Last month, nurses saw a 3.3% increase in their pay packets, a rate confirmed by the government in February. Health secretary, Wes Streeting, announced that “We’ve listened to the workforce and acted early. Nurses can count on this government to deliver their pay award on time.” In previous years the pay offer has been delayed.
Despite Streeting’s confidence and timely delivery, the pay award has not been warmly received. Royal College of Nursing (RCN) general secretary, Professor Nicola Ranger said: “Unions were misled to expect direct negotiations with government.” However, the government used an external pay review body (PRB), which most of the trade unions representing Agenda for Change (AfC) staff withdrew from. AfC contracts cover nurses and most other NHS staff excluding doctors, dentists and some senior managers.
Jo Galbraith-Marten, RCN executive director of legal and member relations, criticised the government for outsourcing its pay review responsibilities, resulting in a pay award that will mean real-terms pay cuts for nurses. She stated “It’s clear that nursing staff are being failed on pay,” and “You simply can’t agree fair staff pay without talking to staff.”
Helga Pile, head of health at UNISON, was equally frustrated: “Hard-pressed NHS staff will be downright angry at another below-inflation pay award.”
Changing economic forecasts
When the announcement was made in February, the UK inflation rate sat at 3%. This was forecast to fall to 2.2% over the 2026/27 financial year, according to the PRB, resulting in pay awards slightly above inflation (S.4:38).
However, the pay settlement was reached before the start of the US-Israel war on Iran. As a result of the war, the UK inflation forecast has been revised to 4% for 2026 – the biggest upward change of any large, advanced economy, according to the International Monetary Fund (IMF). If the forecast is right, nurses are looking at a significant real-terms pay cut.
Nurses feel “angry and let down”
In a joint letter to Wes Streeting, signed by 14 unions, over 58,000 nurses have shared their frustration with the pay award, stating that “3.3% is not enough. Not enough to keep pace with the cost of living. Not enough to restore what has been lost through pay erosion.” The letter also calls on the government to improve the AfC pay structure.
Unions say negotiations to improve the pay structure were promised 18 months ago and the delay has damaged trust. The government is yet to respond.
The effect on nurses in Yorkshire
Between 2020-23 the number of people accepted onto nursing courses in Yorkshire and the Humber fell by 25%. Once qualified, nurses often work in the region where they have studied so this is likely to mean fewer nurses in areas such as Yorkshire and the Humber, with decreasing acceptance rates. Nursing degrees usually take 3-4 years, so the impact of this may be felt right around now.
Additionally, from 2020-2023 the north east and Yorkshire had one of the smallest increases in nurses joining the workforce, a 10.2% increase, in comparison to a 15.7% increase in the south east. Since then, nursing vacancies have reduced. In March of 2024 there were 3,436 vacancies, and by December 2025 there were 2,523 vacancies. That still leaves a large gap to be plugged, and currently, that gap is being filled by overworked nurses.
Nurses are dedicated but struggling
The RCN 2025 state of the profession report found that 70.4% of nurses work in excess of their contracted hours at least once a week, 62.9% said they feel too much pressure at work and only 38.2% said they felt able to balance home and work lives. However, hope is not entirely lost, as 59.7% still describe nursing as a rewarding career.
It’s fair to say there’s a lot of anger around the pay uplift, and simply delivering the pay offer on time didn’t do much to soften the blow. The government’s February statement also promised talks with employers and trade unions as part of the pay package, delivering additional pay increases for some staff that would be backdated to April 1, 2026. However, unions are doubtful, as they say that these talks were promised 18 months ago. For now, it’s a case of waiting with bated breath to see if and how the government decides to move forward with additional pay increases, and how they respond to nurses’ disappointment.
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