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While the RCN caves to the Tories’ tawdry pay offer, grassroots campaigners are urging NHS workers to say ‘no’

Steve Topple by Steve Topple
7 October 2025
in Analysis, UK
Reading Time: 4 mins read
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The Tory government and NHS unions have reached an offer over pay. This comes after months of industrial action from workers. However, while trade unions like the Royal College of Nursing (RCN) are urging their members to accept the deal, workers aren’t convinced. Moreover, the problems with the offer are far-reaching.

The Tories’ NHS pay offer

As Nursing Notes reported, the government and most NHS unions have reached a pay offer. It noted that this included:

a 2% non-consolidated pay rise and a so-called “Covid-recovery bonus” for the current financial year, plus a rise of 5% for most workers in 2023-24.

The government is giving the lowest-paid NHS staff a 10.4% pay increase from April. However, the bonuses are simply that – bonuses – and they’re subject to tax. So, in reality the Tories are giving workers one percentage point more in pay this year than last. Unions like the RCN are urging their members to accept the government’s offer. Its general secretary Pat Cullen said:

It is not a panacea, but it is real tangible progress and the RCN’s member leaders are asking fellow nursing staff to support what our negotiations have secured.

Financial sleight of hand?

However, not everyone agrees that workers should accept the offer. Unite has told its workers to reject the offer. Its general secretary Sharon Graham said:

It is clear that this government does not hold the interest of workers or the NHS at heart. Their behaviour and disdain for NHS workers and workers generally is clear from their actions.

Grassroots campaign group NHS Workers Say No has hit back at the government’s offer. It said in a statement:

Non-consolidated one-off payments are not the same as a pay restoration. This is an attempt by the government to entice staff to end our dispute, but it will not solve the long term recruitment and retention crisis.

Indeed, the Tories’ offer does little more than make up for some of the real-terms pay losses workers have faced. As senior research economist Ben Zaranko wrote for the Institute for Fiscal Studies (IFS):

This pay deal would, on the basis of the latest set of official government forecasts, see NHS pay grow slightly faster than CPI inflation (4.1%) and private sector pay (4.5%) in the coming financial year. That would still leave consolidated pay up to 5% lower in the longer run than it was in 2021–22.

In other words, NHS workers will still end up worse off – more so, after years of effective pay cuts to the tune of £4,300 for nurses alone. Then, you have the issue of where this money is coming from.

More Tory cuts to the NHS?

NHS Workers Say No said:

The government saying there’s no more money is a standard line they feed, too. There was no money for this offer back in December, but here we are.

The problem with the new government pay offer is it may well come out of existing NHS budgets – meaning cuts to services. As Zaranko pointed out:

There was no additional funding provided in the Budget for this purpose. Just over three weeks ago, the Department of Health and Social Care was claiming that pay awards of more than 3.5% were unaffordable. A 5% pay offer rather than 3.5% would add around £1.5 billion to the NHS pay bill.

If no extra cash is forthcoming from the Treasury, it may be that for the second year in a row, the health service is asked to somehow absorb these additional costs – whether through reductions in headcount, or lower spending on things like digital transformation. There must be a risk that the NHS is asked to make heroic efficiency savings to absorb these costs, struggles to do so, and instead has to be bailed out in 6 months or a year’s time. That would hardly lend itself to sensible financial planning.

However, the biggest problem with the government’s pay offer is that the unions have just accepted it – despite it being bad for the health service and bad for its workers.

Reject, reject, reject

The Guardian reported the heads of Unison, the RCN, and the GMB all praising workers’ efforts and celebrating the pay offer as some sort of win. However, NHS Workers Say No urged union members not to give in:

when the ballots arrive for NHS workers in England, we are urging you to use your vote to reject this offer.

If workers do approve the deal, it will do little for them in the long run. Moreover, it certainly does nothing for patients – as the government’s tawdry pay rise will have to come out of existing health budgets. So, healthcare staff need to heed NHS Workers Say No’s call to reject the offer. Anything less is unacceptable for everyone involved in the health service.

Featured image via NHS Workers Say No

Tags: Conservative PartyNHSstrikestrade unionsUnison
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