UNISON members in the London Ambulance Service on the picket line

NHS pay 2023

The NHS Staff Council met on 2 May 2023 to make a decision on NHS pay. The majority of NHS workers and their unions, including UNISON, voted to accept the pay offer. It took months of strike action to force this from the government, but the decision meant we finally had a deal.

In addition to the £1,400 a year pay rise NHS staff got in autumn 2022, the deal was: 

  • An extra one-off lump sum which begins at £1,655 for the lowest paid staff and rises in value up the pay bands. 
  • A permanent 5% pay rise on all pay points for 2023/24, worth at least £1,065. 
  • A permanent 10.4% increase to Band 1 and the entry point of Band 2, raising the lowest pay point in the NHS to £11.45 an hour – 55p higher than the real Living Wage. 

The deal (both lump sums and the 5% consolidated for 23/24) was implemented in June 2023 pay packets.

What the deal means for you

UNISON has made sure there is a process for employers to offer staff an option to take their lump sum in instalments rather than in one month’s pay packet – which may be helpful for staff in receipt of benefits such as Universal Credit. If this affects you, you will need to let your employer know. Your employer and your local UNISON branch should be in touch to let you know how to do this where you work.

Once we had confirmation that the pay offer UNISON members voted to accept would be paid, that marked the end of that particular dispute. But it’s not the end of our campaign to improve NHS pay.

What’s next?

We demonstrated how powerful NHS staff are when we all come together. We forced this hostile government to get around the table with us and present a better offer.

Industrial action works. Direct negotiation works. This pay round has proved that for good. Now we build.

With greater support and a higher turnout, we can force the government to go further, faster in future.

There’s so much still to do. We need you and your colleagues to help expand our campaign on re-banding, to make sure that all NHS staff are on the right band, getting the right pay for the work they do. And to campaign on overtime pay, so that everyone gets the pay they are owed. And that’s just to start with.

The government has also committed to reviewing the process for setting pay awards going forward. After years of waiting in vain on a Pay Review Body process over which we have no control, we’ve proven this year that negotiation gets results. So we’ll keep pushing for this.

And we’ve proven that we’re strongest when everyone in the NHS comes together as One Team.

It should never have come to this. The government must now invest long term in NHS pay and staffing.

The fight for the future of the NHS and its workforce is not over. This is only the beginning.


NHS pay consultation

  • How does the pay offer compare to inflation?

    The £1,400 salary increase NHS staff received for 2022-2023 was below inflation for every band; this was one reason why UNISON encouraged members to vote for strike action to oppose it. Inflation for the 12 months to April 2023 was around 10%-13%, depending on whether you use CPI or RPI to measure inflation. The imposed £1,400 award was worth 4.75% on average across the paybill.

    The lump sum additions on offer for 2022/23 amount to an extra 6% of the paybill on top of the 4.75% already awarded. The total cash NHS staff in the lower half of the pay bands would get for the 2022-23 pay year would match or exceed inflation. But this is not the case for staff in the highest bands. And the lump sum payments are one-offs so don’t get added to your salary going forward.

    The offer for 2023-2024 of a permanent 5% salary uplift is – based on current forecasts – expected to be above inflation for the year to come.  Independent as well as government economic forecasters are currently predicting that both CPI and RPI (the two main measures of inflation) will be at or below 4% for the 12 months to April 2024. 

  • Will the lump sum impact my Universal Credit payments?

    The additional amount you get in your pay in June could reduce the amount of Universal Credit you receive in July. In some cases, it could stop your UC.

    UNISON has made sure there is a process for employers to offer staff the option to take their lump sum in instalments rather than in one month’s pay packet, which could help lessen the impact on any Universal Credit payments.

    You will need to look at your own circumstances to work out whether instalments would be better for you.

    Using the pay calculator above, you can work out how much lump sum you are entitled to. Remember the figures here are for full-time employees so if you’re part-time you’ll need to pro-rata this. You will also get the effects of your 5% permanent pay increase (higher if you’re on band 1 or band 2 entry) in your June salary, with backpay to 1 April. For precise details you can contact your payroll department.

