Health unions are calling on the government to get on with promised direct talks to get wage structures right and deliver pay awards on time, they say today (Friday).
The 14 unions representing staff on ‘Agenda for Change’ contracts within the NHS have written jointly to health secretary Wes Streeting urging him to honour a commitment made last year to tackle problems in the pay system that are harming staffing and morale.
Given the delay, unions say these talks should now be widened to also include the headline pay award for 2026, which would need to be decided early next year if it is to be paid on time in April, as ministers have committed to do.
Unions say staff trust and confidence in the current pay process, involving a time-consuming pay review body (PRB), has hit rock bottom and a more efficient approach is needed for the coming year.
That means setting aside the PRB process and focusing efforts on comprehensive talks backed by sufficient investment from ministers to allow a deal to be reached, the unions say. This must be enough to cover the cost of reforming pay bands and an acceptable pay increase.
Hardworking staff need to see the government values them and understands their cost-of-living struggles, say the health unions.
Most NHS workers received a pay rise this year that was significantly lower than the one given to doctors and dentists, and which has now slipped below the level of inflation.
The unions – representing more than a million NHS workers – say discontent with the 2025 pay award and the broken promises on talks have “heightened industrial tension” and time is running out.
As a result all but one of the NHS unions have today announced they will not participate in the next pay review body process for 2026/27.
This year’s pay rise of 3.6% was lower than almost all public sector wage increases decided through pay review bodies. And with CPI inflation standing at 3.8%, unions point out pay is being outstripped by the rising cost of living.
The unions say this is further evidence of how the current pay review body (PRB) process is not fit for purpose.
Meanwhile, problems have mounted with the current Agenda for Change system put in place two decades ago, but the absence of regular negotiations means these have not been addressed. Pay bands need to be adjusted to ensure skills and responsibilities are correctly rewarded, the unions point out.
They say it makes little sense to tackle pay rises and structural adjustments separately when a streamlined process would be more efficient.
In their letter the unions say of this year’s rise: “Far from being what the government claimed to be an ‘above-inflation award’, it is in fact a real-terms cut as things stand.
“This has done nothing to boost workforce morale or generate the goodwill needed to deliver the government’s much-needed NHS recovery plan.”
The unions say they will focus their efforts on pushing for extra “meaningful funding” to reform Agenda for Change, in addition to ensuring NHS workers get the decent pay rise they deserve.
Chair of the NHS unions and UNISON head of health Helga Pile said: “The government promised talks over a year ago and they still haven’t got round the table with unions with any proper plan to sort things out.
“The only way to get a system that’s fit for purpose and meets the needs of staff in a modern health service is to fix the structure at the same time as making sure staff can cope with the cost of living.
“Some things need sorting urgently while others will take longer to work through. But the important thing is that we agree a plan and get the funding needed to reach a deal.
“The health secretary wants a more efficient system and that begins with getting pay right. Tackling this now will help to deliver the pay rise when it’s due in April rather than kicking the can down the road leaving staff with months of delays.”
Secretary to the NHS unions and assistant director for employment relations at the Chartered Society of Physiotherapy Jim Fahie said: “The government’s failure to honour the structural reform commitment for the 2025/26 pay year, alongside a lower pay award than other PRB groups, has led to high levels of dissatisfaction among our members.
“Our collective efforts are focused on securing a fair annual uplift in pay for our members and for separate funding to be provided for Agenda for Change (AfC) structural reform.
Notes to editors:
– The 14 Agenda for Change unions are the Association for Laboratory Medicine, British Association of Occupational Therapists, British Dietetic Association, British Orthoptic Society, Chartered Society of Physiotherapy, GMB, Pharmacists’ Defence Association, Prison Officers Association, Royal College of Midwives, Royal College of Nursing, Royal College of Podiatry, Society of Radiographers, UNISON and Unite.
– The NHS pay review body is due to take evidence over the coming months in order to prepare its recommendation on the 2026/27 wage increase. Ministers have separately promised they will ask the NHS Staff Council negotiating body to hold talks on structural issues, but they have still not confirmed funding and a mandate for formal talks.
Media contacts:
Anthony Barnes (UNISON) M: 07834 864794 E: a.barnes@unison.co.uk
Jon Ryan (Chartered Society of Physiotherapy) M: 07917 091200 E: ryanj@csp.org.uk
The article Ministers must make good on NHS pay-talk promises, say health unions first appeared on the UNISON National site.
Comments are closed.