Three of the UK’s biggest health unions are urging the government to hold direct NHS pay talks and ignore the advice of an independent panel.
Unison, the Royal College of Nursing and Unite have called on the heathy secretary to axe the “unfit for purpose pay body” in a move it believes will stop staff leaving, enhance patient care and reduce the health service backlog.
In a letter to Wes Streeting, the unions claim bypassing the panel that reviews NHS pay is vital if the service is to be fit for the future.
They are calling on him to hold direct pay talks with them, rather than wait until the extensive NHS pay review body process is over before awarding next year’s wage rises.
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Minimum wage concerns
Their letter highlights that if the government only acts after receiving the pay review body’s report, a million of England’s NHS workers – including paramedics, nurses, healthcare assistants, health visitors, porters end estates staff – won’t get their increase as expected in April.
The unions added that failure to confirm the new wage rates on time also means the NHS’s lowest paid workers will fall below the national living wage (NLW) threshold that comes into effect the same month.
In April 2025, the NLW hourly rate is increasing to £12.21 for those aged 21 and over, while the lowest-earning NHS staff currently get paid 13p less than that at £12.08 per hour.
The letter stated: “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“Sticking with the out-of-date pay review body process risks repeating the mistakes of the past.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.”
According to the unions, finalising next year’s pay increase during wider planned talks on pay scales and role structures would be more effective and quicker than a ‘twin-track’ approach.
“The pay review body process is outdated and belongs to a bygone age.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,” the letter added.
Th unions believe that a streamlined wage rise process will use “fewer resources, and more importantly, deliver next year’s pay rise on the day it’s due”.
The letter stated: “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.”
‘A bygone era’
Claiming that the pay review body process is from a bygone era and should be axed, Unison assistant general secretary Jon Richards said: “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 believes its members need “action and clarity on their future” to help them rebuild the nursing profession, the NHS and modernise the delivery of care.
She said: “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 called the current review process “broken beyond repair”, claiming NHS staff have suffered “substantial real-terms pay cuts for over a decade”.
He added: “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.”
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