Disappointment at NHS pay award

Martin Shipton

Unions representing NHS workers have reacted with disappointment and anger to what they see as a real terms pay cut for their members.

Cabinet Secretary for Health and Social Care Jeremy Miles claimed that the workers would get an above-inflation increase based on predictions that inflation will fall from its current level.

But the unions insisted that the rise of 3.3% was below the current rise in the cost of living, and would continue the below-inflation pattern of salary increases workers in the NHS have had for more than a decade.

In a written statement, Mr Miles said: “I am pleased to announce I am today accepting the recommendations made by the NHS Pay Review Body (NHSPRB) from April 1 2026.

“The NHSPRB recommended a 3.3% consolidated uplift effective from 1 April 2026 for all Agenda for Change pay points. Staff employed under these terms and conditions include nurses, cleaners, porters, and healthcare support workers.

“The NHSPRB economic analysis shows this uplift is above the current inflation forecasts for both the Bank of England and the Office for Budget Responsibility (OBR). The OBR expects the rate of inflation to have peaked by the third quarter of 2025 and to fall progressively to the 2% target in quarter one 2027.

“In accepting these NHSPRB recommendations, we are committed to:

* Uplifting all pay points for Agenda for Change staff by 3.3% on a consolidated basis, effective from April 1 2026.

* The Welsh Government has already announced its intention to pay the real living wage (Living Wage Foundation rate) from April 1 2026. This means the increase for the lowest-paid NHS staff will range from 3.8% to 5.9% as a result, significantly above inflation.

* As part of the overall pay package, alongside accepting the NHSPRB recommendation about pay, we will continue to progress tri-nation with the NHS Staff Council to agree and implement improvements to the Agenda for Change pay structure.

“These will build on the constructive discussions to date with unions about a multi-year, funded mandate for Agenda for Change structural reforms in England, Wales and Northern Ireland.

“Our priorities for structural reform include improving pay for the lowest paid staff and graduate pay. Once agreed, these reforms will be effective from, and backdated to, April 2026.

“I would like to extend my thanks to all NHS staff in Wales for their dedication and hard work. Your commitment to providing exceptional care and services is truly appreciated.”

Three unions issued statements expressing dissatisfaction with the pay award.

Angry

Unison said NHS staff across Wales were likely to be angry with another below inflation pay award. With inflation at 4.2%, the union says the 3.3% rise announced by health secretary Jeremy Miles will leave nurses, healthcare assistants, porters and catering staff worse off in real terms.

The union added that health workers’ pay in Wales already lags behind Scotland, where staff negotiate pay directly with government and employers through their unions.

Unison Cymru said the London-based pay review body system used in Wales was outdated and failing to deliver pay increases needed to recruit and retain health staff.

The union wants ministers to open direct pay negotiations after the Senedd election.

Unison Cymru chair of health committee Dawn Ward said: “For many NHS staff, this is not about percentages on paper, it’s about choosing between heating and eating, watching every pound and worrying about the next bill.

“The lowest paid workers are already stretched to the limit. Healthcare assistants, cleaners and porters keep services running but struggle to make ends meet. Morale is low because people feel taken for granted.

“Staff want fairness and respect. That means a pay rise that makes a real difference in their lives, not one that disappears as soon as it reaches their bank account.”

‘Pay cut’

Unison Cymru head of health Tanya Bull said: “Let’s not pretend this is generous. It is another real terms pay cut.

“Health boards cannot expect to recruit and retain staff when supermarkets are offering higher starting rates.

“Workers in Scotland negotiate directly with their government through their unions. They are treated better because they have a voice at the table.

“Health is devolved, yet Welsh NHS pay is still tangled up in decisions made in Westminster. That’s absurd.

“NHS workers deserve respect and a proper pay rise that reflects the real rise in the cost of living, not another squeeze.”

Unison said that Bands 1, 2 and the entry point of band 3 on Agenda for Change would all remain on the same pay rate from April 1. Earlier this year the Welsh Government confirmed it would apply a real living wage top-up to those bands. As the pay review body recommendation is lower than that uplift, these staff will see no additional increase.

‘Very disappointing’

RCN Wales Executive Director Helen Whyley said: “A 3.3% pay award is very disappointing and shows a failure to grasp the reality facing nursing staff in Wales. At a time when the cost of living remains high another real term pay cut is being imposed again on a workforce already stretched to its limits.

“The Welsh Government has made a commitment to pay restoration back to 2008, and this award falls well short of that pledge and of what is needed to value and retain staff.

“It is particularly indefensible that the government have once again fallen back on the Pay Review Body process that unions widely rejected after raising expectations for direct negotiations. Nursing staff were led to believe a different approach was coming. Instead, they have been handed more of the same.

“The Welsh Government must also match the career progression measures announced for NHS nursing staff in England yesterday. Our members in Wales will not accept being left behind. If progress can be delivered for staff across the border, it can and be delivered here.

“Morale is already fragile and staff feel consistently undervalued. Fair pay and clear career pathways are essential to keeping experienced professionals in the NHS and attracting the next generation.

“We will now review this award against the rest of the NHS staff pay and across the public sector before deciding our next steps.”

Rachel Harrison, GMB National Secretary said: “GMB welcomes the efforts made to ensure NHS workers will receive their pay increase when it is due, in April.

“The first time this will have happened in years.

“But this award is just not enough to make up for more than a decade of pay cuts under the Tories. NHS workers deserve more and GMB will fight for that at the long overdue agenda for change structural talks we have now been promised.

“GMB reps will now meet to discuss the pay award and determine next steps.”