New analysis which shows pay for nurses and midwives fell further than for other key NHS staff groups is ‘more evidence’ nursing is undervalued for being female dominated, the General Secretary of the Royal College of Nursing (RCN) says.
The analysis, released today at Nuffield Trust’s Summit, shows that in the 14 years to March 2025, real-terms average annual earnings for NHS nurses fell 10.7%.
Meanwhile for other NHS professions, including ambulance staff (-8.1%), resident doctors (-8.6%), consultants (-10.0%), the falls were smaller.
Nurses and midwives (-13.5%) are the two most female dominated professions working in the NHS in England and the two worst affected by real terms pay cuts.
Professor Nicola Ranger, RCN General Secretary and Chief Executive, says:
“When nursing and midwifery, the two most female dominated professions in the NHS, are disadvantaged like this there can be little doubt that institutional sex and discrimination has had undue influence on how our profession is recognised and rewarded.”
Figures from NHS England show there are 408,363 nurses and health visitors working in the NHS, of which 87.9% (359,018) are female. For midwives the proportion that are female is 99.6%.
Professions including doctors (47.8% female), ambulance staff (51.2% female) and consultants (40.9% female) all have a smaller proportion of female staff and fare better when it comes to pay.
The recently announced 3.3% uplift for 2026/27 is predicted to still leave nurse pay 10.3% below the level it was 15 years ago in real terms.
Pay recovery for nurses and midwives ‘is still out of reach’, says the analysis.
RCN General Secretary and Chief Executive Professor Nicola Ranger, said:
“Just days before we mark International Women’s Day, we are handed more evidence that our profession is undervalued for being female dominated. Despite being the largest NHS workforce and delivering the vast majority of care, we are pushed to the bottom on pay, facing among the largest real terms cuts, slowest wage growth and far away from recovery.
"When nursing and midwifery, the two most female dominated professions in the NHS, are disadvantaged like this there can be little doubt that institutional sex and discrimination has had undue influence on how our profession is recognised and rewarded. This year’s award, which is barely likely to be above inflation, shows history continues to repeat itself, but only when other public sector pay awards are announced will we see if nursing and the NHS is once again at the back of the pay queue.
“Nursing is a safety critical profession, vital to patient wellbeing, the future of our health service and economic growth. With its announcement last month, the government in Westminster has started to turn a page on nursing staff stuck at the lowest pay band for their entire careers. That really must be a humble beginning. Today’s analysis adds to the weight of evidence for a radical overhaul in the treatment of nursing. That couldn't be more necessary if we are to recruit and retain the highly skilled nurses we need and transform patient care.”
ENDS
Notes to editors
The RCN described the 3.3% pay award for 2026/27 as an 'insult' - LINK