    You can also use UNISON’s online benefits calculator at https://unison.entitledto.co.uk – you can put in what your monthly income will be for June including the lump sum and see what it suggests will be your benefit entitlements. But to get a more accurate picture contact Universal Credit via your online account or calling the free Helpline on 0800 328 5644.

    If you think taking the lump sum in instalments would be better for you, make a request for instalments following your employer’s process. You will need to agree the number of instalments that will work best for you.

    If you have any questions about how this will work locally you can contact your branch.

  • What if the lump sum stops my Universal Credit payments?

    If your Universal Credit payment stops, make sure you let DWP know that your income will be going down again once the lump sum element drops out of your pay packet. You are likely to need to make a fresh claim as soon as possible when your income adjusts down.

    • To reclaim, log into your Universal Credit
    Journal and follow the advice about how to ‘Reclaim’. You will have to answer a few simple questions.
    • If you have problems re-starting your claim, contact Universal Credit, the helpline is 0800 328 5644.
    • Further help can be obtained from Jobcentre Plus staff.

  • Will the lump sum impact other in-work benefits?

    Other benefits work in different ways – for example tax credits are based on the income you declared for the previous tax year. However, HMRC advises that you should immediately report a change in income especially if it is £2,500 or more.

    Tax credit helpline details are here.

  • Am I eligible for the lump sum?

    Eligibility for the lump sum payment will be staff in post as of 31 March 2023 using pay point and contractual hours applicable on that date. 

    If you left the NHS before this date you will not be eligible to receive the payment.  

  • Does the deal also apply to private contractor and/or social enterprises staff providing NHS services?

  • Does the deal apply to bank staff?

    This pay deal is for staff on substantive contracts in NHS employment. What employers do in relation to bank staff will depend on the terms and conditions staff are on. 

    In some cases, depending on your contract, bank staff may have changes to NHS pay values reflected in your pay rates. You should ask your employer what they intend to do.

  • Is the lump sum taxable, pensionable, or pro-rated?

    Here are some details about the lump sum: 

    • It is taxable
    • It is not pensionable and you will not pay pension contributions on it
    • It will be pro-rata depending on your hours worked; NHS employers have confirmed they intend to measure this as on your normal hours at the end of March 2023. 

    UNISON has made sure there is a process for employers to offer staff an option to take their lump sum in instalments rather than in one month’s pay packet – which may be helpful for staff in receipt of benefits such as Universal Credit. If this affects you, you will need to let your employer know. Your employer and your local UNISON branch should be in touch to let you know how to do this where you work.

  • Is there a separate pay spine for nurses?

    No, this deal does not include a separate pay spine for nurses. The NHS is one team, and this deal is for all staff on the pay scales covered by NHS pay, terms and conditions. UNISON strongly opposes proposals on divisive nurse-only pay awards and pay spines.

    You can read more about UNISON’s position on this here.

  • Will the pay award offset the government’s decision to increase pensions contributions for some staff?

    The government’s changes to pensions contributions mean many staff, particularly lower paid staff, will pay more. Although for others like part-time or higher paid staff the changes are positive. The first stage of changes was implemented in October 2022 with the second stage due to happen in 2023 – but the date is not confirmed. Our pay claim asked that increases in basic pay for 2022/23 should be sufficiently large to absorb any increases to pension contribution rates at specific points in the system. But the government has not addressed this. Unions have asked the government to delay the second phase of contribution increases and we understand that ministers are now considering a delay until next year. 

  • Will this pay award push me into a new pension contribution tier?

    A new system that unions pushed for means the earnings thresholds for where each new pension tier starts will now get adjusted upwards in line with annual pay awards. This means that if your basic salary gets increased by the 5% award for 2023/24 this alone should not result in a change to your pension contribution rate. However, making the adjustment to pension tiers has to be done through regulations once the pay award has been confirmed. So it will take a little time to process and adjust through payroll, but the change will be backdated to 1 April. And you should be aware that other changes to your earnings can push you into a higher (or lower) pension contribution tier – for example changes to amount of unsocial hours worked or to contractual hours.