What will the pay deal mean for you?

Unions are happy with proposed pay rise for NHS staff in England, but some nurses say it’s not enough

Nurses in England are being offered their biggest pay rise in a decade in a new multi-year deal negotiated by NHS staff unions, the Department of Health and Social Care, and NHS Employers.

Picture: iStock

Could this boost to salaries help to address a burgeoning workforce crisis that has left the profession struggling to maintain recruitment and retention, with 40,000 vacancies in England alone?

Nurses’ unions believe so, saying the deal will begin to address the 14% real-terms pay cut their members have endured since 2010, as well as going some way to restoring morale in the workforce.

The offer follows months of campaigning by the RCN and other unions last summer against the government’s 1% pay cap and seven years of pay restraint.

The proposed three-year deal would give each of the 1.3 million workers on the NHS Agenda for Change (AfC) pay contract a minimum pay rise of 6.5%, with no change to annual leave entitlements or unsocial hours payments.

£4.2 billion

of new money has been committed by the Treasury to enable the proposed pay rises

Half of nurses will receive a much higher pay rise of between 9% and 29%, depending on their pay band and increment.

A registered nurse who is three years into their career and earning around £24,500 will be more than £6,000 a year better off by 2020-21.

The Treasury has committed to fully fund the deal with an extra £4.2 billion for the NHS, meaning that trusts and other employers will not be asked to find the money from existing resources.

Higher starting salaries and shorter pay bands

In a bid to recruit and retain more nurses, the new system will allow individuals to reach the top of their pay band sooner.

Other key points include:

  • Starting salaries across all pay bands will be increased – increments at the bottom of pay bands that overlap with those below will be removed
  • A new provision detailing pay for apprentices will be negotiated by NHS Staff Council ‘as a matter of urgency’
  • Band 1 will be closed to new entrants from 1 December 2018 and current staff will move up to a new basic minimum NHS wage of £17,460
  • The new pay structure will allow staff in bands 2-9 to reach the top of their pay band more quickly – in two to five years, rather than five to eight years

Lead staff side negotiator, Unison head of health Sara Gorton, says: ‘The NHS at the moment is going through a staffing crisis of daunting magnitude – experienced staff leaving in greater numbers than ever before, difficulty attracting new staff to work in the NHS – and the people who are left are carrying the strain. Pay is a root cause of all of this.’ 

Four years

the amount of time it will take to reach the top of band 5, not seven years as it does currently

The pay deal ‘won’t solve every problem in the NHS’, she adds, ‘but would go a long way towards making dedicated health staff feel more valued, lift flagging morale and help turn the tide on employers’ staffing problems’.

An important element for recruitment is that it will make starting salaries more attractive for those considering a career in the NHS, she says.

'Productivity comes from a healthy, motivated workforce’

Josie Irwin

RCN associate director for employment relations Josie Irwin says: ‘Members campaigned hard to put an end to the years of poor pay rises and this deal is a significant move in the right direction from a government still committed to austerity.

‘Starting salaries will be higher and current nurses will reach the top of their pay bands much faster than ever before, without changes to their leave entitlement or unsocial hours payments.

‘With this agreement, the government and NHS has acknowledged that the greatest rise in productivity will come from a healthy and motivated workforce.’

Health and social care secretary Jeremy Hunt says the agreement would ‘extend shared parental leave rights’ to all staff.

The proposed pay agreement also states an ‘ambition… that through positive management of sickness absence, the NHS will match the best in the public sector’.

NHS Employers chief executive Danny Mortimer says: ‘We believe this three-year deal does give us an important platform to become the most desirable employer in the country.’

Mr Hunt says: ‘Employers and unions have made a commitment to reducing sickness absence through a better shared focus on staff health and well-being, all of which will be welcomed by staff after a very tough winter.’

The agreement proposes a programme of work to help address the main factors affecting levels of sickness absence in the NHS, and a review of the current agreement on absence management.

None of this will alter the sick pay provisions set out in the terms and conditions of service handbook.

Mixed front-line reaction

Joan Pons Laplana

However, nurses’ reaction to the deal has been mixed.

James Paget University Hospitals NHS Foundation Trust transformation nurse Joan Pons Laplana says he believes none of the proposed percentage increases translate into rises once cost of living and inflation are taken into account

He says: ‘I want people to vote no to this deal because I want to see if unions can try and get something better – I want unions to realise this deal is not as good as it sounds.’

