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NHS nurse pay in England is set to rise by 6.5% over three years under new proposed deal


Nurses and other NHS staff on the Agenda for Change contract in England are to be offered an average 6.5% pay rise over three years, with many staff set to receive more than this under proposals revealed today.

Unions said the three-year deal gives each of the 1.3 million staff on the NHS Agenda for Change contract a pay rise worth at least 6.5%, without changes to annual leave entitlements or unsocial hours payments.

“If health workers accept the offer, everyone’s wages will go further”

Sara Gorton

Under the multi-year deal agreed by unions and employers, all but the very highest paid staff would get 3% in April 2018, 1.7% and a 1.1% lump sum in April 2019, and 1.7% from April 2020.

Overall, basic pay will increase over the three years by 22% (£4,842) for a band 5 nurse who started this year, 16% (£3,819) over the three years for a band 5 nurse with two years’ experience and 6.5% (£1,869) if they are at the top of the pay band.

According to the Royal College of Nursing, half of nurses will receive significantly more than 6.5%. It cited the example of a registered nurse, currently three years into their career and earning around £24,500, who it said would be over £6,000 a year better off by 2020-21.

“The government has acknowledged that the greatest rise in productivity will come from a healthy and motivated workforce”

Josie Irwin

The college also today said that the proposed new system would allow individuals to reach the top of their pay band sooner and starting salaries will be increased. The starting salary of a nurse will rise to £24,907, from £22,128 now, according to the Department of Health and Social Care.

If accepted, the deal would also result in an end to band overlaps, which have seen some employees on lower ones earning more than more senior colleagues the next level up.

In addition, the healthcare assistants will get significantly more than 6.5% via the tiering arrangement. Unison said staff on the lowest pay grade would get an immediate pay rise of over £2,000 this year – an increase of between 11% and 13%.

Under the proposals, band 1 would be scrapped altogether by April 2021 and all staff moved to the next pay scale. The lowest salary in the NHS would then be £18,005.

“NHS staff have never worked harder and this deal is recognition of that”

Jeremy Hunt

The government has harboured ambitions to reform the contract for a long time, with ministers seeking to end what they saw as automatic pay rises being given through regular increment rises.

When first introduced, increment change was expected to be tied to staff appraisals via the knowledge and skills framework – but use of this part of the process has increasingly been seen as patchy.

Other measures outlined today as part of the deal include extending shared parental leave rights to all staff, and employers and unions making a “commitment” to reduce sickness absence through a ”better shared focus on staff health and wellbeing”.

Meanwhile, the idea that staff would be required to sacrifice a day’s holiday in return of the 6.5% increase, which was mooted in a national newspaper story earlier this month, appears to have been dropped.

Union members will be asked to vote on the new proposals, which are being recommended by unions and employers with the exception of the GMB, before they can be introduced.

Unions have also launched a website with more information on the proposal, including a “pay calculator” so staff on different bands can what they would get over the three years.

Unison head of health and lead pay negotiator for the NHS unions Sara Gorton said: “Seven years of pay freezes and wage increases well below the cost of living have meant significant financial hardship for health staff and their families. It’s also created headaches for employers as they struggled to attract new recruits and hold onto experienced staff.

sara gorton unison

sara gorton unison

Sara Gorton

“If health workers accept the offer, everyone’s wages will go further, and the lowest paid would get a significant income boost. Starting salaries for nurses, midwives and other health professionals would also become more attractive to people considering a career in the NHS,” she said.

RCN associate director employment relations Josie Irwin said: “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 nursing staff will reach the top of their pay bands much faster than before, without changes to their leave entitlement or unsocial hour payments,” she said. “With this agreement, the government and NHS has acknowledged that the greatest rise in productivity will come from a healthy and motivated workforce.”

Unite national officer for health Sarah Carpenter said: “At long last, after eight years of pay austerity, there has been a significant recognition that this harsh pay regime imposed on hard working and dedicated NHS staff can no longer be sustained.

“Unite welcomes many aspects of this deal, on which we will be consulting our membership over the next couple of months. However, we regard this as the start, not the end, of the journey for true pay justice for NHS staff, which we will campaign for with vigour in the coming months and years,” she said.

Jon Skewes, lead negotiator for the Royal College of Midwives, said: “This pay deal is the best that has been achieved for any public sector workers, and one that completely breaks the government’s pay policy of recent years. It is a deal that I encourage our members to accept.”

“Also, no holidays will be lost by any staff as part of this agreement. The RCM along with the other unions also resisted any undermining of the value of unsocial hours payments. Crucially this agreement will also be fully funded by the government and not come out of existing NHS funding,” said Mr Skewes.

The Treasury has committed to fully fund the deal with £4.2bn extra for the NHS. Hospital trusts and other employers will not be asked to find the funds from existing resources.

Jeremy hunt new website

Jeremy hunt new website

Jeremy Hunt

Health and social care secretary Jeremy Hunt said: “NHS staff have never worked harder and this deal is recognition of that – alongside some important modernisation of the way their contracts work.

“Over one million employees on Agenda for Change contracts – including the lowest paid NHS workers – will get pay rises that see starting salary increased from £15,404 to £18,005 in 2020-21,” he said.

“The starting salary of a nurse will rise to £26,970 which will have a significant impact on retention and recruitment issues,” said Mr Hunt.

NHS Employers chief executive Danny Mortimer said: “This three-year agreement sets out the pay investment that will be made and the reforms that employers, NHS trade unions and the Department of Health and Social Care are agreeing to implement together.

