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Our biggest ever strike ballot is now closed, and members at the majority of NHS employers across the UK have voted to take strike action in their fight for fair pay and safe staffing.

We’ve repeatedly demanded that governments protect the health service, patient safety and the wellbeing of nursing staff by giving them an adequate pay rise of 5% above inflation. So far, all NHS pay offers and awards mean nursing staff across the UK face another real-terms pay cut.

What do we mean by a real-terms pay cut? 

Pay rises above inflation are called real-terms pay rises because yearly wages increase more than inflation (a measure of the change in the cost of living). When pay rises are below the level of inflation, they can be considered real-terms pay cuts as prices are rising quicker than yearly wage increases, which means your income won’t go as far. 

When does inflation happen? 

Prices for goods and services can always change, they can rise and they can fall. However, inflation happens when there is a broad increase in the prices of goods and services, not just of individual items. Essentially it means you can buy less for £1 today than you could yesterday.

How is inflation measured? 

The Office for National Statistics does a monthly record of the cost of more than 700 items that people regularly buy, such as a loaf of bread or items of clothing and it tracks what the cost of the basket was with what it was a year ago. The percentage change is the rate of inflation and this figure is updated monthly.  

There are also several different types of inflation calculation and while all these measures of inflation use that shopping basket of goods and services and how they have changed over time, they take different approaches. The RCN refers to the Retail Price Index (RPI) when calculating the impact of inflation on nursing staff earnings.  

An example of inflation: if a bottle of milk costs £1 and that rises by 10p compared with a year earlier, then inflation for the cost of milk is 10%. The current level of RPI inflation is 12.3% (as of August 2022). 

RPI includes housing costs such as mortgage interest payments, which means it tends to be higher than the Consumer Price Index (CPI) measure of inflation, which doesn’t include housing costs.

How is this relevant to our fight for fair nursing pay?  

Our strike ballot was called in response to the latest NHS pay award for staff on Agenda for Change contracts in England and Wales, and the NHS pay offer in Scotland. Nursing staff in Northern Ireland have yet to receive a formal pay offer for 2022/23 due to the absence of a functioning Northern Ireland Executive. 

The UK government has given NHS staff in England a pay rise of £1,400, enhanced for the top of bands 6 and all points of bands 7 so it is equal to a 4% pay rise. The Welsh government has matched this for NHS staff in Wales. The Scottish government has offered a pay rise of 5% for the majority of NHS staff on Agenda for Change contracts.

What’s the current real-terms pay cut? 

We had asked for a fully-funded pay rise of 5% above inflation for NHS nursing staff across the UK, to combat years of wage stagnation and the cost-of-living crisis. 

At the time of the pay award in England and Wales, the rate of RPI inflation was running at 11.7% meaning that the pay award falls well short of what is needed to keep up with the cost of living. In fact, the impact on the take-home pay of a nurse employed at the top of Band 5 was a real-terms pay cut of over £1,000. The pay offer in Scotland also represents a drop of over £1,000.  

A succession of below-inflation pay awards over the last decade has resulted in NHS Agenda for Change salaries worth on average 10% less in real terms than they were 10 years ago. 

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