More than 1.4 million National Health Service (NHS) workers across England and Wales are set to receive a 3.3% pay rise from April 2026, following a government announcement on February 12, 2026. The move, which the government says is designed to provide a “real terms pay rise,” has sparked a fierce debate among health unions, NHS leaders, and patient advocates, with many arguing that the increase falls short of what is needed to address years of stagnating wages and the ongoing recruitment and retention crisis in the NHS.
Health Secretary Wes Streeting was quick to highlight the government’s efforts to speed up the pay review process this year. In a statement, Streeting said, “We have listened to the workforce and understand the difficulties they face when pay awards are not delivered on time. That’s why this Government committed to speeding up the pay review process, remitting the pay review bodies months earlier than previous years, and submitting written evidence earlier too.” He emphasized that the 3.3% uplift is above the Office for Budget Responsibility’s forecast inflation of 2.2% for 2026-27, declaring it a “real terms pay rise” for NHS staff. Notably, this is the first time in six years that NHS staff will see their pay increase land in their pay packets at the very start of the pay year in April.
The pay rise, which covers nearly the entire NHS workforce apart from doctors, dentists, and senior managers, has been accepted in full following the recommendation from the independent NHS Pay Review Body. The Welsh government has also agreed to the same increase for its NHS staff, and the recommendation extends to Northern Ireland, although no final decision has been made there yet. According to the Department of Health and Social Care, this marks the third consecutive year of above-forecast inflation pay increases for NHS staff, including nurses, paramedics, midwives, and hospital porters.
Despite the government’s framing of the pay award as a positive step, health unions and staff representatives have voiced strong criticism. Helga Pile, head of health at Unison, the largest health union, summed up the mood among many NHS workers: “Hard-pressed NHS staff will be downright angry at another below-inflation pay award. Yet again, they're expected to keep delivering more while effectively being given less, as pay slides behind living costs. Having an increase on time for once is only small comfort.”
Other unions echoed these concerns, arguing that the 3.3% rise is not enough to offset years of pay erosion. Rachel Harrison, GMB national secretary, welcomed the timely payment but stressed, “This award is just not enough to make up for more than a decade of pay cuts under the Tories. NHS workers deserve more and GMB will fight for that at the long overdue agenda for change structural talks we have now been promised.”
The Royal College of Nursing (RCN) also condemned the award, pointing out that it lags behind the current consumer price index (CPI) inflation rate of 3.4% and the retail price index (RPI) inflation of 4.2%. Professor Nicola Ranger, RCN general secretary and chief executive, said, “A pay award below the current level of inflation is an insult. Unless inflation falls, the Government is forcing a very real pay cut on its NHS workers. This knife-edge gameplaying is no way to treat people who prop up a system in crisis. Nursing staff will not tolerate the disrespect of other years, when we were bottom of the pile.” Ranger also noted that the RCN and almost all other unions withdrew from the Pay Review Body, stating it is “not fit for purpose and fails nursing staff.”
Sharon Graham, general secretary of Unite, was equally forthright in her condemnation: “It beggars belief that a Labour Government should seek to ride roughshod over the health unions when deciding on NHS pay. For too long, NHS workers have been overworked, underpaid and undervalued. Today’s announcement will simply increase the problems of low pay that has seen thousands of healthcare workers leave, worsening the recruitment and retention crisis in our NHS.” Graham also warned of growing anger if a separate, potentially more generous deal is struck for junior doctors, raising the specter of further industrial action.
Gill Walton, general secretary of the Royal College of Midwives, expressed disappointment over what she described as another missed opportunity to invest in maternity services and address chronic understaffing. Walton said, “Without fixing the unfair pay system, this real-terms pay cut is an insult to midwives who work 100,000 unpaid hours every week just to keep maternity services running. Our members are sick and tired of these broken promises to sort out pay and staffing and their anger is justified.”
The Society of Radiographers, the only union to submit evidence to the Pay Review Body, welcomed the body’s attention to low pay and graduate starting pay, but cautioned that the 3.3% increase “is unlikely to improve this situation, or even come close to narrowing the pay gap.” Dean Rogers, the society’s executive director of industrial strategy, added, “This is not a sustainable strategy if the Government is serious about having a positive workforce plan for the NHS.”
On the employer side, Dean Royles, interim chief executive of NHS Employers, acknowledged the significance of the government’s early acceptance of the pay award. “This early acceptance by the Government of the Pay Review Bodies’ recommendations will ensure that for the first time in many years, all NHS Agenda for Change staff will receive their annual pay uplift at the very start of the pay year in April. In previous years it has been as late as September or October, so this will be welcomed by many. A fair and timely award is also essential for retaining experienced colleagues and attracting new talent into the NHS.” However, Royles cautioned that NHS employers are “navigating an increasingly challenging financial environment while maintaining high-quality patient care,” and stressed the need for clarity on funding for the pay award.
The pay rise announcement comes against a backdrop of ongoing industrial action and mounting pressures on the NHS. In the run-up to Christmas 2025, strike action by resident doctors brought hospitals to a standstill, with nearly half of the medical workforce in England walking out for five days. This coincided with what was described as the “worst flu outbreak” ever recorded in the UK. Health Secretary Streeting had previously described the strikes as “self-indulgent, irresponsible and dangerous,” warning of “fatal harm” to patients.
Patient advocates and campaigners have also weighed in, calling for broader investment in the NHS and social care. Mathew Hulbert, Patient Leader at Just Treatment, remarked, “Any pay rise for the hard working, dedicated staff of our NHS is to be welcomed but has to be set against the years of real-terms cuts they've had to endure, especially under the last government. From a patient perspective, what I also want to see is a significant investment in the NHS from the current administration, as we still lag behind the European average on health spending.”
While the government maintains that the pay rise is a positive step and a demonstration of its commitment to NHS staff, the reaction from unions and staff suggests that discontent remains high. The coming months are likely to see further negotiations, with unions signaling that they will continue to push for pay restoration and reforms to the Agenda for Change pay structure. For now, NHS workers will see a pay boost in April—but for many, the debate over fair pay and the future of the NHS workforce is far from settled.