NHS pay 2025

This is the message from the Department of Health & the response from UNISON's Head of Service:

• All NHS staff to be awarded above inflation pay rises for second year in a row as government recognises their hard work in rebuilding our broken NHS.

• Department’s endorsement of Pay Review Body recommendations will be backdated to April and will appear in pay packets from August.

• Pay uplifts will be funded by cutting duplication and waste in the central health budget.

All NHS workers, including doctors and nurses, will receive real terms pay rises for the second year in a row, as the Health Secretary has today accepted the independent Pay Review Bodies’ headline pay recommendations for all NHS staff. 

The government is funding a pay rise of 4% for consultants, specialty doctors, specialists and GPs, with dentists also receiving a contract uplift to increase their pay. In addition, the Department of Health and Social Care has worked closely with unions to deliver on non-pay arrangements, agreed as part of last year’s deals, to improve working conditions for these staff groups. Resident Doctors will see their pay rise by an average of 5.4% (a 4% rise plus a consolidated payment of £750). 

Agenda for Change (AfC) staff, which includes nurses, health visitors, midwives, ambulance staff, porters and cleaners will see their pay rise by 3.6%. This has increased the starting salary of a nurse, for example, from £27,055 in 2022/2023 to around £31,050 this year – an increase of around £4,000 over the last three years.  Alongside the real terms pay increase for AfC staff, the government has also accepted the PRB recommendation to allow the NHS Staff Council to undertake pay structure reform next year to resolve outstanding concerns about banding within the AfC pay structure. 

Health and Social Care Secretary Wes Streeting said: 

These are thoroughly deserved pay rises for all our hard-working nurses, doctors and other NHS staff. We inherited a broken health service with extremely low morale after years of pay erosion and poor industrial relations.  Which is why, despite the difficult financial situation the nation faces, we are backing our health workers with above-inflation pay rises for the second year in a row. This government was never going to be able to fully reverse a decade and a half of neglect in under a year, but this year’s pay increases – and last year’s – represent significant progress in making sure that NHS staff are properly recognised for the outstanding work they do. 

In the past ten months, through our Plan for Change, we have worked with staff to cut waiting lists by 200,000 and put the NHS on the road to recovery. These real terms pay rises demonstrate our commitment to continue on our shared mission, to build an NHS fit for the future.

Sir Jim Mackey, NHS chief executive, said:  

Today’s announcement of a real terms pay rise shows the government’s support for NHS staff and is recognition of their huge efforts and hard work over the last year. It is particularly welcome as it comes amid significant pressure on the public purse, and so the NHS will in turn focus on reform, cutting waste and reducing duplication to be as efficient as possible, while also offering patients faster and better care.

All pay uplifts will be backdated to April 1st and will appear in pay packets from August – two months earlier than last year and the earliest award in years. 

The above inflation pay awards come at a time of serious pressure on the public finances. The Department of Health and Social Care can award across-the-board pay rises above the affordability figure set out by the government (2.8%) because of reforms already being made to cut waste and unnecessary bureaucracy across the health service. Over the past few months, we have identified how extra funds will be freed up by cutting duplication between the department and NHSE, cutting NHSE headcount, slashing budgets for corporate services like NHS communications teams, and bringing down ICB costs by 50%. As a result of the savings found, none of the pay increases will be paid for by cutting frontline services. 

The government has also reiterated its desire to get NHS staff their money more quickly in future awards. This year’s was the earliest in years, but this government want to go faster in the future, so that the pay award process is bought back into line with the financial year. The government has committed to remitting the pay review bodies for 2026/27 before the end of July, two months before last year, with an ambition to implement awards as soon as possible in 2026/27. 

 Helga Pile, UNISON’s Head of Health said:

The pay rise is more than ministers said they could afford, but it barely matches inflation. The money will also be landing in pay packets four months late.

“Health workers had high hopes this government would have learned from the mistakes of its predecessors.

“But a reliance on the slow, outdated and unnecessary pay review body process has once again failed to deliver.

“Direct talks between ministers and unions in Scotland showed what’s possible, with an 8% two-year deal and inflation-proof guarantee.

“And not everyone in the NHS is getting the same. The absurd pay review body process has led to two different awards for employees. But the NHS is one team and should be treated that way.

“Nurses, porters, paramedics, healthcare assistants, cleaners and other workers on Agenda for Change contracts will feel less valued than their doctor colleagues. That will generate more discontent from an already demoralised workforce.

“So long as coffee shops, supermarkets and parcel delivery firms pay more than the NHS, staff will go on leaving. Without an emergency top-up last month to the lowest-paid workers, NHS trusts would have breached minimum wage laws.

“The ridiculous pay process continues to give employers a real headache. Just a few pennies more and low-paid staff would be on the real living wage. A few pounds extra and employers wouldn’t face losing much-needed overseas staff because they don’t meet the visa threshold.

“Ministers must also get to grips with the shortcomings of the NHS salary structure. Government promises last year to begin talks on this went nowhere and the failure to act is causing health employers major problems.

“Improving the fortunes of the NHS is a key government pledge. Soon ministers will publish the ten-year plan setting out how they intend to do that.

“It’s vital the government gets staff on board. This pay announcement will do little to achieve this.”