Unions have warned that NHS workers are “angry” and “fed up” with another below-inflation pay rise, after the decision by the UK and Welsh governments to accept the recommendations of the NHS Pay Review Body for a 3.3% rise for most staff from April.

“Ministers have missed a vital opportunity and heightened the risk of industrial turmoil across the NHS, warned MiP chief executive Jon Restell.

“Our members are angry about this below-inflation pay award, which does not recognise the contribution made by managers at a time of upheaval and uncertainty, does not start to restore real terms pay levels and does not help the NHS attract and keep the workforce it needs,” he said.

It was now even more important that much delayed talks on reforming the Agenda for Change pay system, now expected to begin this summer, “deliver results”, he added.

Although the award is lower than consumer price inflation, currently at 3.4%, UK health secretary Wes Streeting told the Commons that it was above the government’s “affordability position” of 2.5% and NHS organisations would have to find the additional funding from within existing budgets. But “none of the pay increases will be paid for by cutting frontline services,” he insisted.

Streeting also said the award was above the 2.2% level of inflation forecast for 2026-27 by the government’s spending watchdog, the Office for Budget Responsibility.

UNISON head of health Helga Pile warned that, due to the “hopeless pay review body process”— which unions have boycotted since 2023—NHS pay was “sliding behind living costs” and that “having a pay increase on time for once is only a small comfort”.

She added: “Nurses, healthcare assistants, occupational therapists, ambulance staff, porters and all the other essential health staff need proper investment in their pay.”

“Before Christmas the government finally started working towards a wider-ranging, longer-term deal,” she continued. “But today there’s been a handbrake turn and a lurch back to the review body process unions have boycotted.”

The award is expected to be included in April pay packets, the first time in six years the pay review body process has resulted in awards being paid on time. All Agenda for Change pay bands will be increased by 3.3% from April.

Although the pay review body also covers NHS staff in Northern Ireland, the award had not been formally accepted by the Stormont executive at the time of going to press.

Health Minister Mike Nesbitt said it was “his desire to proceed” with the 3.3% award, but it could not be implemented until the Northern Ireland Assembly has set a budget for 2026-27, which he hoped would be “as early as possible in the incoming financial year”. Last year, pay awards for NHS staff in Northern Ireland were delayed by ten months as assembly members haggled over the budget settlement.

The pay review body no longer covers NHS staff in Scotland, where the Scottish government negotiates pay directly with trade unions. In April, Scottish NHS staff will enter the second year of a pay deal worth 8% over two years. The deal includes an “inflation guarantee” that will increase the award if inflation is higher in this April than when the deal was agreed in May last year.

Doctors, dentists and executive-level NHS managers are covered by separate pay review bodies which had yet to publish their recommendations at the time of going to press. //