Nursing pay: splitting up the NHS team

The government has launched a call for evidence on proposals which would create separate pay arrangements for NHS nurses in England, splitting up the NHS team.

UNISON has a large nursing membership, including registered nurses, midwives, nursing associates, healthcare assistants and thousands of healthcare students and future nurses.

Our nursing and midwifery committee, made up of elected nursing representatives from across the UK, opposes this policy; and UNISON health conference 2023, the largest national gathering of NHS staff, voted unanimously to campaign against this divisive move.

What would separate pay arrangements mean?

Introducing separate pay arrangements for nurses in England:

  • Would not increase the overall commitment to spending on NHS pay, nor would it necessarily mean a greater share of overall funding going to nurses.
  • Would lead to greater inequalities in NHS pay. Current arrangements ensure equal pay for equal jobs. Separate, complex arrangements for nurses could lead to unjust and unequal pay between different staff groups.
  • Would collapse collective pay bargaining in the NHS. Other occupational groups would likely also demand separate arrangements, ending our One Team approach to pay and dividing the workforce irreparably.

Why are UNISON nurses speaking out against this proposal?

Victor Tapah. Critical Care Registered Nurse.

“Whether you are a nurse, physiotherapist, cleaner or doctor, we all are facing the same struggles and should not let this government divide us further”

Victor Tapah, critical care registered nurse


Wilma Brown. Registered Nurse. Chair UNISON Health Service Group Executive.

“The introduction of a separate pay spine would cause many serious problems for the NHS from an equal pay perspective. The damage it would do to morale and the ability of the NHS team to deliver the best patient care would be devastating.”

Wilma Brown, nurse and chair of UNISON’s health service group executive


Stuart Tuckwood

“Separate pay arrangements would be a confusing distraction from the real problems facing nurses. This divisive proposal would turn NHS staff against each-other when we should be working collectively to tackle unsafe staffing levels and a lack of recognition for the skilled work we perform.”

Stuart Tuckwood, registered nurse


Gamu Nyasoro

“The real problem for nurses is more than a decade of pay cuts, job descriptions not being updated, and not enough investment in local job evaluation and banding processes”

Gamu Nyasoro, registered nurse


Trudie Martin
“I feel honoured to be part of a team and a job evaluation system that recognises my skills and the role I play in the NHS family and how we care for our patients.  I do not want to be included in a separate pay spine. This proposal will cause havoc in job evaluation and lead to inequities across the UK and with the devolved administrations.”

Trudie Martin, assistant practitioner


What happens next?

You can read the government’s call for evidence, which opened on 11 January and closes on 4 April 2024:

Separate pay spine for nursing

UNISON will be responding to the call for evidence as an organisation and encouraging our members to respond with their views.

Following the call for evidence, the government will decide on whether to move forward with implementation of a separate pay arrangements for nurses.

UNISON will continue to focus on campaigning collectively and winning better pay for nurses, and everyone in the NHS.

We extensively surveyed our UNISON nursing family recently. You told us:

  • You are struggling constantly with unsafe staffing levels
  • Your jobs are growing more complex and you are acting with more autonomy
  • You are taking much more responsibility for leading teams, as well as supervising and educating students and junior staff

Our nursing and midwifery committee is overseeing an ambitious programme of work to tackle these issues:

  • Our ‘Only Enough is Enough’ campaign is growing and supporting nurses to challenge unsafe staffing levels at work.
  • We’re leading a review of the national nursing and midwifery job profiles. UNISON nurses and midwives can join our upcoming seminar to discuss this work and share your experiences on job evaluation.

We’re negotiating with the NHS, following industrial action last year, on better career progression for nurses. We’re using the evidence you’ve given us about how your jobs have evolved to argue for better career options and progression systems for nurses.

Complex and lengthy negotiations about separate pay arrangements will distract from these goals, weaken trade unions and divide the NHS team.

We’re stronger as One Team – let’s improve NHS pay together.