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NHS pay in England: ‘We need formal negotiations now’
Pay reform talks were promised, now they need to happen, health unions say in a joint letter to the Westminster government
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The RCN has joined 13 other health unions in calling on the Westminster government to urgently begin promised direct talks on NHS pay reform and future pay awards.
In a joint letter to health secretary Wes Streeting MP, unions representing staff on Agenda for Change (AfC) contracts in the NHS in England urge the government to honour the commitment made last year to tackle the problems in the pay system that are harming staffing and morale.
For the first time, the majority of unions have also confirmed they will not take part in the NHS Pay Review Body (PRB) process. We will again refuse to submit evidence and have been severely critical of the PRB over recent years.
RCN Executive Director of Legal and Member Relations Jo Galbraith-Marten said: “Unions are standing together today and saying that there is no justification for outsourcing responsibility for NHS pay to a failed PRB process. We will not take part. The best way to deliver reform and a fair pay award is to negotiate directly with trade unions.”
This year’s pay award was rejected in record numbers, and we believe bigger change is needed to turn the profession around. To ensure that nursing staff are properly valued for the work they do, long-overdue structural reform of nursing pay in the NHS is needed, in every country of the UK.
Ministers separately promised they will ask the NHS Staff Council to negotiate structural reform, but they have still not provided a mandate for formal talks.
We believe talks should now be widened to also include the pay award for 2026/27. This needs to be decided early in 2026 if it’s to be paid on time in April, as ministers have committed to doing.
Unions say discontent with the 2025/26 pay award and the broken promises on talks have “heightened industrial tension” and time is running out.
Meanwhile, problems with AfC continue to mount. Pay bands no longer reflect the skills, responsibilities or autonomy of modern nursing roles. Tackling pay rises and structural reform separately makes little sense – a streamlined process is urgently needed.
Jo added: “Ministers promised talks on reform over a year ago. Since then, nursing staff delivered another damning verdict on pay. There is no excuse for wasting more time, we need formal negotiations now.
"Nursing has changed beyond recognition. It is a more skilled and autonomous profession, with much more responsibility. But the profession is still rooted to the bottom of the pay scale and unable to progress, with nursing pay stuck in a time warp as if the last 20 years of progress didn’t happen. The only way to recruit and retain the nursing staff we need is to deliver Agenda for Change pay structure reform.”
The NHS PRB is taking in evidence over the coming weeks to prepare its recommendation on 2026/27 pay.
