‘A betrayal of nursing staff’: RCN responds to government pay evidence

The Department of Health and Social Care (DHSC) has submitted its evidence to the NHS Pay Review Body (PRB) for the 2027/28 pay round, which sets out the DHSC funding for pay recommendations for staff in England on Agenda for Change (AfC) contracts. For nursing staff, the figure proposed was 2.4%. 

Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “A proposed pay award of 2.4% is on course to be below inflation and would be a betrayal of nursing staff in our NHS. It would see living standards fall for the largest workforce in the health service, doing nothing to address more than a decade of collapsing real-terms pay.

“Our hundreds of thousands of members working in the health service will be furious today, and they are right to be."

The government's evidence submission is its formal case to the NHS PRB, setting out what it believes NHS staff should be paid and what it says the health service can afford. The PRB then considers that evidence alongside submissions from unions, employers and other stakeholders before making recommendations on NHS pay.

The RCN, with 13 of the 14 health unions, has withdrawn from the NHS PRB process as we believe it’s not fit for purpose and fails nursing staff.

“We will not entertain this sham PRB process, nor allow ministers to hide behind it. NHS pay is their responsibility, and they will have to do much, much better than this. Ministers should negotiate directly and reach a fair agreement that puts the NHS on a better path and values the staff who work within it,” Nicola said.

The evidence submission comes after months of growing pressure from the RCN and other health unions over NHS pay in England. 

In February 2026, the government announced a 3.3% pay award for AfC staff in England for 2026/27.

A month later, the RCN joined 13 other health unions in challenging the award, arguing it failed to keep pace with inflation and calling for wider pay reform, including changes to career progression and the AfC structure.

In July, the government launched the 2027/28 pay review process, a move which we criticised. We said talks on AfC reform should conclude before the next pay round begins.

Nicola said: “When the prime minister took office, nursing staff said they would back him if he backed them, but his government is in danger of proving it’s no different to the ones that came before.

"Our female-dominated profession, performing the majority of care in every service, isn’t a cost centre but an investment. We deserve respect and fair pay, and patients want that for us, too.”

We’re encouraging members to ensure their roles are reviewed against new nursing job profiles. Also, following commitments from the Westminster government to review band 5 nursing roles in England, we believe accurate job evaluation will be crucial to ensuring staff are paid and recognised appropriately for the work they do.

Make sure your details are up to date to receive the latest information on your pay and job evaluation.