Nurses’ pay dispute: quick guide to what’s being offered, where

NHS nursing staff are battling for better pay and working conditions, with unions in each part of the UK at a different stage in negotiations
Line of nurses on strike in RCN pay dispute hold protest banner outside Queen Elizabeth Hospital in Birmingham

NHS nursing staff are battling for better pay and working conditions, with unions in each part of the UK at a different stage in negotiations

Line of nurses on strike in RCN pay dispute hold protest banner outside Queen Elizabeth Hospital in Birmingham
Union members picket Queen Elizabeth Hospital in Birmingham. Picture: Alamy

This article was updated on 6 June to reflect developments

Nurses in England are currently voting on a further six months of strike action in their dispute over better pay and working conditions. Meanwhile, nurses in Wales are taking to picket lines again after rejecting the Welsh Government’s latest pay deal.

While the NHS Pay Review Body’s (RB) £1,400 recommendation in July 2022 covered the whole of the NHS, the four countries of the UK are at different stages of negotiations for a better deal.

Here’s what is happening in all four corners of the UK.

ENGLAND: Nurses reject pay offer and face new vote on strike action

A new pay offer was put on the table for nurses in England in mid-March after weeks of negotiations with the Westminster government.

The new offer consisted of two non-consolidated payments, one of 2% and the other dubbed an ‘NHS backlog bonus’ worth the equivalent of 4% of nurses’ current pay.

The one-off payments were worth between £1,655 and £3,789 for staff on Agenda for Change contracts in England, according to the RCN. This is on top of the 4% already awarded for 2022-23.

Additionally, nurses would see a 5% pay rise for 2023-24, up from the initially proposed 3.5%.

A number of non-pay-related measures were also put forward, including an agreement to create a new pay structure exclusive to nursing staff, as well as a promise of a national evidence-based policy on safe staffing.

The new offer was put to union members in an online ballot that closed on 14 April, with the RCN recommending that members vote to accept the offer. However, the results revealed that nurses rejected the offer overall. In total, 61% of eligible members voted, with 54% of those rejecting the offer.

The union announced a 48-hour walkout over the bank holiday weekend, from 8pm on 30 April until 8pm on 2 May.

Secretary of state Steve Barclay later challenged the legality of the strike action planned for 2 May and took the RCN to the High Court, which ruled in the government’s favour and said that the mandate for industrial action expired on 1 May.

Nurses took part in a 28-hour walkout from 8pm on 30 April until 11.59pm on 1 May.

Immediately after the walkout, a new England-wide statutory ballot was launched to ask RCN members whether they support further industrial action over pay for both 2022-23 and 2023-24. This ballot will end on 23 June.

Previously, nurses went on strike for a sixth day on 7 February, after similar walkouts on 15 and 20 December, 18 and 19 January and 6 February.

A striking nurse outside Royal Preston Hospital on 6 February. Picture: John Houlihan

In July 2022, a much-delayed 2022-23 pay offer of 4%, or around £1,400, was announced. Some 300,000 RCN members were balloted on the offer, with the majority of those who voted rejecting it.

Eligible nurses will now be asked to join the industrial action, and also to vote in the new strike ballot. Meanwhile all unions representing Agenda for Change staff will meet on 2 May as part of the NHS Staff Council to decide next steps.

SCOTLAND: Industrial action averted as nurses in Scotland accept new pay offer for 2022-23 and 2023-24

Despite nurses voting to strike, walkouts in Scotland have been avoided after the Scottish Government made a revised pay offer for 2022-23 and accelerated its offer for 2023-24.

The Holyrood government revised its pay offer to 8% in November 2022 after its initial offer was rejected. RCN members again rejected that offer and strikes were back on the table.

But follow-up talks resulted in suspension of action in February on condition that swift progress could be made on next year’s pay offer. And on 17 February, ministers put forward a pay offer for the coming financial year of 6.5% for most staff on Agenda for Change contracts, plus a one-off payment of between £461 and £821, depending on the band.

Alongside the accelerated offer for 2023-24, the proposal includes a review of the Agenda for Change pay bands.

The RCN recommended its members accept the offer in the ballot held between 28 February and 20 March. On 21 March, RCN Scotland announced that members had narrowly voted to accept the offer.

Some 53% of members in an RCN ballot voted to accept a pay rise of 6.5% for 2023-24, which will make them the highest-paid nurses in the whole health service.

WALES: Nurses to vote on ‘best and final offer’ from government

Nursing staff staged strikes on 15 and 20 December last year. RCN members had been due to continue industrial action on 6 and 7 February, but this was called off thanks to last-ditch talks with the government.

Ministers offered 3% on top of the current 4% offer, to be backdated to April 2022.

The Welsh Government then published a more detailed breakdown of the offer. The extra 3% consisted of a 1.5% consolidated rise that would be permanently added to salaries. The other 1.5% was non-consolidated, which means it was a one-off payment.

Non-pay elements included:

  • Unsocial hours allowance to be reinstated after three weeks’ sickness absence rather than six
  • A review of career progression starting with nurses and others on bands 5-6
  • A commitment to the principle of restoring pay to 2008 levels, which will include influencing the UK government and the NHS Pay Review Body processes
  • Establishing a working group to explore reducing working hours to a 36-hour week without loss of earnings
  • A pledge to reduce reliance on agency staff by making NHS employment more attractive
  • Commitments to drive up retention and ensure flexible working – including a new policy on retire and return

RCN Wales members voted down the offer, prompting the government to reopen talks despite a majority of combined health union members in the NHS Wales Trade Union Group accepting the deal.

After several weeks of negotiations, the Welsh Government offered a 5% consolidated increase for 2023-24, to take effect from April 2023.

But RCN Wales members who took part in the ballot rejected the new deal by 53% to 47%, prompting the Cardiff government to reopen talks. This was despite a majority of combined health union members in the NHS Wales Trade Union Group once again accepting the deal.

After several more weeks of negotiations, the government offered a 5% consolidated increase for 2023-24, to take effect from April 2023, alongside a new, one-off ‘NHS recovery payment’ averaging 3% for all healthcare staff, including bank staff, for 2022-23.

This offer was also rejected by RCN Wales members and nurses took to picket lines on 6 and 7 June. The RCN warned further industrial action would take place on 12 and 13 July if pay talks were not reopened.

NORTHERN IRELAND: Strikes could be back on the table as pay dispute drags on

NHS nursing staff voted for industrial action and joined the first phase of RCN strikes in December after rejecting the £1,400 pay offer made by the Department of Health.

Political deadlock and suspension of the Stormont assembly means the pay offer came later than elsewhere in the UK.

RCN director Rita Devlin says that while there are no further strike dates planned, college members remain in dispute over pay. Further strikes are not ruled out.

As RCN members in England rejected the latest pay offer, RCN Northern Ireland wrote to secretary of state for Northern Ireland Chris Heaton-Harris to urge him to facilitate a pay deal. They said they would be forced to take action soon if there was no movement from the government.

It looks likely that further action will depend on concessions from Westminster, and strikes could be coordinated with those in England. New strike dates could be announced in the coming weeks.

This article was originally published on 7 February and was previously updated on 28 April 2023

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