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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.

Read our case

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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.

Know your rights

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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.

Get informed

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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.

See what's happening

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.

Thanks to our sustained campaigning, the Westminster government has now committed to ensuring all nurses paid at a band 5 have their role reviewed, as well as other positive steps towards reform. 

Nursing pay around the UK and Crown dependencies

England

What’s happened so far 

In February, the Westminster government announced the 2026/27 NHS pay award will be 3.3%. The government misled unions to expect direct negotiations on a multi-year pay deal. Instead, it’s returning to a flawed NHS Pay Review Body process that has failed nursing staff.

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 delivered that message loud and clear to government ministers and, after months of discussions, the Westminster government has made three commitments to:

  1. increase graduate pay
  2. review the work and salary of every nurse paid at band 5
  3. establish a single national nursing preceptorship  

Get more information

What happens next? 

Your elected members will now consider the detail. They’ll look at whether this is fair treatment compared to other professions and sectors and understand what the government means when it asks for talks on reforming the structure of Agenda for Change.

But the evidence is clear – low pay and poor working conditions have brought morale down to a historic low and it won't be tolerated. 

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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What else we're demanding for nursing   

Respected as a safety-critical profession

Our campaign for proper recognition.

See our calls

Supported to thrive

Our campaign for a healthy, developed and supported nursing workforce.

Get involved

Safely staffed by law

Our campaign for safe and dignified care for every patient.

See how you can help

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