In a joint letter to Health Secretary Wes Streeting, the 14 unions representing many of the lowest paid NHS staff have warned the 2026/27 pay award fails to keep pace with the cost of living, won't repair years of lost pay and doesn't address lower rises for those on Agenda for Change contracts than other groups.
Describing the 3.3% pay rise as inadequate, the unions say the government must improve its offer by putting significant extra funding into long-delayed pay restructure talks or the workforce crisis will continue to grow.
The unions point out that by relying on the much criticised NHS Pay Review Body process rather than negotiating directly with unions, ministers have wasted an opportunity to deal with headline pay awards and much-needed reform of the pay structure at the same time through comprehensive talks.
The 2026/27 headline rise will be imposed on April 1, with negotiations to follow on structural fixes, which would mean additional rises for some staff if a deal is reached. However, unions say those talks were promised more than 18 months ago and the ongoing delay has wrecked trust.
The letter says
“Day in, day out staff are battling understaffing, overwork and the constant worry that – despite their best efforts – patients are not getting the care they deserve.
“To rebuild confidence, negotiations must now move quickly and show clearly how they will improve on what staff have already been offered."
The government must provide sufficient funding to make sure talks succeed, unions add.
Despite the anger over pay, workers say they remain committed to the future of the health service.
“No one wants the NHS to succeed more than the staff who keep it running. But that requires a workforce that is properly valued and properly paid.”
The unions are also asking health workers to sign an online version of the letter to demonstrate the strength of feeling.
Chair of the NHS unions and UNISON Head of Health Helga Pile says: “For most NHS staff this will feel like a pay cut not a wage rise. After years of rising pressure and falling wages, health workers expected better from this government. If ministers really want the NHS to recover, they have to start by valuing the staff who keep it going.
"There's a lot riding on these talks. Real money on the table from government will be key."
Survey says
The recently published annual NHS staff survey of nearly three quarters of a million workers in England showed the scale of morale problems and dissatisfaction among workers. Only one third of staff (32.14%) are happy with their level of pay and nearly one third (29.55%) say they often think of leaving their job.
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.
