The government has announced NHS staff will receive a 3.3% pay award for 2026/27, in line with Pay Review Body recommendations. This will be paid in April 2026.
We say 3.3% is not enough.
Not enough to keep pace with the cost of living.
Not enough to restore what has been lost through pay erosion.
And not enough to address the longstanding unfairness of staff on the Agenda for Change contract getting less than other groups.
Negotiations on NHS pay structure
After 18 months of promises, we have finally entered into formal negotiations on the NHS pay structure.
Talks will only succeed if the government puts enough money on the table. We can make the strongest possible case for that money if those in power hear directly from you about why reforms to the pay structure are so urgently needed.
Now is your chance to get your voice in the room.
What we’re calling for:
You ought to be on the right band for the job you’re doing. We want to see proper recognition for staff working above their band, and if you’re promoted, you should see a proper pay rise.
The government has recently agreed to the programme of work we asked for to ensure staff are paid properly for the work they do. But this progress hasn’t come through the pay review process, and we know it will be a while before you see the impact of these changes.
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.
Your latest pay offer
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FAQs
Here are our most frequently asked questions on 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 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 rate for band 3 is not a great deal more than band 2. Combined with a reduction in unsocial hours payments, this creates a massive disincentive for staff looking to take on more responsibility.
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 experienced staff. In our autumn survey we saw this was a real priority for experienced nurses working at band 5.
Bands 7-9
At band 8a, staff often lose all eligibility for unsocial hours payments and overtime, but working at band 8a often means a big jump in responsibility – shouldn’t there be a decent reward for those making the move up from band 7?
New graduates
Graduate entry into the NHS is at band 5 – compare this with teachers’ starting pay rates, and jobs in the private sector which are often higher. We run the risk of not being able to fill vacancies if we let the NHS fall behind.
Find out more about the pay scales for NHS staff in England.
The government has recently agreed to the programme of work we asked for to ensure staff are paid properly for the work they do.
UNISON has been helping band 2 healthcare support workers come together in their thousands to win re-banding through our 'Pay fair for patient care' campaigns up and down the country.
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.
There is no national agreement on bank pay so it depends on local terms and conditions. We would push for and expect employers to update their bank pay rates in line with national pay awards.
We are encouraging all NHS employers to adopt the principles in our Better NHS Bank Charter. Speak to your UNISON branch and your bank colleagues about building a campaign to get your employer to sign up to our charter.
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 and Welsh governments are already committed to reducing the standard NHS working week. Staff in England deserve the same conversations.
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