The government must bypass the independent panel that reviews NHS pay if the health service is to be fit for the future, say three of the UK’s largest health unions today (Tuesday).
UNISON, the Royal College of Nursing (RCN) and Unite have written to health secretary Wes Streeting urging him to hold direct pay talks with unions, not wait until the lengthy NHS pay review body process (PRB) has run its course before awarding next year’s wage increase.
Their letter to the health and social care secretary says yet again a million NHS staff in England, including nurses, paramedics, healthcare assistants, porters, health visitors and estates workers won’t receive their pay rise on time in April if the government waits for the pay review body to report.
Failure to finalise new pay rates by 1 April next year also means those workers on the lowest NHS pay bands will slip below the national living wage*, add the unions.
The unions say that if the secretary of state wants to achieve his aim of improving NHS efficiency, there’s no better way for him to do this than ditch the current time-consuming pay process for good.
It would be quicker and more effective to finalise next year’s pay increase during wider planned talks on wage scales and job structures, rather than having a ‘twin-track’ approach, unions say.
Today is the deadline for evidence to the NHS pay review body, but the three unions aren’t submitting anything this year.**
The three have taken this stance because they say the pay review body system is ‘inefficient, outdated and not fit for purpose’. They are calling on the government and NHS employers to host direct pay talks with unions instead.
In the letter to Wes Streeting, the unions write: “Health workers are the beating heart of the NHS … and are key to improving patient care, and getting health and community services back on their feet.
“Sticking with the out-of-date pay review body process risks repeating the mistakes of the past. That doesn’t fit with your wider vision for a 21st century NHS that has a stable and motivated workforce at its core.
“The pay review body process is outdated and belongs to a bygone age. It takes forever, is bureaucratic and is inefficient too. Scrapping this would save tens of thousands of pounds and spare the NHS, the government and other health organisations the many hours it currently takes to compile, submit and present evidence.”
When this year’s NHS pay rise was announced in the summer, the health secretary also agreed to provide funding and a mandate to fix the Agenda for Change pay structure.
The 20-year old pay system needs reform because many health jobs have changed dramatically since it was put in place, say unions. The pay bands need to be adjusted to ensure they reward skills and responsibilities in the right way.
Unions and employers making up the NHS staff council negotiating body are still awaiting the green light from government to get these promised talks underway.
With time running short, an NHS pay rise could be discussed at the same time, the unions say.
Doing so through a streamlined wage rise process could use up “fewer resources, and more importantly, deliver next year’s pay rise on the day it’s due,” the letter adds.
“This would be the most compelling way to help get the NHS back on track, hold on to the experienced staff it needs to do this and attract the recruits key to filling the huge gaps in the workforce.”
UNISON assistant general secretary Jon Richards said: “The pay review body process is from a bygone era and should be axed. A modern NHS needs modern pay practices to keep and recruit the staff it needs.
“The health and care secretary says he wants to improve patient care, make the NHS more efficient and turn around its fortunes.
“The best way to start this off would be a complete break with the past. The government should scrap the inefficient twin-track approach to NHS pay, save itself some money and focus on direct talks with unions instead.”
Royal College of Nursing general secretary and chief executive professor Nicola Ranger said: “Our members need action and clarity on their future now so we can rebuild the nursing profession, the NHS and modernise the way care is delivered.
“That is why we need to get round the table for meaningful discussions. We have taken this approach in the interests of nurses, the patients and communities we serve, and the NHS itself.”
Unite national officer for health Richard Munn said: “The PRB process is proven to be broken beyond repair. NHS staff have suffered substantial real-terms pay cuts for over a decade.
“This has created a huge recruitment and retention crisis. This is a direct result of staff being tens of thousands of pounds worse off in real terms.”
Notes to editors:
– *The national living wage is going up to £12.21 an hour for workers aged 21 and over in April 2025. The lowest-paid staff in the NHS currently earn 13p an hour below that (£12.08).
– **This is the third year running that UNISON and Unite haven’t submitted evidence as part of the NHS pay review body process. The RCN previously declined to submit evidence during the 2022/23 pay dispute.
