Nurses and other healthcare workers in Northern Ireland have called to consign the NHS Pay Review Body (PRB) process “to the history books where it belongs” following many years of pay delays.
Health and Social Care (HSC) staff, who have consistently battled year-on-year to maintain pay parity with their colleagues in England, have called for the country to adopt the collective bargaining model instead.
“Our members have constantly said to the government of Westminster, to all parties of Northern Ireland, that they cannot be left behind”
Stephanie Greenwood
The calls came during the second day of Unison’s 2025 Health Care Service Group Conference, being held in Liverpool this week.
Today, members of the union voted to “steadfastly advocate for and pursue collective bargained pay outcomes” for all its members, as part of a motion that focused on the pay struggles in Northern Ireland.
The UK-wide union has repeatedly come out in opposition of the PRB process and in 2023 its members voted to move away from the body in every UK country.
Northern Ireland HSC staff gave powerful testimony today on the consequences of the PRB process in the country, and why they want to adopt a collective bargaining approach, which would see unions and employers negotiating a pay deal directly with the government.
The collective bargaining approach is already adopted in Scotland.
Stephanie Greenwood, Northern Ireland regional delegate who put forward the motion, said: “In Northern Ireland, our long-standing concerns of the PRB are grounded by our members having learned the hard way that the PRB recommendations do not come with specific funding to implement them.”
Like their UK counterparts, HSC staff in Northern Ireland were given a 5.5% pay rise for 2024-25 but received the full uplift almost a year late after budgetary constraints caused delays.
Ms Greenwood noted that it was only at the end of March that Northern Ireland members received the full backpay, “many months after our colleagues across England, Scotland and Wales”.
This is not the first time that Northern Ireland has struggled to keep up with other UK countries in delivering health pay awards.
In recent years the country has always been the last to receive a pay offer, and always the last to have it implemented.
Ms Greenwood said the most recent outcome for 2024-25 “was only achieved after protracted negotiations with the Northern Ireland executive, protests and media campaigns”.
She added: “It was only achieved through the active campaigning of every branch across Northern Ireland, and it was only achieved through making it clear that if pay parity was not maintained, our members will take stand through industrial action once again.”
Northern Ireland’s health minister, Mike Nesbitt, has pledged to approve the recommendations of the NHS PRB for the 2025-26 pay awards as soon as they are published.
Ms Greenwood warned it would “not be acceptable” if HSC staff found themselves last to receive the pay award in their pay packets once again.
“In all their pay struggles over the last several years, our members have constantly said to the government of Westminster, to all parties of Northern Ireland, that they cannot be left behind,” she added.
“It’s clear that we will continue to suffer until we see an end to the PRB”
Deborah Yapicioz
Ms Greenwood called for an approach “that will deliver better outcomes for all our members, including our members in Northern Ireland”.
“That is why the call in this motion is to move towards direct collective bargaining,” she said.
“Let’s consign the elongated and complicated PRB process to the history books where it belongs.”
Meanwhile, David Cassidy, branch secretary of the Unison health agencies branch in Northern Ireland, noted that members had been told by political leaders in the country “that they will have pay parity” with their colleagues in England.
He said: “We want to defend and protect that principle, but likely delays due to lack of funding threatens it and makes our members fear that they will be left behind.
“To get our members the pay award they need and deserve, we need to move towards direct negotiations and collective bargaining with funding attached.
“Let’s move away from the PRB process that does not deliver for our members, and let’s make sure that our members, be they in Liverpool, Swansea, Glasgow or Belfast, get the pay awards they deserve without delay.”
Deborah Yapicioz, from the Unison healthcare service group executive, echoed this and said the NHS PRB system was “broken beyond repair”.
“That’s a problem for health workers in all parts of the UK, but nowhere more than for us in Northern Ireland,” she said.
“It’s clear that we will continue to suffer until we see an end to the PRB, a new and effective collective bargaining system and a fairer funding settlement for Northern Ireland.”
The debate comes as the Scottish Government – which has favoured collective bargaining with health unions to secure NHS pay offers over the last few years – today announced that nurses and other NHS staff had been offered a 8% pay rise as part of a two-year pay deal.
If accepted by unions, the offer will see Agenda for Change staff receive a 4.25% increase for 2025-26 and a rise of 3.75% for 2026-27.
Comparatively, England, Wales and Northern Ireland are still waiting on a pay offer for 2025-26.
Ministers previously told the NHS PRB that a 2.8% pay increase is all it can afford for Agenda for Change staff in England for 2025-26.
More on pay in Northern Ireland
