NHS pay (England)

Over 1.5 million NHS staff have their pay, terms and conditions set by a national scheme known as Agenda for Change (AfC). This was first negotiated by UNISON, the other health unions and NHS employers in 2004.

NHS staff have become disillusioned with the Pay Review Body system because they do not believe it is independent. They see the process as long-winded, too often at the mercy of government and unfit for purpose.

UNISON wants to negotiate directly with the government on NHS pay, along with our sister unions in the NHS.

Bands 1-2 

Staff in bands 1 and 2 earn less than the real living wage. Shouldn’t there be an end to poverty pay in the NHS? 

Bands 2-3

Band 2 has become a spot rate, so there is no reward for progression. There should be an incentive for gaining experience and confidence: that means restoring pay progression for band 2.

The gap between band 2 and 3 is worth less than £500 a year. Combined with a reduction in unsocial hours payments, this creates a massive disincentive for staff looking to take on more responsibility.

Band 4  

Staff at band 4 are the only ones who have wait 3 years to be eligible for pay progression. Shouldn’t they see the rewards sooner? 

Bands 5-6

We are at greatest risk of losing new clinical staff in the first two years in their role. The progression from entry to intermediate in band 5 is too small. Shouldn’t in-band progression for early-career staff come with meaningful reward?

Promotion to band 6 does not come with enough of a pay rise for expericed staff. In our autumn survey we saw this was a real priority for experienced nurses working at band 5.

Bands 7-9

Staff moving from band 7 to 8a get just 52p more an hour but losentitlement to overtime pay. Shouldn’t there be decent reward for the increase in responsibility?

See the pay scales for NHS staff in England.

A proper pay rise  

All NHS staff need an above-inflation pay rise so we can continue to restore the value of your wages and kick poverty pay out of the NHS for good. And we need reforms to make sure that when you progress or get promoted you notice a real difference in your pay packet. 

The right band for the job 

All staff should have an up-to-date job description to make sure they’re paid the right band for the job. This requires proper investment to ensure that job evaluation processes are consistent, timely and effective in every NHS employer. 

A shorter working week 

UNISON’s ambition is for a reduced working week in the NHS with no loss of pay to improve wellbeing, reduce burnout and keep colleagues in their jobs. 

Many roles in the NHS have changed over time and have not been re-evaluated, leaving some staff underpaid. Job descriptions are not regularly updated and so may not accurately reflect the work you do on a daily basis.  

Members in their tens of thousands have been organising in UNISON to win re-banding claims using the NHS Job Evaluation Scheme.  

UNISON was recently instrumental in negotiating a new annex 31 to the Agenda for Change terms and conditions handbook. This sets out the contractual right of NHS staff to have an up-to-date job description and access to the changed job review process if their role has changed significantly.  

UNISON has long campaigned for GP and contractor staff to be paid the same rates and benefits as their colleagues who are directly employed by the NHS.

At the moment, some contractors mirror Agenda for Change pay rates and uplift pay accordingly; others implement pay rises when put under pressure to do so; and many don’t match NHS rates at all.

Find out more about our campaign for private contractor staff in the NHS here.

There is no national agreement on bank pay so what employers do in relation to bank staff depends on local terms and conditions. Depending on your contract, your pay may go up in line with the national pay award.   

We think bank rates should be uprated in line with national pay awards and there is no reason employers cannot do this. More broadly, we are campaigning to make work better for bank workers like you. We are encouraging all NHS employers to adopt the principles in our Better NHS Bank Charter. This shows support and values NHS bank staff and includes a commitment for employers to mirror national pay awards for bank staff.  

Speak to your UNISON branch and your bank colleagues about building a campaign to get your employer to sign up to our charter. You can search for your branch and find their contact details here UNISON Branch Finder | UNISON Branch Finder  

Did you know the NHS 37.5-hour 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 these issues? 

Reducing the standard working week wouldn’t result in a reduction in patient services – the NHS is already open overnight, every night, and seven days a week. Hundreds of thousands of staff already work part-time or flexibly. 

The Scottish government have begun to reduce the standard NHS working week. Staff in England deserve the same conversations.