NHS pay 2025
The Health Service Group Executive met on Thursday 9 January 2025 and agreed to significantly escalate our pay campaign in response to the latest announcements from the Department of Health and Social Care. This includes mounting a political campaign where we encourage members and branches to lobby MPs to back urgent negotiations on NHS pay. Thousands of UNISON health members have already written to their MPs using the UNISON tool asking them to back urgent negotiations on NHS pay but we still need as many people as possible to do this.
In the summer, the government committed to talks with unions and employers to fix the serious issues with your pay structure. UNISON members said loud and clear that they need urgent action to address under-banding, lack of reward for progression and the lowest-paid staff repeatedly dipping below the legal minimum wage. But instead of keeping its word, the government is now bypassing unions and asking the outdated Pay Review Body to make recommendations on the budget for these essential repairs. That adds unnecessary delays, kicking the can down the road on important issues. And what's more, it says the cost of fixing the pay structure will knock money off the 2.8% set aside for your next pay rise.
Now we are joining together in UNISON and asking every MP in England to put pressure on the government to open negotiations. Will your MP back the NHS and its staff by putting pressure on the government to change course? Ask them now!
Most MPs hold constituency surgeries, especially on Fridays when Parliament does not sit. To arrange an appointment, you need to contact their constituency surgery rather than their Parliamentary office. Many provide their constituency office address and contact details on the Parliamentary website, but otherwise just do an internet search for your MP's name and the words 'constituency surgery'.
For bands 2-4 members:
The lowest hourly rate of pay in the NHS is £12.08 (as of February 2025), significantly below the Real Living Wage rate of £12.60. You have told us that the cycle of the lowest-paid staff repeatedly dipping below the legal minimum wage damages morale and leaves you feel undervalued. Don't you think there should be an end to poverty pay in the NHS?
With pay at Band 2 so low, lots of staff are being excluded from salary sacrifice schemes or buying and selling leave because it would take them under the minimum wage. This includes salary sacrifice schemes related to the cost of working, such as care hire/lease and car parking. In our latest survey on NHS pay, members told us the removal of their salary sacrifice scheme left them feeling undervalued, and more likely to consider leaving the NHS. Doesn't this prove that the rate of pay is just too low?
Band 2 has become a spot rate so there is no reward for progression. Your colleagues have already told us this is ridiculous. Don't you think you need an incentive for gaining experience and confidence in your roles? That means restoring pay progression for band 2.
The rate for Band 3 is just £456 a year more than Band 2. Combined with the reduction in unsocial hours payments, this is a massive disincentive for staff looking to take on more responsibility. Don't you think we need to double this gap to create a real promotion incentive and reward staff for taking on more responsibility?
For members in bands 5-6
We are at the greatest risk of losing new clinical staff in the first two years in their role. The progression from entry in intermediate in Band 5 is worth just £1.20 an hour. Don't you think in-band progression for early-career staff needs to come with meaningful reward? Promotion to Band 6 is worth just £0.44 an hour for experienced staff. Don't you think promotion should mean a real pay rise?
For members in bands 7-9:
At 8a, staff often lose all eligibility for unsocial hours payments and overtime. But promotion to 8a roles is worth just £946 a year. Band 8a often means a big jump in responsibility - don't you think there should be a decent reward for it?
For new graduates:
NHS salaries are at risk of not being competitive with other public sector jobs. Graduate entry into the NHS is at band 5 - a salary of £29,970, but teachers start at £31,650 - not to mention jobs in the private sector. Don't you think we run a risk of not being able to fill vacancies if we let the NHS fall behind here?
The right banding
All staff should be entitled to annual role and pay band reviews to make sure they are getting paid at the right rate for the job. This requires major national investment to ensure that employer job evaluation processes are fair, timely and effective in every NHS trust.
Unions won a big victory with Agenda for Change when it came in 20 years ago, but do you think employers have invested properly in checking your banding as they have given you more complex work? UNISON is arguing for a right to annual band reviews because too many people are now under banded for the work they do.
A shorter working week
UNISON's ambition is for a reduced working week in the NHS with no loss of pay. A better work-life balance would improve wellbeing, reduce burnout and keep staff in their jobs - reducing reliance on overtime and agency staff. While a shorter working week won't be achieved overnight, many staff have already identified changes that could allow work to be completed in fewer hours.
In our 2024 wellbeing and mental health survey, 3 in 5 of you told us you felt burned out by your work. Almost 1 in 3 of you told us that you regularly work above your contracted hours with no additional pay. Did you know the NHS 37.5 working week is the longest official working week in the public sector? We know that long hours reduce efficiency and increase stress - shouldn't we be talking about how to address the issues in NHS employment and staffing, with nothing off the table? Reducing the standard working week wouldn't result in a reduction in patient services - the NHS is already open overnight, every night, and 7 days a week and no-one works that long! Hundreds of thousands of staff already work part time or flexibly.
For ambulance staff:
Ambulance staff were more likely than most NHS staff to experience stress and burnout at work, and that long hours and shift overruns don't help. Do you think 37.5 hrs is the right standard working week for such a physically and emotionally intense job? Do you think that fixing shift patterns and improving handovers could reduce your workload without having to reduce patient services?