An entry-level registered nurse or midwife would be earning almost £40,000 per year if NHS salaries had kept up with inflation, according to new figures from the Royal College of Nursing (RCN).
Under the conditions of the 2025-26 pay offer from the UK government, an Agenda for Change band 5 registered nurse or midwife currently earns £31,049, up from £29,970 for 2024-25.
“Nursing staff are tired of playing constant financial catch-up, often struggling to pay rent or get on the housing ladder”
Patricia Marquis
However, the RCN has published new analysis on how it views the impact of successive government pay offers below the rate of inflation over the past decade and a half.
The RCN calculated that, had band 5 salaries increased in line with retail price index (RPI) inflation since 2010 – used to measure the purchasing power of wages – entry level nurses and midwives would be earning £39,373.12 per year, which is £8,324.12 (22.9%) higher than the current wage.
According to the RCN, this means that a worker at the bottom of band 5 since 2010 would have had a cumulative loss of earnings of around £68,916 in that time.
Other pay points have also suffered the effects of inflation, as per the RCN’s new figures.
Nurses and midwives at the bottom of band 6, as per the 2025-26 pay offer, earn £38,682. But had the wage kept pace with RPI, this would stand at £46,842, according to the RCN analysis.
Band 7 workers, the RCN stated, would be earning £56,536.39 (up from £47,810) and those at the bottom of band 4 would be earning £33,711.45 (up from £27,485).
The RCN analysis is based on RPI figures for measuring inflation. However, the UK’ official inflation measure is the consumer price index (CPI), on which the government bases its pay decisions.
Because of the way that it is calculated, the CPI will generally be lower than the RPI. Hence its popularity with the government, when it comes to justifying public sector pay awards.
Meanwhile, Patricia Marquis, executive director for RCN England, described the most recent pay award as “derisory” and called on the government to heed the union’s calls for improvements to it.
“[The pay offer] does nothing to reverse the trend of collapsing wages, especially for nurses at the start of their careers, and even by the government’s own calculations barely covers the cost of a sandwich and a drink,” said Ms Marquis.
“Nursing staff are tired of playing constant financial catch-up, often struggling to pay rent or get on the housing ladder.”
During the RCN’s annual congress in Liverpool this year, general secretary and chief executive Professor Nicola Ranger threatened strike action over what the union claimed was a sub-standard pay offer.
Currently, RCN members are being consulted on how they feel about the offer in an indicative ballot, which will inform union leaders in deciding whether to hold a formal ballot that could result in industrial action.
Resident doctors –formerly known as junior doctors – across England, along with healthcare assistants and others in some parts of the country, have already voted to walk out in the second half of 2025 over pay.
Ms Marquis added: “Nursing is an incredible profession, but we are weighted to the bottom of the NHS pay scales and received one of the lowest awards this year, a situation which is deepening the workforce crisis and impacting patient care.
“Attracting and keeping talented people should be the government’s priority, but that requires them to do better on nursing pay,” she said.
“Our members are voting in their tens of thousands and making their voices heard on this pay award. Ministers must realise that the only sensible choice left to them to negotiate directly with the largest health care workforce. It is time to both deliver better pay and pay modernisation for nursing staff.”
