NHS unions have reached a pay deal with the government in a major breakthrough that could herald the end of strikes by frontline staff in England.
The offer consists of a one-off payment of 2% of their salary for the current financial year 2022/23 and a 5% pay increase for 2023/24.
It will apply to key NHS workers including nurses and paramedics but not junior doctors, who are involved in a separate dispute over pay and conditions.
Health Secretary Steve Barclay said the deal means a newly qualified nurse will get more than £1,800 this year on top of a pay rise of more than £1,300 next year.
He said: “I hugely admire the incredible work of NHS staff, including during the pandemic and the progress they have made to tackle the resulting backlog.
“This offer will give nurses, paramedics, physiotherapists and other non-medical staff a fair pay rise while protecting our commitment to halve inflation.”
The offer will now be put to union members for a vote, with industrial action paused during that process.
The Royal College of Nursing, GMB and Unison said they will recommend their members accept the offer – but Unite said it was not good enough.
Advertisement
The unions represent a wide variety of health staff including nurses, paramedics, 999 call handlers, midwives, security guards and cleaners.
Please use Chrome browser for a more accessible video player
0:37
PM ‘delighted’ on NHS pay settlement
Sharon Graham, general secretary of Unite, said the decision ultimately lay with members and strikes will be paused while they are consulted on the deal.
But she added: “The offer from government is not one that Unite can recommend to our members.
“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.
“Britain has a broken economy and workers are paying the price.”
It looks like the government could be on the brink of a breakthrough with striking NHS workers, who will now vote on the latest pay offer.
For months, ministers insisted that they could not budge on pay because they needed to prioritise the public finances and did not want to risk rising wages fuelling inflation.
But that position seems to have softened over the past few weeks and now we see the purse strings have been loosened and some extra cash has suddenly been found.
So why the shift?
Whilst it appeared that Number 10 were – in the early stages – willing to tough out industrial action across a range of sectors, the longer it goes on the more political damage it does.
Day-to-day strikes are disrupting the public in many aspects of their lives, from getting to work to getting vital NHS treatment, and the finger of blame always tends, in the end, to point to those in power.
But the walkouts in the NHS have also created a very specific political problem for the prime minister who has made reducing waiting lists one of his five key pledges – a target he will not be able to hit whilst workers are on the picket line.
So, it is no surprise that this is the area that has been the focus of the most intense negotiations.
Ministers will now be hoping that if a deal is done with this sector others will follow and they will be able to tell voters that broken Britain is slowly but surely getting fixed.
‘Extra 2.5bn put on table’
Other unions were more welcoming of the agreement, even as they acknowledged it was “far from perfect”.
Unison said the one-off payment is worth £1,655 for staff at the bottom of band two (for example porters, cleaners and healthcare assistants), £2,009 for staff at the top of band five (nurses, midwives, physiotherapists), £2,162 at the top of band six (paramedics, health visitors, senior occupational therapists) and £3,789 for staff at the top of band nine.
Rachel Harrison, GMB National Secretary, said the offer is a “huge uplift for the lowest paid to keep them well above the Real Living Wage” as she called the offer “reasonable”.
She said the deal was reached after the government agreed to put an extra £2.5bn on the table to fund the pay increases.
“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,” Ms Harrison added.
She said progress has also been made on non-pay demands, such as addressing violence in the workplace.
Please use Chrome browser for a more accessible video player
2:14
‘It is a decent sum of money’ says Head of Health at UNISON Sara Gorton.
Nursing staff ‘vindicated’
RCN General Secretary and Chief Executive, Pat Cullen, also welcomed the agreement, saying: “The government was forced into these negotiations and to reopen the pay award as a result of the historic pressure from nursing staff. Members took the hardest of decisions to go on strike and I believe they have been vindicated today.”
It is not clear how the pay rises will be funded, with the government previously saying money for wage increases would have to come out of the budget for frontline services.
When questioned on this Mr Barclay deferred to the Treasury, saying only that it “would not come from areas of the budget that impact on patients”.
Prime Minister Rishi Sunak also insisted frontline services will “absolutely not” be affected by the pay deal to end strikes but would not say how the package will be funded.
Pressed during a visit to a south London hospital on whether patient care would be hit, the prime minister said: “Absolutely not. We’re going to be making sure we protect all frontline services with £14bn of more funding we announced at the end of last year.”
He said the deal is “fair and reasonable” and recognises the “fantastic” work NHS staff do while being affordable for the taxpayer.
