NHS staff deserve a real say on their pay
The government has announced NHS staff will receive a 3.3% pay award for 2026/27. This is due to be paid in April 2026.
Yet again, you’re expected to keep delivering more while effectively being given less, as pay slides behind living costs. So having an increase on time for once is only small comfort.
The government had been talking to us about sorting pay out through proper negotiations. Instead, they have announced an award set through the same old Pay Review Body process.
But ministers have also said they intend to do more on pay this year. This would involve negotiations with us on further changes to pay rates, with their priorities to improve pay for staff on the lowest pay bands and on graduate level pay bands across all professions.
They have said that, if agreed, these reforms could deliver additional pay increases for some staff that will be backdated to 1 April 2026.
More than 10,000 of you contacted your MPs to pressure the government to act on NHS pay – be in no doubt that pressure has resulted in an award being paid significantly earlier than in previous years. But we need more than this and it’s not yet clear what could be on offer.
Ministers’ plans for the NHS stand or fall on having a stable, motivated workforce to deliver them.
That’ll need proper progress in restoring the value wiped from pay over the past decade and fixing problems in how the NHS pay system works.
NHS Pay in Scotland, Cymru and Northern Ireland
This information applies to NHS staff in England. For the latest updates on NHS pay in Scotland and Wales or health and social care pay in Northern Ireland, please check the relevant website:
FAQs
NHS Pay 2026/27
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How can we make sure staff are on the right band?
The government has recently agreed to the programme of work we asked for to ensure staff are paid properly for the work they do.
UNISON has been helping band 2 healthcare support workers come together in their thousands to win re-banding through our Pay Fair for Patient Care campaigns up and down the country.
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How is NHS pay decided?
Over 1.5 million NHS staff have their pay, terms and conditions set by a national scheme known as Agenda for Change (AfC). This was first negotiated by UNISON, the other health unions and NHS employers back in 2004.
NHS staff have become disillusioned with the Pay Review Body system because they do not believe it is independent. They see the process as long-winded, too often at the mercy of government and unfit for purpose.
UNISON wants to negotiate directly with the government on NHS pay, along with the other unions in the NHS.
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What about bank staff?
There is no national agreement on bank pay so it depends on local terms and conditions. We would push for and expect employers to update their bank pay rates in line with national pay awards.
We are encouraging all NHS employers to adopt the principles in our Better NHS Bank Charter. Speak to your UNISON branch and your bank colleagues about building a campaign to get your employer to sign up to our charter.
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What about staff working for GPs, private contractors or other employers?
UNISON has long campaigned for GP and contractor staff to be paid the same rates and benefits as their colleagues who are directly employed by the NHS.
At the moment some contractors mirror Agenda for Change pay rates and uplift pay accordingly; others implement pay rises when put under pressure to do so; and many don’t match NHS rates at all.
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What are some of the key problems with the NHS pay scale?
Bands 2-3
Band 2 has become a spot rate, so there is no reward for progression. There should be an incentive for gaining experience and confidence: that means restoring pay progression for Band 2.
The rate for Band 3 is not a great deal more than Band 2. Combined with a reduction in unsocial hours payments, this creates a massive disincentive for staff looking to take on more responsibility.
Bands 5-6
We are at greatest risk of losing new clinical staff in the first two years in their role. The progression from entry to intermediate in Band 5 is too small. Shouldn’t in-band progression for early-career staff come with meaningful reward?
Promotion to Band 6 does not come with enough of a pay rise for experienced staff. In our autumn survey we saw this was a real priority for experienced nurses working at band 5.
Bands 7-9
At 8a, staff often lose all eligibility for unsocial hours payments and overtime, but working at Band 8a often means a big jump in responsibility – shouldn’t there be a decent reward for those making the move up from band 7?
New graduates
Graduate entry into the NHS is at band 5 – compare this with teachers’ starting pay rates, and jobs in the private sector which are often higher. We run the risk of not being able to fill vacancies if we let the NHS fall behind.
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Why campaign for a shorter working week?
Did you know the NHS 37.5 hour working week is the longest official working week in the public sector? We know that long hours reduce efficiency and increase stress – shouldn’t we be talking about how to address these issues?
Reducing the standard working week wouldn’t result in a reduction in patient services – the NHS is already open overnight, every night, and 7 days a week! Hundreds of thousands of staff already work part-time or flexibly.
The Scottish and Welsh governments are already committed to reducing the standard NHS working week. Staff in England deserve the same conversations.
