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NHS nurses industrial action - media fact sheet

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An updated fact sheet covering all staff on the Agenda for Change contract has been published here.


The Royal College of Nursing has announced the first dates for strike action.

This fact sheet sets out the Department of Health and Social Care’s position on industrial action, as well as information on the pay offer made to NHS workers for 2022/23 and how the government is working with the NHS to prepare for potential disruption. Full details of the pay award are published here.

Health and Social Care Secretary Steve Barclay said:

“I am hugely grateful for the hard work and dedication of nurses and deeply regret some union members will be taking industrial action.

“These are challenging times for everyone and the economic circumstances mean the RCN’s demands, which on current figures are a 19.2% pay rise, costing £10 billion a year, are not affordable.

“We have prioritised the NHS with an extra £6.6 billion, on top of previous record funding, and accepted the recommendations of the independent NHS Pay Review Body to give nurses a fair pay rise of at least £1,400 this year. This means a newly qualified nurse will typically earn over £31,000 a year – with more senior nurses earning much more than that – they will also receive a pension contribution worth 20% of their salary.

“Our priority is keeping patients safe. The NHS has tried and tested plans in place to minimise disruption and ensure emergency services continue to operate.”


Q: What is the Royal College of Nursing asking for? (Updated to reflect latest RPI inflation figures for October)

  • The Royal College of Nursing is asking for a pay rise of 5% above RPI inflation.
  • At the time of the RCN ballot result, this equated to a rise of 17.6% using September inflation data.
  • Using October’s inflation data, this would mean a pay rise of 19.2%.
  • Almost all nurses work under the Agenda for Change system which governs pay across the non-medical NHS workforce (including paramedics, physiotherapists, porters, cleaners etc) and means the pay award applies across these staff groups.
  • Each additional 1% of pay for Agenda for Change staff would cost around £700 million per year
  • This means it would cost around £10 billion in total for all staff on the Agenda for Change contract.
  • This is 6.5% of the total NHS budget (£152.6 billion for 2022/23).
  • By way of comparison, average pay settlements in the private sector have been in the range of 4-6%. The RCN has called for more than three times this.

Q: What is the government offering? 

  • By accepting the independent pay review body recommendations we have given over one million NHS workers a pay rise of at least £1,400 this year, the equivalent of around 4-5% pay rises for most nurses.
  • This is on top of 3% last year when public sector pay was frozen, and wider government support to help with the cost of living.

Q: How much are nurses getting paid? 

  • Most nurses have received around a 4-5% pay rise, dependent on where they are in their band, for example:
    • Full-time basic pay for newly qualified nurses starting at the bottom of Band 5 will increase by £1,400, equivalent to nearly 5.5%, to £27,055 from £25,655 last year. This means they will typically earn over £31,000 a year including overtime and unsocial hours payments.
    • Full-time basic pay for nurses with a few years of experience at the top of Band 5 will increase by £1,400, equivalent to 4.4%, to £32,934 from £31,534 last year.
    • A nurse at the top of band 5, which requires at least four years of experience, had a 4.4% increase in basic pay and might expect total earnings over £38,000 a year if they work full-time. This is made up of basic pay of £32,934 plus additional payments including unsocial hours, geographical supplements and overtime.
    • Full-time basic pay for nurses and midwives at the bottom of Band 6 will increase by £1,400, equivalent to 4.3%, to £33,706 from £32,306 last year.
    • With the 4% enhancement, full-time basic pay for experienced nurses and midwives at the top of Band 6 will increase by £1,561, to £40,588 from £39,027 last year.
    • They also receive a pension contribution worth 20% of their salary.

 Q: Is this a fair deal? 

  • We know these are challenging times for everyone, caused by global economic factors, and we have given a fair pay settlement that strikes a careful balance between recognising the vital importance of public sector workers whilst minimising inflationary pressures and managing the country’s debt.
  • The value of the 2022-23 pay settlement was broadly comparable with the private sector where average pay settlements have been in the range of 4-6%.

Q: How is pay decided? 

  • Public sector pay uplifts are determined by the independent pay review bodies (PRBs) who are made up of industry experts.
  • PRBs carefully consider evidence submitted to them from a range of stakeholders, including government and trade unions.  They base their recommendations on several factors including the economic context, cost of living, recruitment and retention, morale, and motivation of NHS staff.

Q: Will patient care be affected? 

  • Our priority is to keep patients safe. NHS England will work with providers, professional bodies and trade unions to agree the safe level of cover.
  • Under the strike arrangements, minimum safe staffing levels must be in place. Hospitals will do everything they can to go ahead with planned procedures during industrial action, especially for patients in greatest clinical need. Realistically, a small proportion of lower priority procedures might be postponed in order to ensure patient safety.
  • NHS England wrote to the healthcare system on 1 November on the need to be prepared for any potential industrial action to ensure there is minimal disruption to patient care and that emergency services continue to operate as normal. As part of this the NHS is testing the system to ensure services can continue safely through Exercise Arctic Willow, a multi-day exercise for Integrated Care Boards, working with trusts, planned to take place from week commencing 14 November.

Q: Will the government go back to the negotiation table with unions? 

  • The PRB process is the established mechanism for determining pay uplifts in the public sector, outside of negotiating multi-year pay and contract reform deals.
  • Industrial action is a matter for unions, but we urge them to carefully consider the potential impacts.
  • Ministers are engaging with unions, including the RCN, and have been clear the door is open to discuss how we can work together to make the NHS a better place to work, tackle the Covid backlogs and deliver the care that patients deserve.

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