As a result of our negotiations with government, we have come up with a framework agreement to put to you, as members, that we believe would benefit all NHS staff. Those benefits include a three year pay deal and changes to the pay structure to make it better and fairer. Crucially, the government has committed new money to pay for the deal – not money taken from patient care.

  • Meaningful increases for top-of-band staff who already benefit from the full rate for the job – for most this would be worth 6.5% over three years plus a 1.1% lump sum in year 2
  • Increases for staff below top of band through simplifying bands so most staff reach the full rate for the job quicker – with the combination of reform and incremental progression worth between 9% and 29% over three years
  •  Removal of band overlaps to ensure promotion comes with a proper pay rise, and to lessen the risk of equal pay challenges
  • Ending poverty pay through an immediate move to a new above-living wage minimum rate, with further increases for the lowest paid staff by the end of the deal
  • Big improvements to starting salaries to help the NHS attract and retain new staff

A closer look

A key aim of this proposed agreement is to make whole pay system fairer and better for current and future NHS staff. All the changes relate to pay band design – the process for allocating roles to bands will continue to be through the current NHS job evaluation scheme.

The changes within this proposed agreement can't be made in one hit, they need to be spread out over a full three year period.  Some people do better than others in individual years, but we have made sure that everyone would gain overall. The most important figure for you to look at is your total gain at the end of the three years.

All staff would get a meaningful pay rise – in every case more than they could expect under the current system of incremental progression and annual awards capped at 1%. The proposals we have negotiated would provide a mixture of annual pay awards, a top-of-band lump sum, incremental progression and improvements to the pay structure.

For staff in bands 2-9 who are below top of band

This would mean:

  • improving starting salaries in each pay band by removing overlaps between bands. This would start in year one and be finished in year two..
  • deleting points in the mid-range of each band in years two and three of the deal.

In each year staff who are due to move up to a point that will be deleted would automatically go to the point above. The combination of these changes would mean increases ranging between 9% and 29% over the three years as we help more people reach the rate for the job more quickly.

Current progression arrangements would continue to apply, so annual incremental progression would continue as expected for staff during the transition. For information on progression arrangements for new starters and staff who are promoted, see the progression section.

For staff at the top of bands 2-8c

 This would mean:

  • 3% in 2018/19
  •  1.7% in 2019/20 plus a lump sum worth 1.1% paid in April 2019
  •  1.7% in 2020/21 

This would amount to a total increase on basic pay of 6.5% over three years plus the extra 1.1% lump sum in April 2019.

For staff at the top of bands 8d and 9

This would mean:

  • An increase of 5.4% at the top of band 8d and 4.5% for the top of band 9 over the three years. These staff would also receive the lump sum worth nearly £800 in April 2019. 

For staff currently in band 1

This would mean:

  • effective from 1 April 2018 the minimum basic rate in the NHS in England would be £17,460 – equivalent to £8.92ph – which exceeds the living wage.
  • For all staff currently in band 1 this would be an immediate increase of about 10%.

However the deal goes further so that by March 2021 all jobs in band 1 would be altered to become band 2 roles. Staff would get training and support to take on any necessary changes. They would therefore benefit from a further increase taking their salary to £18,005, equivalent to £9.21ph, by the end of the deal.

In total, current band 1 staff would receive increases of 15% to 17% over the three years. And from 1 December 2018 band 1 would be closed and new staff would be recruited straight into band 2 jobs.


High cost area supplements (HCAS) will be increased in line with the increase to the top of bands in each of the three years, with both minimum and maximum levels increasing by 6.5% over the duration of the proposed agreement.

Other changes

The NHS trade unions have been in detailed negotiations with employers and the government to get you a better pay deal. During those negotiations we were faced with a list of demands that they put forward for discussion. Many of those demands were unacceptable and in the end were taken off the table.  As a result most terms and conditions – including annual leave – remain unchanged.

But there were a few areas where we were prepared to enter into talks around making certain terms and conditions more consistent, and to address the knock-on effects of moving away from the current system of pay points. 

Unsocial hours payments

There would be no fundamental changes to unsocial hours payments. But there would be adjustments affecting some staff to maintain the integrity of the system, while ensuring no-one loses out.

  • For staff in bands 4-9 unsocial hours payments would be completely unaffected and continue to be calculated as now.
  • For bands 1-3 unsocial hours payments would be calculated in a different way to protect the current cash values for three years while pay changes take place, and thereafter allow them to go up again alongside basic pay increases.
  • Instead of being based on the old pay points, eligibility for the payment of unsocial hours during sick leave would apply to salaries up to £18,160.
  • Current ambulance staff would be given an individual choice between their existing arrangements or the system that applies in the rest of the NHS. 

Unsocial hours calculations in bands 1-3

Unsocial hours payments would be calculated in a different way for bands 1-3 to protect the current value and improve it as basic pay increases over the three years.

These changes have the effect of preserving the cash value of unsocial hours while the pay restructuring takes place, but would stop any leapfrogging effects where staff in lower bands end up earning more than those in the next band up for the same unsocial hours shift. Once the changes to pay bands have been completed, the system would reset with the new adjusted percentages for the future.

In every case, unsocial hours earnings each year would be higher than under existing arrangements (i.e 1% increase per year).

Pay progression

Around half of all current staff are already at the top of their band. Most others will have reached it by the end of the proposed three-year agreement through the effects of the pay increases outlined above. For the small proportion who haven’t – and for new starters and promoted staff in the future ­– incremental progression would work quite differently in the future. Most would progress to the top of their band more quickly than is possible now. Increments would no longer be annual, they would be further apart. But in a year where staff  did get them, they would be worth more. 

You can read more about this on the Pay Progression page.

Read the full technical version of the proposed agreement as a pdf.

What happens next

Every union will be talking to their members about this offer to see what they think – find out more by speaking to your rep or visiting your union’s website.