NHS strikes: Major step as government and unions agree pay offer

Final offer reached after weeks of negotiations and months of strikes

Rebecca Thomas
Health Correspondent
,Kate Devlin,Adam Forrest
Friday 17 March 2023 06:05 GMT
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Ambulance strikes suspended by GMB and Unison ahead of pay talks

NHS unions and ministers have reached a new pay offer for frontline staff in a move which could herald the end of walkouts by nurses and paramedics.

The government and the NHS Staff Council – which represents nurses, ambulance staff and other NHS workers – reached a consensus after weeks of negotiations and months of strikes.

The breakthrough came after The Independent revealed that ministers would introduce a 5.2 per cent wage uplift from April after originally saying they could not go beyond 3.5 per cent.

The offer also includes two one-off bonuses for this year, an issue which has been at the heart of the dispute. The offer covers all NHS staff except doctors, who are on a different contract. Junior doctors walked out for three days earlier this week.

Health secretary Steve Barclay said he was “very pleased” that the formal offer would be put to members, adding that both sides had “engaged constructively”.

The three biggest unions – the GMB, Unison and the Royal College of Nursing – said they would recommend workers accept the new offer when it is put to a vote.

It came as:

  • Unions welcomed the offer, saying they had been “vindicated” after months of walkouts
  • Questions were raised about how the move would be funded after Jeremy Hunt failed to pledge any money to the NHS in his Budget
  • A union involved in wider strikes said the breakthrough could pave the way for other disputes to be settled with the government
  • Junior doctors wrote to Mr Barclay offering to meet with him to discuss pay after rejecting pleas last week to pause strikes
  • Strikes by ambulance members from Unison and Unite next Monday and physiotherapists later this month were called off
  • A former Tory health secretary blamed the Sunak government for several months of avoidable “pain, discomfort and inconvenience” for NHS patients

The Independent revealed on Thursday morning that unions had been offered a 2 per cent one-off payment award for all staff for 2022-23, as well as a second “Covid recovery bonus” which will range from 1.5 per cent for the highest paid and 6.2 per cent for the lowest.

Under the offer for 2022-23, a new nurse working at pay band 5 would get a one-off payment of £1,891, £1,934 or £2,009, The Independent understand. This band would then see increases in their annual salary for 2023-24 of £1,352, £1,459 or £1,647.

The second part of the offer is a pay uplift of 5 per cent for 2023-24. The government has also pledged a series of “non-pay measures” to support the NHS workforce.

Junior doctors hold placards on a picket line outside St Mary's Hospital in London on Tuesday

In a statement, the NHS Staff Council, which includes the RCN, Unison, GMB, Unite, Chartered Society of Physiotherapy and BDA, said the offer represented “a fair and reasonable settlement”.

Unison’s head of health Sara Gorton said: “It’s a shame it took so long to get here. But following days of intensive talks between the Government, unions and employers, there’s now an offer on the table for NHS staff.”

Rachel Harrison, GMB national secretary, said the government has gone from refusing to talk about pay this year to putting an extra £2.5 billion on the table.

She said the offer was “far from perfect”, but added: “GMB members should rightly be proud of themselves. It’s been a tough road but they have faced down the Department of Health and won an offer that we feel is the best that can be achieved at this stage through negotiation.”

RCN general secretary Pat Cullen said: “It is not a panacea, but it is real, tangible progress.” Dr Suzanne Tyler, of the Royal College of Midwives, described it as “a good deal won by the power of collective action by unions”.

Unite, which represents paramedics, said it is not recommending the offer to its members, who will still get to vote on the offer.

The British Medical Association also welcomed an invitation to discuss pay and suggested a new meeting with the government on Friday. The BMA, whose junior doctor members went on strike earlier this week, said negotiations should have started months ago.

Mike Clancy, general secretary of Prospect, whose public sector workers also staged walkouts this week, said the offer “may provide a template for unlocking disputes elsewhere in the wider public sector”.

Striking ambulance workers in February

He said members will be looking closely at what the government has offered and expect ministers to “pursue similar active negotiations” with them.

But questions have been raised about how the offer will be funded, with further discussions set to take place between DHSC and the Treasury. Asked for details, Mr Barclay insisted it will not come at the expense of patients.

“Obviously how these things are funded are a matter for the chancellor,” he said. “We have been very clear in terms of the discussions we have had with the trade unions this will not come from patient-facing aspects.”

Rishi Sunak also insisted frontline services will “absolutely not” be affected by the pay deal. Pressed by broadcasters during a visit to a south London hospital whether patient care would be hit, the prime minister said: “We’re going to be making sure we’re protecting all frontline services.”

But Ben Zaranko, senior research economist at the IFS, said there was a risk that the NHS will be forced to make “heroic efficiency savings” to absorb the costs.

“From what we know at the moment, it is unclear whether the Treasury will eventually provide the funding required to cover the cost of this deal. If it did, that would be a material alteration to the spending plans contained in this week’s Budget before the ink is dry,” he said.

Chief executive of NHS Providers Sir Julian Hartley said the pay offer was a “hugely positive development”.

On funding for the deal, he added: “We are very encouraged by the guarantee from the government that there will be no impact on frontline services or the quality of care that patients receive as a result of this offer.

“We take this to mean that the deal is fully funded rather than relying on raids on NHS budgets, taking money away from key services. This is crucial to the success of the deal.”

He said the progress needed to be “matched by urgent movement” on talks between the government and junior doctors.

Matthew Taylor, chief executive of the NHS Confederation, had warned that any extra money for pay must come out of the Department for Health and Social Care’s central budget rather than hospital bottom lines as their funds are “already extremely tight”.

He told BBC Radio 4’s World At One programme: “It would be completely inconceivable that the money for this year’s bonus comes from the budgets of the trusts and systems in the NHS. We just simply don’t have that money lying around.”

Former Tory health secretary Stephen Dorrell welcomed news of a pay offer – but told The Independent: “It was obvious months ago that strikes would put enormous pressure on the NHS, but the government allowed the dispute to drift on.

“This deal was available five months – why didn’t they do it? If Steve Barclay had sat down with health union leaders the day he was appointed he could have avoided substantial disruption to the NHS, disruption to patients’ lives and disruption employees’ lives. It was an avoidable crisis.”

He added: “Quite apart from possible cases of avoidable mortality, there are undoubtedly cases multiple cases of extended pain, discomfort and deep inconvenience for people as a direct consequence of ministers not facing up to the issue five months ago. And they have added to the care backlog unnecessarily.”

Shadow health secretary Wes Streeting dubbed Mr Barclay “last minute dot com”. He said he hoped the pay offer brought the disruption in the NHS to an end, but added: “Where we are today is where we could have been before Christmas.”

Mr Streeting put pressure on ministers to resolve other health strikes saying the government had “just the junior doctors left to go now”.

Lib Dem health spokesperson Daisy Cooper said: “It should never have taken weeks of strikes to get to where we are today, but government incompetence and obstinance has left patients suffering and staff at their wits’ end.

“Now the government needs to step up and offer fair pay deals to end all the other strikes.”

Strikes from nurses and ambulance workers were put on pause two weeks ago after the government agreed to open negotiations on pay. Unions and the government have been locked in talks all week.

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