ambulance workers

NHS members in England accepted the government’s pay offer on 3 March 2015

This year most NHS staff won’t get a cost of living pay rise. UNISON believes that this is an insult to our members in the NHS and the vital work they do.

The real value of pay in the NHS has been falling for five years.

A third of staff don’t get paid enough to live on. This year 60% of NHS staff will not get any pay rise. Enough is enough – UNISON members in the NHS in England have voted for strike action.

NHS pay proposals 2015

Have your say

The industrial action UNISON health members held last year, together with the threat of further strikes in 2015, resulted in the government increasing the money they plan to spend on NHS pay from April onwards.

There is a new offer from the government which we believe UNISON health members should have an opportunity to consider. This is why we suspended our strike action and are consulting on the offer that has been made. Members of other NHS trade unions are also being consulted on this offer.

UNISON will accept or reject this offer based on the view of the majority of members – so it is vital that all health members take part in the consultation.

While it is fair to say this is an improved offer in many ways, it is not better for everyone. It does increase pay for our lowest paid members and for the 60% of staff who were subject to the planned pay freeze. However, some senior staff are penalised by it.

UNISON believes that this is the best offer that will be achieved through a negotiation and without the need to continue our programme of industrial action. If the majority of UNISON members are not in favour of accepting it then health members will be asked to take further industrial action starting with a strike on Friday 13 March.

All members will be sent a ballot paper to their home address along with a copy of the A4 2-sided letter from head of health Christina McAnea and a pre-paid return envelope. This needs to be returned by 10am on Monday 2 March 2015. If members do not receive a ballot paper by 2pm on 23 February 2015 they should ring 0800 0 857 857 to request a duplicate.

Many branches will be holding workplace meetings to discuss this offer and what it means for staff and it is important that UNISON members find out what the pay proposals mean for them. There are some frequently asked questions here and UNISON reps can also help answer questions. The union urges all health members to take part in this ballot and have their say on pay.

The pay offer in brief

  • 1% consolidated pay rise for all staff up to point 42 (top of Band 8b) from April 1 2015
  • No-one in the NHS would earn less than £15,100 per year (FTE):
  • Deletion of pay point 1 (bottom of Band 1)
  • Increase of pay point 2 to £15,100 per annum (new lowest pay point in Band 1)
  • £200 additional consolidated pay rise for staff on pay points 3-8 (Top of band 1, all Band 2 and some of Band 3)
  • A one-year increment freeze (2015-16) for staff on pay point 34 (Band 8a) and above
  • Talks on changing the redundancy scheme including introduction of a new minimum and maximum for calculation of redundancy payments and ending the facility for employer top-ups for early retirement on the grounds of redundancy
  • Additional concessions for staff employed by Ambulance Trusts in England


What you should do now

  1. Find out what this means for you. These proposals will ‘consolidate’ an increase into your annual salary and your hourly rate. That means that the difference to your earnings will depend on things like how many unsocial hours you work, any overtime, and additional payments based on your basic salary.
  2. The union’s strong advice is that you should read the more detailed information about the pay offer which you will find on the UNISON website or from your branch rep, to see how the proposals would affect your earnings. If you have any questions, please speak to your rep in the first instance, as they have access to further help and advice.
  3. Find out if your branch is holding meetings about the proposals and go along and have your say.
  4. Look out for your ballot paper and use your vote.
  5. Not a member of UNISON? Join now and have your say.


Check UNISON’s detailed briefings for more specific information. 

NHS Pay Ballot Frequently Asked Questions

What is UNISON doing?

Strike action has been suspended.  

Read the offer letter

More information on what this means for you will be published imminently.

What is the issue?

For the first time in the history of the independent pay review body, the government has chosen to ignore its recommendation of 1% pay rise for all NHS staff.

UNISON members are asking for an immediate 1% consolidated uplift for all – and a further consolidated award for 2015-16 – as well as increases in the future that will restore the value of NHS pay.

Here are eight reasons why this issue is so important for NHS staff and patients:

The real value of NHS pay has been falling for five years

Pay in the NHS has not kept in line with inflation and staff have not received an above-inflation pay rise since 2009. If you work for the NHS, you can use our pay calculator to find out how much money you’ve lost from recent pay freezes – and how much you stand to lose in the future.

NHS workers are under paid

This year 60% of NHS staff in England will not get any pay rise and only those at the top of their bands will receive a 1% unconsolidated lump sum. The 1% unconsolidated lump sum is a one-off payment which does not alter the hourly rate, so it will not count towards unsocial hours for evening, weekend or night shifts, it will not be added to overtime, it will not be added to any supplements (such as high cost area supplements, local recruitment and retention premia, or on-call arrangements) and it does not count towards pensionable pay.

