NHS pay 2024

Your pay rise was due on 1 April and the government has let this date slip by without giving you any idea of when it’ll make a decision.

There’s no urgency while your cost of living keeps rising. No urgency while the lowest paid staff are earning just a penny above minimum wage. No urgency while staff are questioning whether it’s worth staying in the NHS, let alone progressing.

Don’t you and your colleagues deserve better than that?

So now there are two questions that all UNISON members working for the NHS in England need to answer.

In short: what would you be willing to do if the government makes a pay award that falls short of your expectations? And what if the delays drag on?

If you’re a UNISON member directly-employed by the NHS in England, you’ll receive an email inviting you to take part in the consultation. This will arrive by 4pm on Friday 5 April.

It’s much easier and quicker to take part via your email with just one click, but you can also have your say here by providing your UNISON membership number or national insurance number and date of birth.

Work in Wales? Your consultation is here

A proper pay rise. The right banding. A shorter working week. That’s what UNISON members want and it’s what NHS staff deserve.

The NHS is in a staffing emergency with over 110,000 vacancies, spiralling workloads and a record patient backlog. You know that meagre pay awards from the government and tinkering around the edges of the pay scale simply won’t cut it. 

That’s why together we’re calling on the government to put NHS pay right to keep dedicated staff in their jobs and ensure more patients can be treated more quickly.

So what will it take to put NHS pay right? In our autumn survey, more than 40,000 NHS staff told UNISON that you need:

A proper pay rise

A majority of UNISON members – in every role, at every pay band – said that increasing core pay is the number one priority.

All staff working in the NHS need a proper pay rise to keep up with rising living costs and to provide a decent reward for the challenging work you do. Over a third of members report that they cannot get through the working day without worrying about finances and this cannot go on.

We need to fix problems up and down the pay scale to kick poverty pay out of the NHS for good; to maintain fairness between staff; and to make sure that when you progress or get promoted, you notice a real difference in your pay packet.

The right banding

All staff should be entitled to role and pay band reviews to make sure you’re getting paid at the right rate for the job. That means major national investment to ensure that the job evaluation process is fair, timely and effective.

Nurses, admin staff, catering staff and many others tell us that they are working above their band. Thousands of UNISON healthcare support workers have come together to fight for and win rebanding and back pay because the current creaking system leaves staff undervalued and underpaid.

A shorter working week

UNISON’s ambition is for a reduced working week in the NHS with no loss of pay. Better work-life balance would improve wellbeing, reduce burnout and keep staff in their jobs, reducing reliance on overtime and agency staff. While there may not be a quick route to a shorter working week, many staff have already identified areas of their work that could run more smoothly. Let’s start the conversation now!

There’s more detail on these three priorities in the FAQ section below, and you can read the full evidence UNISON sent to the Secretary of State in February:

Put NHS Pay Right

Will you join the fight to put NHS pay right?

The most important thing to do is have your say in the consultation, running through April and May.

It’s essential that we always have the right contact details and employer information for every single member so we can keep you updated on any developments with your pay.

Update my details now

Talk to your colleagues about your pay and conditions, and encourage them along to any meetings your branch is holding. Whether it’s sharing leaflets, signing petitions, speaking to the public or explaining UNISON’s position to staff who haven’t joined yet, your union is only as strong as its members.

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Put NHS Pay Right

  • What problems do members want to fix in the NHS pay scale?

    In our autumn survey, 80% of members said improving pay is one of their top priorities. In our 2024 wellbeing and mental health survey, members reported that increasing pay and reward was the single most important way employers could alleviate stress at work – better than offering free counselling sessions, wellbeing apps, more staffing, or better shift and work patterns.

    And it’s not just about a headline pay rise – we need to fix problems up and down the pay scale. For example:

    Bands 2-3

    • The lowest rate of pay in the NHS is £11.45 an hour – only a penny above the minimum wage. This is shocking – NHS staff need a proper pay rise to end poverty pay in the NHS.
    • 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.
    • With pay at Band 2 so low, lots of staff are being excluded from salary sacrifice schemes or buying and selling leave because it would take them under the minimum wage. This proves that the rate of pay is just too low.
    • The rate for Band 3 is just £433 a year more than Band 2. Combined with a reduction in unsocial hours payments, this is a massive disincentive for staff looking to take on more responsibility. We need to double this gap to create a real promotion incentive.

    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 in intermediate in Band 5 is just £1.14 an hour. Shouldn’t in-band progression for early-career staff come with meaningful reward?
    • Promotion to Band 6 is worth just £0.57 an hour for experienced staff. Shouldn’t promotion mean a real pay rise? 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 promotion to 8a roles is worth just £896 a year. Band 8a often means a big jump in responsibility – shouldn’t there should be a decent reward for it?
    • Staff in Bands 8 and 9 need to wait 5 years with no progression to reach the top of their bands. Members say that cutting this length is important – it should only take 4 years to reach the top of the Band for staff in Bands 8 and 9.

    New graduates

    • NHS salaries are at risk of not being competitive with other public sector jobs. Graduate entry into the NHS is at band 5 – a salary of £28,407. Teachers start at £30,000, with jobs in the private sector often higher. We run the risk of not being able to fill vacancies if we let the NHS fall behind.
  • How can we make sure staff are on the right band?

    Unions won a big victory with Agenda for Change when it came in 20 years ago, but employers have not invested properly in checking banding as they have given staff more complex work. UNISON is arguing for a right to annual band reviews because too many people are now under-banded for the work they do.

    UNISON has been helping band 2 healthcare support workers come together in their thousands to win re-banding with almost 100 active campaigns up and down the country. (Find out more about the Pay Fair for Patient Care campaign.)

    UNISON has a track record of securing major wins in role redesign. We won the principle of Band 6 jobs for paramedics to reflect that the role was more advanced.

    The underlying issues raised by nurses are real and urgently need to be addressed. Right now we are leading the nursing profile review. Our work is based on a survey of thousands of nurses who told us what they actually did in their role and how often they got a job evaluation review.

    The NHS should get the right banding in general, so staff don’t have to constantly fight to be paid for the work they do.

  • 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 reduces efficiency and increases stress – shouldn’t we be talking about how to address the issues in NHS employment and staffing, with nothing off the table?

    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 and in talks with the NHS and NHS unions. Staff in England deserve the same conversations.

    We’re very concerned about the response to our survey saying that ambulance staff were more likely than most NHS staff to experience stress and burnout at work, and that long hours and shift overruns don’t help. 37.5 hrs is still the standard working week for such a physically and emotionally intense job. Fixing shift patterns and improving handovers could reduce staff workload without having to reduce patient services.