“It’s a good example of this government getting things done and delivering for the British people,” he said.
Image: Junior doctors are not part of the deal offered by the health secretary
Ambulance members of Unison and Unite were due to strike next Monday and physiotherapists were going to walkout later this month but the action has been called off
Other strikes involving nurses and paramedics were paused earlier this month after the government finally agreed to talk about pay.
At the heart of the dispute was a demand for an increase for the current financial year, which ministers initially insisted was not affordable.
Tens of thousands of nurses, paramedics and other healthcare staff went on strike just before Christmas, then again in January and February.
Last month, the government finally agreed to talk about pay, averting several planned walkouts that would have seen thousands more operations cancelled.
The British Medical Association, which represents junior doctors, has called on Mr Barclay to meet with them tomorrow to discuss pay, following a 72-hour walkout earlier this week.
Rachel Reeves has refused to rule out breaking her manifesto pledge not to raise certain taxes, as she lays the groundwork ahead of the budget later this month.
Asked directly by our political editor Beth Rigby if she stands by her promises not to raise income tax, national insurance or VAT, the chancellor declined to do so.
She told Rigby: “Your viewers can see the challenges that we face, the challenges that are on [sic] a global nature. And they can also see the challenges in the long-term performance of our economy.”
She went on: “As chancellor, I have to face the world as it is, not the world as I want it to be. And when challenges come our way, the only question is how to respond to them, not whether to respond or not.
“As I respond at the budget on 26 November, my focus will be on getting NHS waiting lists down, getting the cost of living down and also getting the national debt down.”
‘Each of us must do our bit’
More on Budget 2025
Related Topics:
Ms Reeves’s comments to Rigby came after a highly unusual pre-budget speech in Downing Street in which she set out the scale of the international and domestic “challenges” facing the government.
What did Labour promise in their manifesto?
Rachel Reeves has refused to say whether she will hike taxes, but what exactly was her manifesto commitment last year?
She said: “We will ensure taxes on working people are kept as low as possible.
“Labour will not increase taxes on working people, which is why we will not increase national insurance, the basic, higher, or additional rates of income tax, or VAT.”
She also hinted at tax rises, saying: “If we are to build the future of Britain together, each of us must do our bit for the security of our country and the brightness of its future.”
Despite her promise that last year’s budget – which was the biggest tax-raising fiscal event since 1993 – was a “once in a parliament event,” the chancellor said that in the past year, “the world has thrown even more challenges our way,” pointing to “the continual threat of tariffs” from the United States, inflation that has been “too slow to come down,” “volatile” supply chains leading to higher prices, and the high cost of government borrowing.
She also put the blame squarely on previous Tory governments, accusing them of “years of economic mismanagement” that has “limited our country’s potential,” and said past administrations prioritised “political convenience” over “economic imperative”.
Please use Chrome browser for a more accessible video player
3:09
Sky’s Beth Rigby said there will be ‘almighty backlash’ after budget, as chancellor failed to rule out breaking tax pledges.
Ms Reeves painted a picture of devastation following the years of austerity in the wake of the financial crisis, “instability and indecision” after that, and then the consequences of what she called “a rushed and ill-conceived Brexit”.
“This isn’t about re-litigating old choices – it’s about being honest with the people, about the consequences that those choices have had,” she said.
‘I don’t expect anyone to be satisfied with growth so far’
The chancellor defended her personal record in office so far, saying interest rates and NHS waiting lists have fallen, while investment in the UK is rising, and added: “Our growth was the fastest in the G7 in the first half of this year. I don’t expect anyone to be satisfied with growth of 1%. I am not, and I know that there is more to do.”
Amid that backdrop, Ms Reeves set out her three priorities for the budget: “Protecting our NHS, reducing our national debt, and improving the cost of living.”
Cutting inflation will also be a key aim in her announcements later this month, and “creating the conditions that [see] interest rate cuts to support economic growth and improve the cost of living”.
She rejected calls from some Labour MPs to relax her fiscal rules, reiterating that they are “ironclad,” and arguing that the national debt – which stands at £2.6trn, or 94% of GDP – must come down in order to reduce the cost of government borrowing and spend less public money on interest payments to invest in “the public services essential to both a decent society and a strong economy”.
She also put them on notice that cuts to welfare remain on the government’s agenda, despite its humiliating U-turn on cuts to personal independence payments for disabled people earlier this year, saying: “There is nothing progressive about refusing to reform a system that is leaving one in eight young people out of education or employment.”
