Members of Unite, a public sector union representing nurses among a range of staff groups, have voted to reject an 3.6% NHS pay rise.
With a majority of 89%, Unite’s consultative ballot of members overwhelmingly voted against the 2025-26 Agenda for Change pay offer, which was issued to NHS staff in England, Wales an Northern Ireland.
“The NHS can’t be repaired while the government continues to erode pay and drastically cut NHS budgets”
Sharon Graham
Unite, which has not revealed the vote turnout, now joins the Royal College of Midwives (RCM), the GMB and the Welsh branch of the Royal College of Nursing (RCN) in voting against accepting the pay offer.
They will now need to decide whether to take the matter further and ballot for industrial action or continue the war of words with ministers while taking the money on offer but without officially accepting it.
The RCM has already acknowledged that it would be unlikely to get sufficient turnout in a strike ballot to pass the legal threshold currently required by the government.
Unions have been vocally critical of the pay rise since its initial announcement in May. They said it was too low to address the issues that nurses and other healthcare staff face, flagging that it was below inflation.
They also aired frustration that it was so much lower than the separate offers given to staff in Scotland, as well as doctors in England and Wales.
Sharon Graham, Unite general secretary, said: “When it came into power this government was clear that the NHS was broken.
“But staff are still leaving in droves and morale is still at an all time low. The NHS can’t be repaired while the government continues to erode pay and drastically cut NHS budgets.
“This pay award does nothing to reverse 15 years of real terms pay reduction. The lowest paid in the NHS will feel especially cheated because part of the award was paid out early in order to get them above the minimum wage. The fact that that needed to be done shows how far we are from where we need to be.”
Richard Munn, Unite national officer for Health, also spoke critically of the UK government’s strategic plans for the NHS.
Earlier this month, health secretary Wes Streeting unveiled the NHS 10 Year Health Plan for England which spoke about the need to improve efficiency.
Mr Streeting has repeatedly hinted at the need for NHS organisations to cut staff numbers to balance the books.
As well as this, the prime minister earlier this year announced a plan to merge NHS England and the UK Department of Health and Social Care, significantly reducing their overall headcount.
Mr Munn added: “On the issue of cuts our members are baffled – it is literal Orwellian doublespeak. How can the NHS be “fixed” with thousands of staff at risk of losing their jobs?
“Unite members are not resistant to better use of technology, ill health prevention and health promotion or the move from hospital to community as outlined in the 10 year plan, provided skills and staff are not reduced.”
Mr Munn said cutting jobs from the NHS is “nonsensical”, adding: “It is no surprise that almost all members who voted are prepared to take action against cuts.”
Unite’s ballot asked members if they would be willing to “take action” to oppose cuts to the NHS; 95% of respondents said they would.
Members of Unite have historically rejected most NHS pay offers in recent times, with the exception of this year’s deal in Scotland.
For example, while the NHS Staff Council, which comprises 12 health unions in England, accepted a pay package made in spring 2023, in the wake of strikes the previous year, Unite remained in formal dispute.
