Nurses across England, Wales, and Northern Ireland are gearing up to overwhelmingly reject the government’s 3.6% pay rise offer for 2025-26, a move that threatens to reignite widespread strikes within the NHS. The Royal College of Nursing (RCN), which has been conducting a consultative vote among its 345,000 members, has described the proposed increase as "grotesque," warning that it would be entirely eroded by inflation and falls short compared to pay rises awarded to doctors, teachers, prison officers, and armed forces personnel.
According to multiple reports, including from the BBC and The Telegraph, the results of the RCN’s online survey are expected to reveal a clear and overwhelming rejection of the pay deal. The union has made it clear that nursing staff — the largest segment of the NHS workforce — feel undervalued and are frustrated by years of stagnant wages and deteriorating working conditions.
Patricia Marquis, executive director for RCN England, emphasized the daily struggles faced by nursing staff, saying they are "tired of playing constant financial catch-up, often struggling to pay rent or get on the housing ladder." The union’s analysis shows that nurses’ pay is approximately £8,000 lower than it would be if wages had kept pace with inflation since 2010, highlighting a quarter-century erosion in real terms.
Adding to the pressure, the GMB union, representing around 50,000 health workers including 20,000 ambulance staff, recently rejected the same 3.6% pay offer by a 67% majority. Rachel Harrison, GMB national secretary, has called for urgent talks with Health Secretary Wes Streeting, stating, "Our national NHS and ambulance committees met on 24 July to discuss the ballot results and determine what the next steps should be. Today, we have written to Secretary of State Wes Streeting, asking him to meet with us to discuss pay and other issues of significant importance to GMB members. We await his reply with interest." This rejection coincided with the start of a five-day strike by resident doctors demanding a 29% pay rise, further escalating tensions within the healthcare sector.
Health Secretary Wes Streeting, who announced the 3.6% pay increase in May 2025, has urged nursing staff to accept the offer, noting that the government has already provided two above-inflation pay rises recently. A spokesperson from the Department of Health and Social Care highlighted that new full-time nurses would receive a basic salary of £30,000 for the first time this year, a milestone reflecting previous pay improvements. However, the government insists it cannot increase headline pay further but is willing to engage with the RCN on reforms related to pay structure, career progression, and working conditions.
The RCN, however, is not satisfied with these concessions. Unlike the British Medical Association (BMA), which has begun seeking views on industrial action from consultants and middle-grade medics over a 4% pay rise they deemed "an insult," the RCN has stated it will not immediately follow the indicative vote with a legal strike ballot. Instead, it plans to press ministers over the summer to negotiate changes to nurses’ terms and conditions, including better financial support for nursing students—a response to the union’s warnings about a collapse in student recruitment and a skyrocketing number of nurses quitting the profession.
Prof Nicola Ranger, the RCN’s general secretary, has repeatedly called for ministers to recognize the vital role of nurses and the need to reverse pay erosion that has driven thousands away from the profession. Speaking at an international nursing conference in Helsinki, she questioned why UK ministers "have once again put nursing at the back of the queue when it comes to pay," despite nursing being "the most valued profession by the public."
The scale of the crisis is underscored by the fact that more than 26,000 nursing posts remain unfilled across the UK. The situation in Scotland contrasts sharply with the rest of the UK, where nurses accepted an 8% pay rise over two years (4.25% in 2025 and 3.75% in 2026/27), maintaining their status as the best-paid nurses in the country.
Recent history also hints at the potential for renewed industrial action. Nurses last staged strikes in the winter of 2022-23, marking the first-ever strike action in NHS history, with four separate two-day walkouts. However, the RCN lost its strike mandate in 2023 after failing to meet the 50% turnout threshold in a re-ballot. Prior to the current pay offer, nurses had rejected pay awards of 5.5% for 2024-25 and 5% for 2023-24, signaling long-standing dissatisfaction.
Meanwhile, the NHS faces mounting disruption as resident doctors continue their strike action, now on the fourth day of a five-day walkout demanding a significant pay increase. Sir Jim Mackey, chief executive of NHS England, has warned that "continued disruption over the coming months could see a snowball effect for patients and for staff," with strikes by doctors and other NHS workers potentially compounding the crisis.
As the RCN prepares to announce its vote results later this week, the government and NHS leaders face mounting pressure to find a resolution that addresses the deep-rooted issues of pay and workforce morale. The stakes are high: without meaningful change, the NHS may confront prolonged industrial unrest that could affect care delivery across the UK.