Image: Chancellor Rachel Reeves delivered a highly unusual pre-budget speech from Downing Street. Pic: PA
And the chancellor had a few words for her political opponents, saying the Tories’ plan for £47bn in cuts would have “devastating consequences for our public services,” and mocked the Reform UK leadership of Kent County Council for exploring local tax rises instead of cuts, as promised.
Concluding her speech, Ms Reeves vowed not to “repeat those mistakes” of the past by backtracking on investments, and said: “We were elected to break with the cycle of decline, and this government is determined to see that through.”
‘Reeves made all the wrong choices’
In response to her speech, Conservative shadow chancellor Sir Mel Stride wrote on X that “all she’s done is confirm the fears of households and businesses – that tax rises are coming”.
He wrote: “The chancellor claims she fixed the public finances last year. If that was true, she would not be rolling the pitch for more tax rises and broken promises. The reality is, she fiddled the fiscal rules so she could borrow hundreds of billions more.
“Every time the numbers don’t add up, Reeves blames someone else. But this is about choices – and she made all the wrong ones. If Rachel Reeves had the backbone to get control of government spending – including the welfare bill – she wouldn’t need to raise taxes.”
The “extraordinary bravery” of the LNER worker who intervened during the train mass stabbing attack on Saturday has been hailed by his company.
Samir Zitouni, 48, also known as Sam, was last night fighting for his life after trying to stop a knife attacker who targeted passengers on a busy train.
He was injured while trying to protect passengers during the mass stabbing on Saturday’s 6.25pm LNER service from Doncaster to London King’s Cross.
Deputy Chief Constable of British Transport Police (BTP), Stuart Cundy, said CCTV from the train showed the man’s actions “were nothing short of heroic and undoubtedly saved people’s lives”.
The train operator said he has been a “valued member” of staff for over 20 years, working on board as a customer experience host.
David Horne, managing director at LNER, said: “In a moment of crisis, Sam did not hesitate as he stepped forward to protect those around him.
“His actions were incredibly brave, and we are so proud of him, and of all our colleagues who acted with such courage that evening. Our thoughts and prayers remain with Sam and his family. We will continue to support them and wish him a full and speedy recovery.”
More from UK
His family also shared a message, thanking those who had shown the “overwhelming support” they have received and calling him a “hero”.
They said: “We have been deeply touched by the outpouring of love and kindness shown to Sam, and by the many well wishes for his recovery.
“The care provided by the hospital and the support from his colleagues at LNER has been incredible. We are immensely proud of Sam and his courage. The police called him a hero on Saturday evening, but to us – he’s always been a hero.”
Image: Forensic investigators at Huntingdon train station in Cambridgeshire
Police investigation
A man, Anthony Williams, 32, of no fixed abode, has been charged with 11 counts of attempted murder over the mass stabbing and another attack earlier at a London station.
British Transport Police (BTP) said Williams had been charged with attempted murder and possession of a bladed article in connection with an incident on a Dockland Light Railway train in the early hours of 1 November.
A victim suffered facial injuries after being attacked with a knife on a train at Pontoon Dock station, the force added.
We’re sat in a silent, empty, cardiac treatment room – on the other side of the door, you can hear the bustle of the largest A&E and major trauma ward in Devon.
Ambulances arrive, patients are wheeled on stretchers, families wait pensively.
Consultant Dr Anne Hicks, from Derriford Hospital in Plymouth, is with me – she’s worked in emergency care for more than 30 years.
There is a long pause when I ask what the hardest part of her job is.
“I don’t think it’s looking after the trauma patients,” she says.
“The toughest part is talking to the relatives. I get huge satisfaction from doing it well – but I can remember the face of every relative I think I’ve ever spoken to.”
She, like many of her colleagues, has had to tell the parents of teenagers killed in car crashes the worst news.
“The tragedy is nothing to what that parent feels when you tell them their child has gone. That their child has died.”
Image: Consultant Dr Anne Hicks
This is the so-called ripple effect – so many lives impacted by deaths on our roads, beyond the immediate family.
Sky News has spent the last year reporting on a long-running campaign – led by grieving families – to get the government to toughen rules on new young drivers within its Road Safety Strategy, which is set to be announced soon.
But as well as relatives, there is a whole other group impacted by deaths on Britain’s roads.
Emergency service workers are often the first to arrive at some of the most horrific and distressing scenes.
We’ve been given access inside Derriford Hospital in Plymouth and Devon Air Ambulance – to understand how frontline workers deal with such trauma.
