Hold direct pay talks in England to fix NHS, RCN tells health secretary

The RCN – along with 2 other unions – is urging the government to negotiate and adopt a simpler, easier way of determining health staff pay in England, to attract and retain NHS workers, cut backlogs and improve patient care.

Along with UNISON and Unite, we’ve written jointly to Health Secretary Wes Streeting, suggesting the government do away with the outdated and bureaucratic pay review body (PRB), the independent panel that reviews NHS pay.

We want the government and NHS Employers to hold direct talks with unions instead.

This decision has been taken by fellow RCN members you’ve elected to the Trade Union Committee and with the support of Council.

The joint letter warns that a million NHS staff in England – including nursing staff – won't receive the pay rise for next year on time in April 2025 if the government waits for the PRB to report.

Failure to finalise new pay rates by 1 April 2025 will also mean workers on the lowest NHS pay bands will slip below the announced increase in the national living wage.

We’re sending the message that if the secretary of state wants to achieve his aim of improving NHS efficiency, he should ditch the current time-consuming pay process for good.

In the letter to Wes Streeting, we wrote: “Health workers are the beating heart of the NHS… and are key to improving patient care and getting health and community services back on their feet.

“Sticking with the out-of-date pay review body process risks repeating the mistakes of the past. That doesn’t fit with your wider vision for a 21st-century NHS that has a stable and motivated workforce at its core.

“The pay review body process is outdated and belongs to a bygone age. It takes forever, is bureaucratic and is inefficient too. Scrapping this would save 10s of 1,000s of pounds and spare the NHS, the government and other health organisations the many hours it currently takes to compile, submit and present evidence.”

When this year’s NHS pay rise was announced in the summer, the health secretary also agreed to a funded mandate to fix issues within the Agenda for Change pay structure.

Unions and employers are still waiting for the government to start talks to reform the 20-year-old system, which desperately needs updating.

Our joint letter adds that an NHS pay rise could be discussed at the same time. “This would be the most compelling way to help get the NHS back on track, hold on to the experienced staff it needs to do this and attract the recruits key to filling the huge gaps in the workforce,” the letter said.

RCN General Secretary and Chief Executive Professor Nicola Ranger said: "Our members need action and clarity on their future now so we can rebuild the nursing profession and the NHS, and modernise the way care is delivered.

“That is why we need to get round the table for meaningful discussions.

“We have taken this approach in the interests of nursing staff, the patients and communities we serve, and the NHS itself.”

Nursing staff can add their own voices by signing our open letter, launched today (26 November), which will call on local MPs to support direct negotiations to address fair pay in the NHS.