets on the day(s) of action. 

You should attend work as normal because failure to do so could be seen as a breach of contract. You could stop at any picket line on the way into work to show support for striking colleagues. You could also visit picket lines during your lunch and break times and can offer support by taking refreshments to striking colleagues.

You should not cover the work of striking colleagues. You should attend work as normal and undertake your normal contractual role. 

You cannot be made or required to undertake work that is outside of your contract of employment. You should support the lawful industrial action of colleagues by not undertaking extra contractual work and/or voluntary overtime. 

When deducting pay for participating in strike action NHS employers should only deduct a calendar day’s pay either 1/365th of your annual salary if you are paid monthly, or 1/30th or 1/31st of your monthly salary, depending on the number of days in the relevant month if you are paid weekly.

Any enhancements expected for working on a public holiday, bank holiday or unsociable hours would not be paid, but only basic pay would be deducted.

If you have seen the incorrect amount deducted from your pay due to strike action, please use these template letters to address the error with your employer.  

No. Taking industrial strike action does not break continuous employment if you return to work after the strike ends. Taking strike action will not impact your entitlement to earned benefits through continuous service, such as paid sick leave or maternity leave. However, days of strike action do not count towards relevant qualifying periods for certain statutory rights.  

Most employers respect the rights of workers to strike. An employer could try to discipline you for striking but it would have to take action against every employee. To do so on a large scale would be counter-productive and create further unnecessary industrial unrest. That’s why we believe disciplinary action is unlikely.

If you take part in lawful industrial strike action, you’re protected against Unfair Dismissal. It would also be automatically unfair to dismiss any member after 12 weeks if that member had stopped taking part in strike action within the first 12 weeks, or the employer had not taken reasonable steps to resolve the dispute at the date of dismissal.  

Any effect of strike action on your pension will depend on which NHS pension scheme/section you are in. 

1995 section:

 The calculation for pension benefit is based on your best pensionable pay of the last three years. Therefore, if you are not planning to retire in the next three years, taking strike action has no impact on your 1995 section pension benefit. If you are planning to retire within three years there may be an impact on your pension benefit. However, you can mitigate this either by using a previous year’s pensionable pay figure or making additional voluntary contributions to your pension if you chose. 

2008 section:

The calculation for pension benefit is based on ‘total reckonable pay’ which is the average of the best three consecutive years pensionable pay in the last ten. Each year’s pensionable pay in the last ten years before retirement is increased by cost of living to bring that pay figure up to what it would be worth on the day of leaving. Therefore, if you are not planning to retire in the next ten years, taking strike action has no impact on your 2008 section pension benefit. If you are planning to retire within ten years there may be an impact on your pension benefit. However, you can mitigate this either by using a previous year’s pensionable pay figure or making additional voluntary contributions to your pension if you chose. 

2015 scheme:

The calculation for pension benefit is based on the ‘build up rate’ which is a fraction of your pensionable earnings each year. In the 2015 scheme you earn a pension of 1/54th of your pensionable earnings for each year in the scheme. Therefore, taking part in strike action is likely to have a small impact on your 2015 pension benefit you can mitigate this by making additional voluntary contributions to your pension if you chose.

It is important to seek both pensions advice and financial advice before making any pension related decision.

Taking strike action will not impact most member’s entitlement to maternity pay. However, if you take strike action in the eight-week period before the fifteenth week prior to your expected week of childbirth, there may be an impact on the amount of maternity pay you receive. This is because your maternity pay is calculated based on your average weekly earnings and regularly paid supplements fo

When applying for indefinite leave to remain, you must provide a letter from your employer that details your absences from work. Absences from work to take strike action will not have a negative impact on your application.

When applying for indefinite leave to remain, your employer will provide a supporting letter confirming your gross annual salary. The letter must also confirm that your gross annual salary meets the salary threshold required by the Immigration Rules. Any reduction in your salary due to taking strike action will not have a negative impact on your application. 

For more information, see the government's 'Workers and Temporary Workers' guidance. 

Our strike benefit is not public funds. So if you strike and lose pay, you’re entitled to receive RCN strike benefit.

Nursing staff in independent health and care organisations deliver safety critical nursing care and they deserve pay, terms and conditions that at least match their colleagues in the NHS.

We’ve always been clear that what the government awards the NHS is an indication of what they believe nursing staff in any setting deserves. We've always called for pay parity between the NHS and every other setting.

We continue to support non-NHS members in seeking appropriate recognition in their pay and working conditions for the complex expert care they deliver.

For more information on our campaigning in this sector, see 'Our fight for fair pay in non-NHS settings'.