Grant Thompson is a paramedic with the air ambulance team based at Exeter Airport. We’re inside the medical stockroom, used to refill the chopper after each callout.
He remembers a callout last summer.
‘A shock to the system’
Image: Grant Thompson, a paramedic with the air ambulance team based at Exeter Airport
“It was one of those jobs when you’re not expecting, I suppose, what you’re going to see,” he says.
“We started realising this was going to be a bad job. You started thinking, ‘how are we going to split up as a team?’We got there reasonably quickly and three of these young people actually died at the scene, which was quite difficult.
“It was trying to give the best care you can for everybody – they were quite severely injured. It’s always a shock to the system when you get to those jobs. It can be tricky. It can be tricky.”
Those three young deaths were among more than 1,600 on Britain’s roads last year – with nearly 130,000 injured.
Some 22% of those fatalities involved a young person behind the wheel.
New data released by the Department for Transport also shows male drivers aged 17-24 are four times more likely to be killed or seriously injured than all drivers aged over 25.
Death is one thing, life-changing injuries another.
Inside the major trauma unit at Derriford, ward manager Larissa Heard says she’s seen the “whole scale” of reaction.
“Some patients are amazingly resilient and take it really well – for others it is absolutely life-changing, and they are hysterical,” she says.
“This could be the first time that they’re actually seeing their injuries in full light. It might be the first time that they’re actually aware they’ve had an amputation or are actually paralysed.
“So having to manage that for us can be really hard.”
Image: Devon air ambulance workers
‘It’s only afterwards the impact hits you’
As we chat, an 18-year-old who has lost a leg in a car crash pushes himself past us; staff say there are always victims of RTCs on the ward.
Treating the physical and mental scars of collisions is, of course, their job.
Like all those in the NHS, that responsibility comes first.
“I don’t think you feel it until you get the lovely thank-you cards at the end, and you find out the patients you looked after knew your name,” says Catie Crisp, a trainee advanced clinical practitioner.
“It’s only afterwards the impact hits you: ‘I can take a deep breath now, that was really hard, that was really emotional.'”
Image: Catie Crisp, a trainee advanced clinical practitioner
A possible solution?
Like the families who lost children, emergency workers would welcome any measure that could reduce the number of young people injured and killed.
Graduated driving licences (GDLs) place restrictions on new young drivers in the first few months of driving, such as a ban on driving late at night and with a car full of people – factors so often part of fatal accidents.
Please use Chrome browser for a more accessible video player
2:18
What are graduated driving licences?
In Canada, one of the first countries to introduce GDLs, it takes at least 20 months to gain a full driving licence, with learners earning certain freedoms in stages. Deaths among young drivers are down 83% in the five years to 2022, compared to the same period before GDLs were brought in.
For emergency consultant Dr Tim Nutbeam, introducing a similar scheme would be a step in the right direction:
“I believe in evidence informed practice and for me the evidence from Canada, from other parts of the world is really strong. I believe GDL saves lives.
“I’ve got four children. One of them in a couple of years will be driving. I as a parent will be making sure a similar structure to GDL is in place to try to keep her safe.”
Image: Dr Tim Nutbeam
But the Department for Transport says it is not considering them.
A spokesperson told Sky News: “Every death on our roads is a tragedy and our thoughts are with everyone who has lost a loved one in this way.
“Whilst we are not considering graduated driving licences, we absolutely recognise that young people are disproportionately victims of tragic incidents on our roads and continue to tackle this through our THINK! campaign.
“We are considering other measures to address this problem and protect young drivers, as part of our upcoming strategy for road safety – the first in over a decade.”
‘They need to reconsider’
For those representing emergency service workers, the government’s position must change.
“In my view, the evidence is overwhelming that they need to reconsider it,” says Philip Secombe – the joint lead on road safety for the Association of Police and Crime Commissioners.
“We need to look at not restricting our young drivers, but actually safeguarding them, and their passengers and other road users.”
Back at the Devon Air Ambulance base, Grant explains how the ripple effect can spread far and wide.
“The loss of any life is tragic and affects a lot of people and clinicians as well, but I think when there’s a young person who survives as well, they’ve got to walk with that for the rest of their lives, 60 odd years or whatever it’ll be, that you’ve got to carry that with you – and more than likely it’d be one of your friends.
“I just hope that shapes people’s attitudes to save driving. You know, these are my mates, my best mates in the world, in my car, I need to adapt my driving to come out safe of this.”