NHS unions have reached a pay deal with the government in a major breakthrough that could herald the end of strikes by frontline staff in England.

The offer consists of a one-off payment of 2% of their salary plus a COVID recovery bonus of 4% for the current financial year 2022/23, and a 5% pay increase for 2023/24.

It will apply to key NHS workers including nurses and paramedics but not junior doctors, who are involved in a separate dispute over pay and conditions.

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Health Secretary Steve Barclay said the deal means a newly qualified nurse will get more than £1,800 this year on top of a pay rise of more than £1,300 next year.

He said: “I hugely admire the incredible work of NHS staff, including during the pandemic and the progress they have made to tackle the resulting backlog.

“This offer will give nurses, paramedics, physiotherapists and other non-medical staff a fair pay rise while protecting our commitment to halve inflation.”

The offer will now be put to union members for a vote, with industrial action paused during that process.

The Royal College of Nursing, GMB and Unison said they will recommend their members accept the offer – but Unite said it was not good enough.

The unions represent a wide variety of health staff including nurses, paramedics, 999 call handlers, midwives, security guards and cleaners.

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PM ‘delighted’ on NHS pay settlement

Sharon Graham, general secretary of Unite, said the decision ultimately lay with members and strikes will be paused while they are consulted on the deal.

But she added: “The offer from government is not one that Unite can recommend to our members.

“It is clear that this government does not hold the interest of workers or the NHS at heart. Their behaviour and disdain for NHS workers and workers generally is clear from their actions.

“Britain has a broken economy and workers are paying the price.”

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NHS strikes have forced govt into action due to waiting time targets

Liz Bates is a political correspondent

Liz Bates

Political correspondent


It looks like the government could be on the brink of a breakthrough with striking NHS workers, who will now vote on the latest pay offer.

For months, ministers insisted that they could not budge on pay because they needed to prioritise the public finances and did not want to risk rising wages fuelling inflation.

But that position seems to have softened over the past few weeks and now we see the purse strings have been loosened and some extra cash has suddenly been found.

So why the shift?

Whilst it appeared that Number 10 were – in the early stages – willing to tough out industrial action across a range of sectors, the longer it goes on the more political damage it does.

Day-to-day strikes are disrupting the public in many aspects of their lives, from getting to work to getting vital NHS treatment, and the finger of blame always tends, in the end, to point to those in power.

But the walkouts in the NHS have also created a very specific political problem for the prime minister who has made reducing waiting lists one of his five key pledges – a target he will not be able to hit whilst workers are on the picket line.

So, it is no surprise that this is the area that has been the focus of the most intense negotiations.

Ministers will now be hoping that if a deal is done with this sector others will follow and they will be able to tell voters that broken Britain is slowly but surely getting fixed.

‘Extra 2.5bn put on table’

Other unions were more welcoming of the agreement, even as they acknowledged it was “far from perfect”.

Unison said the one-off payment is worth £1,655 for staff at the bottom of band two (for example porters, cleaners and healthcare assistants), £2,009 for staff at the top of band five (nurses, midwives, physiotherapists), £2,162 at the top of band six (paramedics, health visitors, senior occupational therapists) and £3,789 for staff at the top of band nine.

Rachel Harrison, GMB National Secretary, said the offer is a “huge uplift for the lowest paid to keep them well above the Real Living Wage” as she called the offer “reasonable”.

She said the deal was reached after the government agreed to put an extra £2.5bn on the table to fund the pay increases.

“GMB members should rightly be proud of themselves. It’s been a tough road but they have faced down the Department of Health and won an offer that we feel is the best that can be achieved at this stage through negotiation,” Ms Harrison added.

She said progress has also been made on non-pay demands, such as addressing violence in the workplace.

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‘It is a decent sum of money’ says Head of Health at UNISON

Nursing staff ‘vindicated’

RCN General Secretary and Chief Executive, Pat Cullen, also welcomed the agreement, saying: “The government was forced into these negotiations and to reopen the pay award as a result of the historic pressure from nursing staff. Members took the hardest of decisions to go on strike and I believe they have been vindicated today.”

It is not clear how the pay rises will be funded, with the government previously saying money for wage increases would have to come out of the budget for frontline services.

When questioned on this Mr Barclay deferred to the Treasury, saying only that it “would not come from areas of the budget that impact on patients”.

Nurses protest during a strike by NHS medical workers, amid a dispute with the government over pay, outside St Thomas' Hospital, in London, Britain, February 6, 2023. REUTERS/Peter Nicholls

Prime Minister Rishi Sunak also insisted frontline services will “absolutely not” be affected by the pay deal to end strikes but would not say how the package will be funded.

Pressed during a visit to a south London hospital on whether patient care would be hit, the prime minister said: “Absolutely not. We’re going to be making sure we protect all frontline services with £14bn of more funding we announced at the end of last year.”

He said the deal is “fair and reasonable” and recognises the “fantastic” work NHS staff do while being affordable for the taxpayer.

“It’s a good example of this government getting things done and delivering for the British people,” he said.

Striking NHS junior doctors on the picket line outside Queen Elizabeth hospital in Birmingham as the British Medical Association is holding a 72-hour walkout in a dispute over pay. Picture date: Wednesday March 15, 2023.
Junior doctors are not part of the deal offered by the health secretary

Ambulance members of Unison and Unite were due to strike next Monday and physiotherapists were going to walkout later this month but the action has been called off.

Other strikes involving nurses and paramedics were paused earlier this month after the government finally agreed to talk about pay.

At the heart of the dispute was a demand for an increase for the current financial year, which ministers initially insisted was not affordable.

Tens of thousands of nurses, paramedics and other healthcare staff went on strike just before Christmas, then again in January and February.

Last month, the government finally agreed to talk about pay, averting several planned walkouts that would have seen thousands more operations cancelled.

The British Medical Association, which represents junior doctors, has called on Mr Barclay to meet with them tomorrow to discuss pay, following a 72-hour walkout earlier this week.

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