London community nurse Annique Simpson says the minimum 6.5% is ‘not a proper pay rise’ and represents a cut when set against inflation.

She says: ‘It will not reverse the haemorrhaging of tens of thousands of skilled nurses, nor the loss of valuable senior nurses, nor improve recruitment.

‘If this is the deal… then it is a big no from me'

London community nurse Annique Simpson

‘It will not encourage more people to take on £50,000 in debt to undertake a nursing degree, it will not improve morale, it will not improve safe, holistic care for our NHS patients.

‘If this is the deal… then it is a big no from me.’

‘This goes some way to making nurses feel valued’

On the other hand, band 7 learning disability nurse Denise McLaughlin says she feels after years of a 1% pay cap, the deal would finally mean nurses could predict their income for the next three years.

‘It’s as good as we are going to get negotiated, and this goes some way to making nurses – who go above and beyond each day for their patients – feel valued.

‘This will also go some way to improve interest in learning disability nursing generally.’

Basic pay will increase by £4,842 (22%) over the three years for a new band five nurse

Band 7 neonatal intensive care sister Tracey Budding agrees. She says: ‘I think it’s the best deal we could have got, the alternative is 1%, so it addresses recruitment and retention, which is in crisis.

‘Nurses are thinking of retiring early because of the pressures, and if staff are burnt out that affects patient care.’

Ms Budding says she feels a sense of triumph that the government bowed to pressure after the RCN’s Scrap the Cap campaign, and believes there would be no deal at all had that protest not occurred.

Devolved countries

While the proposals concern staff in England, their impact will be felt across the whole of UK.

If agreed in England, money would flow through to Scotland, Wales and Northern Ireland via the Barnett formula, which makes adjustments to public expenditure in the devolved nations.

NHS trade unions have approached the pay talks on a UK-wide basis, ensuring representation from Wales, Scotland and Northern Ireland at every stage, but devolution of health matters means discussions on NHS pay have to happen on a country-by-country basis.

Unions are talking separately to the devolved governments and employers about how they could use the agreement for England to put together a package that might work in their own countries. 

The hope is to preserve the NHS pay framework across the whole of the UK, which would give unions the opportunity to push for alignment of pay scales across the four countries, as well as level up pay rates where they have diverged.

The Scottish Government has already indicated its intention to negotiate a pay deal that ensures NHS staff in Scotland will be paid at least as much as their counterparts in other parts of the UK.

RCN Scotland director Theresa Fyffe says the organisation ‘strongly believes’ maintaining pay, terms and conditions across the UK is best for the future of the NHS.

‘Failure to do this will have a significant impact on recruitment and retention in NHS Scotland.

‘We welcome the Scottish Government’s decision to open negotiations on NHS pay.

‘Like them we want to move quickly and will work hard to secure the best deal for our members.’ 

Timeline: what happened and what’s next?

  • In 2017, the Department of Health and Social Care did not give the NHS Pay Review Body (RB) a remit to look into NHS pay in July as it usually does
  • For the first time, last September, the NHS unions submitted a pay claim directly to the chancellor and the finance leads in the devolved nations, calling for an above-inflation pay rise, an £800 one-off payment and money to fund reforms to the pay structure
  • The RCN has endorsed the pay deal and will put it to a membership vote from late April, with most of the other NHS staff unions following likewise
  • The NHS staff consultation will conclude in June
  • If supported by members, the higher payments – backdated to April 2018 – are expected to begin in July and will be in effect until 2021
  • Any extra funding for English health budgets will go through the Barnett formula into budgets in Wales, Scotland and Northern Ireland. RCN Scotland hopes to push for a deal with the Scottish Government to go out to consultation in April and May
  • If the pay deal is not accepted, the NHS pay increase for 2018-19 will be determined through the usual mechanism: based on NHS Pay Review Body (RB) recommendations
  • The government would be expected to take into account the RB recommendations and make a pay award, accordingly


Further information

Check what your pay would be under the deal with this calculator 
NB Nurses in Scotland, Wales and Northern Ireland can use the calculator to see what their equivalent in England would receive, but it does not account for pay differences in the four nations

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