In Wales, instead of a pay rise most NHS staff have been offered a one-off payment of £160. This payment will be a ‘non-consolidated’ sum, a non-consolidated lump sum is a one-off payment which does not alter the hourly rate, so it will not count towards unsocial hours for evening, weekend or night shifts, it will not be added to overtime, it will not be added to any supplements (such as high cost area supplements, local recruitment and retention premia, or on-call arrangements) and it does not count towards pensionable pay.

The Welsh Government is implementing the living wage for all NHS Wales staff, which is a welcome commitment to tackling in-work poverty.

A third of NHS staff do not get paid enough to live on

More than a third of NHS staff, who are non medical, are paid less than £21,000 a year. The government has failed to lift those staff out of in-work poverty. But this does not save money as people not paid enough to live on rely on in-work benefits.

Cutting pay affects whole families

Over half of UNISON members working in the NHS have school-age children, a third are carers for elderly relatives and 20% have infants.

A pay rise for a minority is divisive

Giving an increase only to those who have reached the top of their grade is divisive and means that staff who are starting work now have to cope with increased workloads, more unpaid extra hours and fewer opportunities for promotion, but don’t get the same packages because they have not been there as long.

Cutting pay does not save jobs

Last year more than 10,000 jobs were lost as a result of the unnecessary restructuring of the NHS in England. The government has tried to argue that cutting pay means more jobs, but in fact it is making cuts to both pay and jobs. On top of that comes “downbanding”, where whole grades of staff are re-graded for budget reasons.

Staff need to know they’re valued

Staff need to be treated well. The NHS is facing unprecedented challenges, telling more than half the workforce that they are not worth even a tiny pay rise will not help to engage them in meeting these challenges.

No other pay review recommendation has been ignored

The independent Pay Review Body for the NHS recommended a 1% increase to all pay points for all staff across all four countries, however health secretary Jeremy Hunt MP ignored them in March and announced an unconsolidated payment for only a minority of staff in England. For the situation in Scotland and Northern Ireland see the frequently asked questions on the ballot.

Pay in Scotland

The Scottish government announced a 1% increase to all pay points (consolidated) with additional sums at the bottom to take the lowest paid in the NHS in Scotland above the living wage level. Therefore currently members in Scotland are not being balloted for action.

Pay in Northern Ireland

There has been no announcement yet, but it is anticipated that the award will mirror the English award, as this has been the case in previous years. Currently members in Northern Ireland are not being balloted for action.

What can I do?

Strike action has been suspended.

Patient voices for the NHS

UNISON’s health members in England are in the middle of action, fighting for fair pay.

Much of the focus so far has been on politicans and NHS staff, but what of the people who use the NHS – the patients? What do they think?

We asked some people who are currently, or who have recently, used the NHS about their experiences and what they think about staff they rely on taking industrial action.

Andy Harris, Buckinghamshire

My son George was born in Stoke Mandeville Hospital in April 2012. He was diagnosed with meningitis within hours and for the first week of his life he was in the neo-natal intensive care unit. The care from everyone was exceptional.

We feel we owe them his life and his ongoing health.

Actually, everything about his birth was difficult. My wife Jo had a group B streptococcus infection, so she had to have antibiotics during labour, then needed a emergency caesarean.

The midwife kept us calm throughout the birth, because she had done it so many times before and knew what we were going through.

It’s the little things you remember. We brought music with us, to relax Jo, but had forgotten to put it on. It was the midwife who said ‘Why not play it?’.

Then she started singing along to one of the songs. That was her attitude: this is ordinary, everyday, we’re going to get through this. She was so relaxed, and you only get that through experience.

But George was very poorly from the moment he was born. Meningitis can be fatal, and at the very least can cause permanent damage to hearing and vision.

To see him listless, not moving, hooked up to all the drips and things was a scary experience.

For the staff, it was all about getting him stable: giving him antibiotics, keeping his temperature down. They succeeded, and because of them we have a perfectly healthy little boy.

We’re so thankful.

Our nurses were wonderful, so supportive, always making sure we were told what was going on. The paediatric doctor had a really good manner, and was excellent.

The exceptional thing about the NHS is the staff – the care they give you, the knowledge they have, the way they identify with you as people. I just think that the NHS lends itself to the sort of people who are good at giving that kind of care.

But there are a number of funding issues for the NHS and pay is one of the most important ones. So I absolutely support the pay campaign.

The way I see it, if you work in the private sector and you don’t like your pay, you look for another job with better pay.

That’s not an option for people working in the NHS. People don’t go into the public sector for the money, but because of their passion and love for the job. To then shortchange them is just unfair.

Retired patient from Warwickshire, 69 years old

I have just had a complete knee replacement. It was my left knee, which I was told was riddled with arthritis.

It’s a very big operation. It can be pretty painful. But my experience to date has been really pretty good.

