NHS nurse pay inequality: this clear injustice must end
Nursing staff in England, Wales and Northern Ireland need only look to their Agenda for Change colleagues in Scotland to be left wondering why they continue to be short-changed in annual pay awards. The 3.6% award for staff on Agenda for Change contracts in every part of the UK except Scotland, as recommended to by the NHS pay review body, was called grotesque by the RCN. The college pointed to the higher award afforded to medical colleagues. And the experience of nursing staff in Scotland’s NHS, who have already accepted a higher pay rise, negotiated without input from any pay review body, is evidence the current system needs a shake-up. England health and social care secretary Wes Streeting should look to how NHS pay is set in Scotland if he wants to see a system that works in nurses’ best interests.
Nursing staff in England, Wales and Northern Ireland need only look to pay awards in Scotland to see how they continue to be short-changed in their annual pay rise
Is it fair to compare the pay award of NHS nursing staff with those of medical colleagues, teachers or, indeed, supermarket staff?
The 3.6% pay award for nursing and other healthcare staff on Agenda for Change contracts in England and Wales was labelled grotesque by the RCN, when viewed in the context of the doctors’ 4% increase for 2025/6 (and £750 consolidated payment for resident, formerly junior, doctors). Nurses and support staff in Northern Ireland have subsequently been awarded 3.6% too. Teachers though, like doctors, receive a 4% uplift.
NHS pay awards in Scotland versus England – the comparison is stark
Meanwhile, the NHS Pay Review Body dismisses what it heard from health staff ‘you get paid more stacking shelves’ by stating AfC offers more than ‘headline pay’, citing the NHS pension scheme, holiday entitlement and career development.
Yet the starkest evidence of inequality is in the difference in pay and conditions between nurses in Scotland and their colleagues elsewhere in the UK. Our data show pay for AfC staff in Scotland rising above awards for those in England each year since Scotland abandoned the RB process.
This year’s award of 4.25% in Scotland is 0.65 of a percentage point above that for England, Wales and Northern Ireland and part of a two-year deal worth 8%, which has been accepted by RCN members. It includes a Scottish government guarantee that pay will increase by one percentage point above inflation each year, alongside other benefits such as the incremental steps being taken to achieve a shorter working week. The day before the 3.6% award for England and Wales was announced, inflation hit 3.5%.
PODCAST Nurse pay and conditions: why are they better in Scotland?
Minister must keep promise to reform Agenda for Change
The RCN and other unions did not submit evidence to the RB for this year’s award, arguing the system was outdated and ineffective. The RB itself says the Westminster government must honour its commitment to reform AfC by funding its promise to do so.
Writing exclusively for Nursing Standard, health and social care secretary Wes Streeting says he values nurses – words that many may feel to be a kick in the teeth – and pay improvement is a ‘journey’.
Perhaps he should take a journey over the England-Scotland border to see how it’s done.
HAVE YOUR SAY:RCN to consult members on pay award