Health Foundation comments on Agenda for Change pay award for NHS workers

Responding to the government’s updated Agenda for Change pay award for NHS workers in England, Anita Charlesworth, Director of the Health Foundation’s REAL Centre, said:  

'Today’s breakthrough in negotiations between the government and Agenda for Change unions is a welcome and important step towards ending industrial action that has caused widespread disruption to patient care. The government’s offer is for two 'one-off’ payments, together amounting to 5-7% of average basic earnings in 2022/23, in addition to the existing pay award of around 4.8% in 2022/23, and a 5% pay award for NHS staff in 2023/24. This will go some way to helping NHS staff who are struggling with the impact of the cost-of-living crisis and reeling from a decade of falling real earnings.  

'However, as much of the 2022/23 offer is for a one-off payment, average earnings for NHS staff in the spring of 2024 will still be worth less than in spring 2022. With today’s offer set to cost around an additional £4bn for the one-off 2022/23 pay increases and at least an additional £1bn for the 2023/24 pay increases relative to the amount previously budgeted for, it is vital the NHS is fully funded to cover these costs. The industrial action taken by NHS staff over the winter was not just about pay – it was a protest against the impact of years of under-funding and staff shortages. 

'Even if union members in England accept the government’s latest offer and it is implemented, there is a need for a thorough review of the NHS pay determination process. The suggestion that there may be “a separate pay spine for nursing staff exclusively” signals a possible end to Agenda for Change which has provided a single pay structure for the majority of NHS staff.  

'Consideration will also have to be given to how this pay increase for the NHS will impact social care. Care workers already earn around £1 an hour less than NHS healthcare assistants who are new to their roles. This award will increase that differential unless the government finds a way to boost care workers’ earnings. Social care is already suffering workforce shortages with a record 165,000 vacancies in 2021/22, and anything that exacerbates those shortages is not in the interest of patients or the NHS.'

Media contact

Ash Singleton
ash.singleton@health.org.uk