The Westminster government will soon submit its evidence to the NHS Pay Review Body (PRB). But let’s be honest – you already know what it’ll say.
It’ll talk about how big the NHS wage bill is, and cost-saving measures, but it won’t acknowledge the real value you bring to patients, families, and the NHS.
That’s why most NHS unions stood together to reject this flawed, failing, government-manipulated process. The PRB process has failed us – year after year, it keeps nursing at the bottom.
It doesn’t fix the crisis. It doesn’t value your skill. It doesn’t listen.
Nursing is worth more. You deserve a pay structure that recognises your true value. One that reflects your skill, your sacrifice, and your central role in society.
We’re continuing to make the case to the UK governments for wider reform – and every day that case gets stronger and harder to ignore. Earlier this year, members in England sent a clear message that 3.6% is not enough. It was a resounding message from our members: we will not fight for scraps anymore.
The current pay framework is broken and long overdue reform to the pay structure is needed. Agenda for Change was introduced more than 20 years ago.
Since 2018, the Nursing and Midwifery Council’s updated Standards of Proficiency have acknowledged the dramatic evolution of nursing practice – yet pay structures remain frozen in time.
Nursing became a graduate profession in 2013, but the Agenda for Change framework has failed to keep pace. While qualifications, responsibilities, and pressures have intensified, the career support and progression pathways for newly registered nurses have stagnated. This disconnect between professional development and pay progression is not just outdated – it’s unjust.
Now, nursing is stuck in a bottleneck, with staff waiting years for progression while their responsibilities and clinical expertise grow daily. Too many nurses begin and end their careers at band 5. We can and must break out of the cycle of decline.
Nursing has been cut, squeezed and devalued
These challenges stretch to every corner of the UK. Long-overdue structural reform of nursing pay in the NHS is needed in every country. Nursing staff in Scotland, Northern Ireland and Wales face similar pressures due to the state of Agenda for Change pay structures. Each and every member of the nursing profession, in every setting, deserves a future where their value is recognised and rewarded.
A yearly pay award will not solve this. That doesn't mean we won't demand better. But that we have bigger, bolder and more urgent ambitions for our profession.
We need structural reform that goes beyond percentages. We need swift, meaningful and fully funded pathways to progression between bands that recognise the increased skill, knowledge and responsibility of roles in nursing. Crucially, all nursing staff must be on the correct band, reflective of their responsibility. That includes addressing the bottleneck in nursing progression from band 5 to band 6. We also need a fair approach to overtime and unsocial hours for all nursing staff.
This isn’t just about fairness. Nursing has been cut, squeezed and devalued. You're asked to deliver more with less, year after year. The value placed on you, your skills, and your time has been eroded.
Real pay reform is about retention. It’s about safety. It’s about rebuilding a profession that has been stretched to its limits. Pay reform isn’t a luxury – it’s a necessity. It’s how we turn things around for our profession.
Let’s get what nursing needs, together. This autumn, we need to open formal negotiations between governments and unions. We need to make Agenda for Change fairer as a system, and the salary levels within it reflect what you actually do.
