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Apr 01

Delays to health workers’ pay rise causing huge problems for NHS

  • 1 April 2025

The government’s decision to stick with the ‘painfully slow’ NHS pay review body process means yet another lengthy delay before health workers in England* get the annual wage rise they should be due today (Tuesday), says UNISON.

NHS staff are meant to receive their pay increase on 1 April every year, but this hasn’t been delivered on time in a very long while, adds the union. And this year is no different with the workforce left waiting once more.

Unions had hoped the change of government would signal a break from the past and the poor way Conservative governments had handled NHS pay. Staff too had been banking on a different approach, says UNISON.

Health workers assumed ministers, appreciating the crucial role workers will need to play in turning around the fortunes of the NHS, would have avoided repeating the pay mistakes of their predecessors, says the union.

But the government has refused union requests to hold direct talks that could have sped up the pay-setting process, preferring instead to wait for the review body to make its recommendation.

It’s not just staff morale the pay delay is harming, says UNISON. Some overseas workers could now be deported because they’re unable to renew their visas.

This is because – with the pay award due today running late – the salary threshold for staff on the health and care visa will rise to £25,000 a year next week.

Lower-paid workers, such as healthcare assistants, needing to renew their visas could be sent home because they’ll be earning less than the new minimum visa salary.

That means the government’s failure to ensure a timely annual wage rise is giving trusts an added headache and causing terrible distress to some overseas staff, says UNISON.

This isn’t all, says UNISON. Earlier this year, the government had to set up an emergency pay intervention to stop trusts being in breach of the law when the national minimum wage increases today.**

Without this pay top-up, health workers on the lowest NHS salary scales would be on illegal hourly rates. From today, staff on bands 1 and 2, including cleaners, catering assistants and porters will get an 28p extra an hour, raising their hourly rate to £12.36.

This is still just 15p above the legal minimum and well short of the real living wage*** paid by many major supermarkets, says UNISON.

UNISON head of health Helga Pile said: “NHS staff have had their hopes of a prompt pay rise dashed once again. Knowing how key they are to the government’s NHS pledges, health workers had been banking on ministers pulling out all the stops on pay this year.

“But they’ve been left disappointed. It looks like the government is simply repeating the mistakes of the past.

“Worse still, the NHS could lose essential staff recruited from overseas because pay rates are out of sync with the visa salary threshold. Trusts have been put in a terrible position and migrant workers whose visas are about to run out are being caused untold distress.

“The government should’ve ditched the painfully slow pay review body process when it had the chance and held pay talks with unions, which could have avoided these problems.

“Ministers need staff to help them reduce delays for patients and get treatment waits down. Awarding a decent pay rise on time would have helped persuade health workers that ministers understand the problems facing the NHS and have a plan to start solving them.

“If the government did the right thing and delivered a decent pay rise on the day it was due, there’d be no need for this endless cycle of interim top-ups to stop NHS wages dropping below the legal minimum.

“A pay system that needs emergency action every year to correct illegal wages isn’t up to the job. This outdated process does nothing to aid morale nor make essential workers feel valued. It doesn’t help recruitment into the NHS either, especially when employers on the high street are paying substantially more.”

Notes to editors:
– *Health workers in Wales and Northern Ireland are also subject to the same protracted process, as their governments have chosen to fall in behind the Westminster government’s lead.
– **The national minimum wage rises today to £12.21 an hour and following the pay top-up announced in January, the salaries of NHS staff on the two lowest pay bands will rise to £12.36 an hour. More details here. Pending the pay award, the lowest rates will be topped up to the legal minimum of £12.21 for health workers in Northern Ireland and to £12.60 for workers in Wales. All health workers in Scotland are already paid more than the new legal minimum and their pay is set through negotiations with health unions, which got underway last month.
– ***The real living wage set by the Living Wage Foundation is £12.60 an hour and £13.85 in London.
– Changes affecting the recruitment of overseas health and care staff are due to come into force on Wednesday 9 April, including a higher salary threshold for the health and care worker visa. This is going up from £23,200 a year to £25,000 meaning anyone on bands 1, 2 or the lowest salary point of 3 won’t be earning enough to qualify.

Notes to editors:
– UNISON is the UK’s largest union with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.

Media contacts:
Anthony Barnes M: 07834 864794 E: a.barnes@unison.co.uk
Liz Chinchen M: 07778 158175 E: press@unison.co.uk

The article Delays to health workers’ pay rise causing huge problems for NHS first appeared on the UNISON National site.

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