11 Reasons to REJECT the NHS pay proposal

The headlines of a 25 percent pay rise are misleading, but you need to take a look at the evidence and […]

Ian Snug
23 March 2018

The headlines of a 25 percent pay rise are misleading, but you need to take a look at the evidence and balance up the facts.

Twelve healthcare unions are supporting the proposed changes but you shouldn’t let the figures in the headlines sway your decision to accept, what is essentially, a sub-inflation pay rise and a further cut to both pay and entitlements.


However, we think the unions should encourage you to examine all the facts – rather than simply a glamorous newspaper headline.

At the time of writing only the GMB has recommended its members reject the deal.

The agreement that was reached with NHS Employers, the body that negotiates on behalf of the government, applies to medical staff including nurses, midwives, healthcare assistants and paramedics, but not doctors, dentists and some senior NHS managers.

You can view the proposed agenda for change pay scales and the full consultation document.


It’s below the rate of inflation.

The Office for Budget Responsibility (OBR) forecasts that RPI inflation is set to increase by 9.6% over the next three years, which means a 6.5% pay rise is significantly below the rate of inflation.

NHS staff have already endured a 14% real-terms pay cut in the past 7 years – do we really deserve another? 

The percentages are misleading.

Unions are advertising a 25% increase in pay for some staff over the next three years – but this figure includes increments you are already on track for.

The chart below demonstrates the true total pay rise, excluding the increments, you will receive. Some of these are well below the advertised 6.5% and none of them hit the headlining 25%.


Image: Samantha Margerison

You need to take deductions into account.

Staff would likely move between contribution points on deductibles such as pension contributions, student loans or tax – the change would see the majority of band 5s move from 7.1% to 9.2% a year pension contributions.

While this would be the case with pay progression anyway it should be taken into account when working out take-home pay and the final effect on wages as it would be possible take-home pay could be less after the rise.

Yearly incrementation will be a thing of the past.

Presently staff receive yearly incrementation to their pay, this not only reflects their experience and loyalty to the service but helps to ensure staff receive a regular reward for their hard work.

Under the proposed scheme staff could go several years without any significant increase in pay as progression points are significantly spaced out.

Image: NHS Employers


Band 6 and 7 will see only two increments over a five year period while staff at band 8 and above will be forced to wait five years for a single rise.

The proposal document suggests those staff whose wages will fall on an incremental pay gap amount at the end of the three years could be forced to wait a further three or four years so see another rise.

Increments will no longer be automatic.

Historically, increments have been linked with time of service but the proposals will formally link them with performance requirements.

To move onto the next pay point staff will have had to:

  •  Completed our yearly appraisal.
  •  Have no live disciplinary actions on our record.
  •  Have completed all our mandatory/statutory training.
  •  And if you’re a line-manager you must have completed all your staff’s appraisals too (5).

If your employing organisation or line manager feel you have not met these targets they would withhold this incrementation.

Experienced staff will not be rewarded.

The proposal ensures new staff would be rewarded quickly with faster incremental progression but the proposed pay deal would see long-serving, experienced, staff rewarded the least.

The 52% of NHS staff who are currently at the top of their banding will only receive a 6.5% rise.

It will improve recruitment but not retention.

The increased starting salaries and quick pay progression should work wonders for recruitment but will do nothing for the retention of experienced and long-serving staff.

Cuts to unsociable hours.

The way some unsociable hours payments are made is changing, these will be assigned a financial figure rather than a percentage increase meaning the percentage enhancement will drop over the three year period.

Image: NHS Employers

Removal of unsociable enhancement on sick pay.

Buried in the official proposal document it reveals that new entrants to the NHS, appointed with effect from 1st July 2018 onwards, will not have access to the payment of unsocial hours during occupational sick leave. This means sick pay will be paid at the basic rate only.

Staff who leave the NHS or have a break in service would also be subject to this change.

It unclear if this rule will also be applied to maturity leave, carers leave or bereavement leave.

There is no long-term plan.

We have a deal for the first three years, but what is the plan after that? What will the incremental points be? Will we keep unsociable hours payments and annual leave allowances past this point? We need a long-term promise to ensure NHS pay will be above the rate of inflation and staff will not see a further pay cut.

The Unions think we can’t do any better.

The Royal College of Nursing’s own Chief Negotiator, Josie Irwin, warned earlier this year that staff should be ‘realistic’ with their pay expectations and more recently said admitted that Unions couldn’t push for a better deal as Nurses are not prepared to strike.

Following the pay announcement Ms Irwin went on to tell the NursingTimes she thinks; “It is the best possible deal we could negotiate given the current climate“.

How can recommending another real terms pay cut be the strategy of our unions?

Are you worth more than 6.5% in 10 years?!