First, I was very surprised by how quickly they got me in for the operation – within a matter of weeks. I was in hospital for four days.

You are put completely in the picture before the operation, so that you know what to expect. And afterwards there was a clear empathy and desire to make one as comfortable and relaxed as possible. All the staff were very good. The doctors, the nurses, the cleaners, I could not fault anyone.

The day after I was discharged someone from what they call their ‘swat team’ came to my home to ensure I had the facilities I needed, especially for getting around the house, and to make sure that everything was OK.

I am currently going back to the hospital every Friday for physiotherapy. It’s quite intensive. The physiotherapists are very committed, very thorough. It’s quite funny – maybe because of our ages, while they’re making us perform the physical jerks they play music from the ’50s and ’60s.

I’m a firm believer in the NHS, I believe in it passionately, but I don’t see it through rose-tinted glasses.

Some areas of the service are over-managed. And of course I don’t agree with the privatisation.

UNISON and the other health unions have a vitally important role in this country and particularly in the NHS I think. It’s important to ensure they can participate in the day-to-day activities of the health service, because they have the right ethos.

Anne McCormack, UNISON retired member and former further education chair. Merseyside, 64-years-old

In August 2010 I was diagnosed with breast cancer. It was originally picked up in a routine mammogram, for women over 50, which I had in a Portakabin in Tesco car park.

That was such a great idea – you do your shopping then have a check-up. It was an extra level of encouragement, because you see it every day. But that Portakabin has since been closed, because they had no money to keep it going.

A week later I had a letter saying I had to go to the hospital for another test. I had a biopsy straight away. A week after that it was confirmed as malignant. And two or three weeks after that I had a lumpectomy. Then a course of chemotherapy and radiotherapy – all done and dusted.

The speed of my treatment was down to the resources ploughed into the NHS by the Labour government. If I had not been diagnosed and treated that quickly it could have been much worse. I might have had to have a mastectomy, or even died.

No-one takes privatisation of the NHS seriously. But if I had had to pay for that treatment it would have cost me a fortune. The cleaners, the porters, the radiographers, the nurses – they are all trained. I had one of the best surgeons in the country. Money can’t buy that kind of treatment.

My cousin leaves in New Jersey, in the States. She’s the same age as me, and had the same problem. But she had to go back to work, from retirement, because her insurance had run out and she couldn’t afford to pay for her drugs – drugs that I get for free. So she had to get a job at 64.

It worries me terribly that his could happen in the NHS, and people no longer get these treatments automatically.

The pay strike is not a sudden thing.

The day I checked in, the ward clerks were all having to reapply for their own jobs on less pay. That was in 2010.

They and their colleagues have suffered and struggled through pay cuts and reductions in terms and conditions for four years, putting up with it because they really care about the patients.

Only now are they taking strike action, because they are at the end of their tether.

Ben, 27, London

I have a rare congenital heart condition, which seriously affects the oxygenation of the blood. I had to have a major operation when I was 13 months old. And I still require regular check-ups, including an echo, MRI scan, ECG.

In addition I have arrhythmia problems. Now and then I will have palpitations and need a catheter procedure. I’ve had four of those. And I’ve had about a dozen scares, when I’ve gone in just to be safe.

I’ve been going to the same hospital my entire life, the Royal Brompton.

It’s a specialist heart hospital, a teaching hospital and one of the best of its kind in the world. And everyone there, not just the doctors but the nurses and the support staff have always been absolutely fantastic.

It’s important with cardiac patients to calm them and make them feel supported. And whenever I’ve been to the Brompton that’s what I’ve experienced.

I know I’m in good hands. It’s difficult to describe – when I was younger I always felt safe as soon as I went through the hospital doors. It was like crossing the finish line, and knowing then that things would be alright.

If I had been born in another country, where there was no provision of free medical services, either my family would be bankrupt or I would be dead. Possibly both. If I had been born in the US, that would have been it.

Excluding the fact that without the Brompton I would be dead, I don’t think I would have the same quality of life without the treatment I’ve been given. To know they are there when I need them is crucial.

In the main part of the hospital there are two plastic trees fixed to the wall, with plastic discs hanging from them. Each one represents a donation from a patient. It’s very moving, and demonstrates the excellence of  the hospital.

If you don’t pay people a decent wage for what they are doing, they are not going to be as motivated. It’s as simple as that.

And if people are having to work two jobs to support themselves and their families, in a vital public service like the NHS, that’s worrying and dangerous, because they will have their focus divided.

It’s also morally wrong. I don’t think anyone should be paid less than the living wage. It’s particularly important that we recognise the contribution that these people make to society, to individual lives.

There are many people in the country who are paid vastly more than NHS staff – like bankers or marketing people – whose work has very little benefit to society.