Hundreds of thousands of NHS staff are set to receive pay rises of between 9% and 29% over the next three years after ministers abandoned a seven-year health service salary squeeze.



All of the more than 1 million personnel working for the NHS in England will receive at least a 6.5% increase, if they back the deal in ballots to be run by the 14 trade unions to which they belong. They include nurses, midwives, paramedics, scientists, porters and cleaners.

All of the unions except the GMB are advising their members to accept the government’s offer. The 13, which include Unison, the Royal College of Nursing (RCN) and Unite, welcomed the deal as an end to the 1% pay cap and a boost to efforts to tackle widespread and worsening understaffing.

“The agreement means an end at last to the government’s self-defeating and unfair 1% pay cap, said Sara Gorton, Unison’s head of health, who has been the unions’ chief negotiator in talks with ministers and NHS Employers over the last five months. “It won’t solve every problem in the NHS, but would go a long way towards making dedicated health staff feel more valued, lift flagging morale and help turn the tide on employers’ staffing problems.”

Both sides agreed that the £4.2bn freed up by the Treasury to pay for the deal should be targeted at the lowest paid NHS staff, both in absolute and relative terms.

The half of NHS staff who are already at the top of their pay scale will get the 6.5%. But the other half will receive pay rises of 9% to 29%, with those at the bottom of their pay scales receiving the most, by 2020-21.

For example, the salary of a specialist nurse, physiotherapist or other worker on the bottom of the band-seven pay scale, who currently earns £31,696, would rise by 29% to £40,894 by 2020-21. Similarly, the pay of the 13,925 nurses, therapists, scientists and other staff in the middle of band five will rise over the three years from £24,547 to £30,615 – a 24.7% increase.

A newly qualified nurse’s starting salary on band five will go from £22,128 to £26,970 – a 22% rise. If accepted, the package would also give about 100,000 staff a minimum salary of £17,460 by 2020-21 – and mean they earn more than the living wage.

Q&A Does the UK have enough doctors and nurses? Show The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals. NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem. Read a full Q&A on the NHS winter crisis

“NHS staff have never worked harder and this deal is recognition of that, alongside some important modernisation of the way their contracts work. Over 1 million employees on Agenda for Change contracts – including the lowest paid NHS workers – will get pay rises that see starting salary increasing year on year from £15,404 to £18,005 in 2020-2021,” said Jeremy Hunt, the health and social care secretary.

He and the RCN’s general secretary, Janet Davies, played a key role in persuading government negotiators to drop their previous insistence that staff forfeit a day’s annual leave in return for more cash, which had threatened to spark a backlash.

Staff will also see no changes to existing extra payments for working antisocial hours but there will be a drive to reduce staff sickness.

The unions will consult members for their views until the end of May and announce the outcome of that by 8 June. If the unions agree then staff will start to receive their rise in July, backdated to April.

However, the Treasury has warned other cabinet ministers not to regard the NHS deal as a signal that Philip Hammond will provide extra resources to award above 1% pay increases to other public sector workers.

A series of other pay review body reports, including for teachers, are due in the coming months.

No 10 is insistent an across-the-board pay cap is no longer in place. “The independent pay review bodies will make their recommendations in the normal way. We have made clear as a government that the arbitrary 1% cap is no longer in place – if people recommend changes, they will be considered,” a Downing Street source said on Wednesday.

But Hammond is clear the NHS is a special case – and other ministers will have to find any extra resources from within their existing budget.

• This article was amended on 22 March 2018 to correct the end figure of an example salary rise.