Danny mortimer

Danny mortimer

Danny Mortimer

“To support long-term attraction and recruitment, starting salaries for all our non-medical staff groups will also see increases, which will help to make these roles more attractive,” he said. “It will also ensure that existing staff receive deserved increases to pay, which will assist our work to value and retain these vital colleagues.

He added: “We will also extend shared parental leave rights to all staff, and employers and unions have made a commitment to reducing sickness absence through a better shared focus on staff health and wellbeing, all of which will be welcomed by staff after a very tough winter.”

The deal was officially revealed today following the latest meeting of the NHS Staff Council, which saw the proposals rubber-stamped by representatives from 14 unions. 

As reported by Nursing Times, NHS nurses have become increasingly frustrated at having their pay either frozen or restrained since 2010, most recently due to the cap that has limited basic wage rises to 1% since 2015.


Sarah Carpenter

Sarah Carpenter

Pay negotiations have been happening sporadically between unions and the body NHS Employers, which represents the government, since the strike action that took place in 2014.

However, the discussions had stalled due the previous absence of an offer of any new money for pay increases above 1% – a barrier that was seemingly lifted last year.

A sequence of events in 2017 showed that progress appeared to be finally being made with the government publicly signaling an end to the 1% cap that was originally due to be in place until 2020.

A series of workforce warnings from high profile figures in healthcare were succeeded by the health secretary himself saying that he planned to relay concerns about staff pay to the chancellor and then confirmation that the cap had indeed been scrapped.

This was followed by the budget statement, in which the chancellor committed to provide “additional funding” for a salary rises tied to contract changes, potentially with a multi-year deal. Philip Hammond subsequently reiterated a commitment to end the 1% cap ahead of his recent spring statement.

Meanwhile, all sides have also submitted evidence to the independent NHS pay review body, which is meant to assess the arguments and then recommend a figure for salary increases.

However, the contract changes and multi-year deal are being negotiated separately by the interested parties and it is not currently clear what role the review body will play in the process.

Inflation, as measured by the consumer price inflation, was above 2.5% in February. But the rate fell from 3% in January to 2.7%, the lowest since July 2017, driven by falling petrol prices and a slower rise in the cost of food.

What you need to know about the pay deal

Magnifying glass

Magnifying glass

  • The proposed agreement would mean that every NHS worker in England is to be paid £17,460 from 1 April 2018, which is at least £8.93 per hour.
  • Under the proposed agreement, which would take effect from 1 April, staff currently paid below the top of their pay bands would receive between 9% and 29% over the three years.
  • For staff already at the top of their band, most would get 6.5% between April 2018 and April 2020. All but the very highest paid staff will get 3% in April 2018, 1.7% and a 1.1% lump sum in April 2019, and 1.67% from April 2020.
  • The 29% applies to less than 1% of the workforce.
  • The pay increases are a combination of what was already built into the pay bill for annual increments and the three year increase on the pay bill of 3% per annum.
  • Health unions will now consult with their members over the pay offer. If the agreement is accepted, the funding put into English health budgets will flow through the Barnett formula into budgets in Wales, Scotland and Northern Ireland. This will allow unions, devolved governments and employers to hold discussions on whether and how they want to implement the framework agreement for their health staff.

Updates to follow…



Readers' comments (22)

  • Once again the core of staff in the NHS are penalised.
    Those that have dedicated many years of their working lives to caring for our patients and who are top of their bands, be that 5, 6 or 7 get the minimum increase.
    Whilst I agree that it would be advantageous to recruitment of nurses I can see no advantage in the retention of hard working qualified staff who have been in the service for many years.
    Don't penalise experience reward it.

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  • I may have more £33.00 in my payslip!!!!!
    It's ridiculous!
    I wonder if unions are really defending our interest??
    Just if we stay at home they may understand.

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  • How is this pay deal fair for those nurses who have worked their way to the top of a band, and sat there for the last few years seeing an reduction in the real worth of our pay and now coming out of this with the worst offer. Just goes to show our experience and years of keeping the NHS going count for nothing.

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  • It seems to me that the work of the trade unions is to get us to stay calm and accept the general culture disrespectful towards nurses.

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  • I agree with the above comments, it. I think it is an insult to experienced nurses, who have forfeited pay rise for years.

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  • Some of us remember the similar pay awards in the 1980’s where nursing sold their soul for a degree and look where it got us........Just waiting to see what they want in return....
    I wonder what new nurses now, will be saying in 30 years time!

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  • knowledge and skills as a top band 7 with no increment for the last 5 years will be rewarded with what exactly? I do the work of 2 nurses and an administrator because there is, apparently, no money in the pot to recruit. of course, the RCN, Unison, GMB etc still have to canvas their members to see if we are happy with the deal. I, for one, will vote no, the increase won't even cover the rise in my rent and council tax this year never mind subsequent years. I'm not the only person in this position either, I know numerous band 6 and 7 nurses in the same boat. Recruitment is all well and good but how are you going to teach these new nurses when all the experienced highly educated and knowledgable ones leave?

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  • Having done some calculations - the mean increase of those of us on bands 6 and 7 and at the top of their bands is approximately £2700 over three years - this equates to about £18.75 per week(before deductions) .Go figure it for yourselves.

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  • This pay deal feels like it's penalizing me for being a nurse with years of experience at the top of my band. I don't understand why it can't be the same level of pay rise for all band 5s. I understand that they want to recruit more people into nursing but surely keeping those experienced nurses in post should be just as important.

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  • HCSW

    I am really happy with that arrangement.

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