More than 1.4 million NHS staff in England and Wales are set to receive a 3.3% pay rise from April 2026, following an announcement by the government on February 12, 2026. The move, which covers a broad range of workers from nurses and midwives to physiotherapists and porters—though notably excluding doctors, dentists, and senior managers—marks the first time in six years that NHS staff will see their pay uplift at the very start of the financial year. The pay increase follows the recommendation of the independent NHS Pay Review Body and was accepted in full by the government, a step officials say demonstrates their commitment to NHS workers.
Health Secretary Wes Streeting stressed the government’s effort to listen to the workforce and address the persistent issue of delayed pay awards. "We have listened to the workforce and understand the difficulties they face when pay awards are not delivered on time," Streeting said, according to The Irish News. He pointed to the government’s expedited approach to the pay review process, stating, "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."
Streeting further emphasized that the 3.3% uplift is above the Office for Budget Responsibility’s forecast inflation rate of 2.2% for 2026-27, calling it a "real terms pay rise." The Welsh government has also agreed to the same increase, and the recommendation extends to Northern Ireland, although a final decision there is pending due to budget considerations.
Despite the government’s positive framing, the announcement has drawn sharp criticism from healthcare unions and professional bodies, who argue the pay rise falls short of keeping pace with the actual cost of living. The Retail Price Index (RPI) inflation rate currently stands at 4.2%, and the Consumer Price Index (CPI) at 3.4%, both higher than the awarded increase.
Professor Nicola Ranger, general secretary of the Royal College of Nursing (RCN), did not mince words: "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 game-playing is no way to treat people who prop up a system in crisis." Ranger indicated that the RCN would closely scrutinize awards for other NHS staff and the broader public sector before deciding on their next steps, recalling the previous year’s discontent when nurses felt they had been left at the bottom of the pile.
Unison’s head of health, Helga Pile, echoed this sentiment, stating, "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." Pile also raised concerns about the NHS’s ability to compete with high street supermarkets, noting that many supermarket staff now earn at least the real living wage, putting additional pressure on NHS recruitment and retention.
The GMB union’s national secretary, Rachel Harrison, acknowledged the benefit of timely pay but was clear that the award is "just not enough to make up for more than a decade of pay cuts under the Tories." Harrison pledged that the union would continue to fight for better pay in the upcoming structural talks on the Agenda for Change pay system.
Other union leaders voiced similar frustrations. Sharon Graham, general secretary of Unite, condemned the government’s approach: "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 expressed concern over rumors of a separate, potentially more favorable pay settlement for junior doctors, warning it could further divide the workforce and spark industrial action.
Gill Walton, general secretary of the Royal College of Midwives, described the pay rise as "an insult to midwives and maternity support workers who work 100,000 unpaid hours every week just to keep maternity services running." Walton criticized the government for failing to address what she called an unfair pay system, despite months of promises to invest in maternity services.
Jim Fahie of the Chartered Society of Physiotherapy pointed out that the award "is less than last year’s and lower than the current rate of inflation, so is a real-terms pay cut and makes absolutely no ground on restoration." He highlighted the ongoing strain on staff due to shortages and long waiting lists.
Dean Royles, interim chief executive of NHS Employers, welcomed the promptness of the award, noting, "This early acceptance by the government of the Pay Review Body’s 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." However, Royles cautioned that NHS trusts had budgeted for a lower award, making it "essential that the funding of the award is clarified as soon as possible." He emphasized the need for fair and timely pay to retain experienced colleagues and attract new talent, especially as the NHS faces challenging financial conditions.
The Society of Radiographers, which was the only union to submit evidence to the Pay Review Body, said it was pleased some of its recommendations around low pay and graduate starting pay were heard. Still, Dean Rogers, the society’s executive director of industrial strategy, warned, "The gap between NHS pay and average earnings continues to grow, further undermining morale, recruitment and retention in radiography. A 3.3% pay increase is unlikely to improve this situation, or even come close to narrowing the pay gap."
Meanwhile, the Department of Health and Social Care reaffirmed its appreciation for NHS staff and its commitment to work with the NHS Staff Council to reform the Agenda for Change pay structure, prioritizing increases for graduates and the lowest paid. A spokesperson said, "This government hugely appreciates the incredible work of talented staff across our NHS, which is why we have agreed to work with the NHS Staff Council and invest in reforming the Agenda for Change pay structure."
The political fallout has not been limited to union leaders. Shadow health secretary Stuart Andrew criticized the government for leaving the NHS "underfunded and struggling to meet demand" and accused ministers of failing to prioritize economic growth, resulting in stretched budgets, overworked staff, and longer patient waits.
As the pay rise is set to hit pay packets in April 2026, NHS staff and unions remain skeptical about whether the increase will be enough to stem the tide of departures and address chronic staffing shortages. The coming months will test whether the government’s promises of reform and timely pay can turn the tide—or if anger and frustration will fuel further unrest within the health service.