The context of this deal

It is over 13 years since Agenda for Change was implemented nationally. Delivering the most radical reform to pay and reward the NHS had ever seen was not easy – nor free from criticism - but trade unions can be proud of building a pay system based on the principle of equal pay for work for equal value.

However, the pay scales and structures we ended up with were far from perfect. It still takes too long to reach the full rate in a band, some pay points are too close together, there is too much overlap between bands, and pay at the bottom of the structure is too little to live on.

These issues have been compounded by nearly eight years of pay restraint. The Government’s failure to maintain the value of the pay structure has led to staff at the top of their pay bands feeling neglected, as well as financially worse off. This contributed to a difficult industrial relations environment. The autumn of 2014 saw the first national industrial action in the NHS over pay for 30 years.

When that dispute was settled in England in 2015 the trade unions agreed to hold talks with the employers and the Department of Health about refreshing the pay structure to make it fit for the future.

From that point onward, the joint NHS trade unions have led the agenda on reforming NHS pay. Trade unions have pushed for talks with a view to:

  • Improving the “rate for the job” at the top of each pay band
  • Introducing the real living wage
  • Increasing starting salaries
  • Reducing the length of time it takes for new staff to reach the full rate for the job

In March 2017 it became apparent that the Government was unwilling to provide the funding needed to make reform possible. It became clear that the only way of changing the pay structure without additional funding would be to stop annual pay awards for staff at the top of their band. This was not something trade unions were willing to consider.

Following the general election there was an unprecedented amount of pressure on Government on public sector pay from trade unions, Labour, and campaign groups. In that environment, and with mounting uncertainty about NHS pay, the joint NHS trade unions submitted a pay claim to the Government, calling for pay rises for all NHS staff, as well as funding to improve the NHS pay structure.

NHS Staff Council

The national NHS Staff Council has overall responsibility for the NHS pay system and has representatives from both employers and trade unions.

It's remit includes:

  • maintaining the pay system
  • negotiating any changes in core conditions for staff on Agenda for Change and reflecting these in the NHS terms and conditions of service handbook
  •  providing national support on interpreting the national agreement for employers and trade unions.

The trade unions representing staff that are covered by this framework agreement are the the British Dietetic Association, the British Orthoptic Society, the Chartered Society of Physiotherapy, the Federation of Clinical Scientists, GMB, Managers in Partnership, POA, the Royal College of Midwives, the Royal College of Nursing, the Royal College of Occupational Therapists, the Society of Chiropodists and Podiatrists, the Society of Radiographers, UNISON and Unite.

Additionally, the British Medical Association, British Dental Association and the Hospital Consultants and Specialists Association have seats on the NHS Staff Council and negotiate on issues relevant to their membership. Medical and dental staff have separate pay, terms and conditions arrangements and are not in the scope of this framework.


What this deal means for me

See a detailed breakdown of the deal by pay band

Overview of the deal

A breakdown of the key elements of the deal.