NHS strikes - media fact sheet

From: Department of Health and Social Care Media Centre
Published: Mon Mar 20 2023

*Updated 17 March*

This fact sheet sets out the Department of Health and Social Care's position on industrial action by NHS staff.

Statement issued on 16 March:

Health and Social Care Secretary Steve Barclay 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.

"We have engaged in constructive and meaningful discussions with unions and NHS Employers and I look forward to continuing our work together to make the NHS a better place to work."

Statement issued on 17 March:

A Department of Health and Social Care spokesperson said:

"We deeply regret that over 175,000 appointments and procedures were cancelled this week, despite our offer to start formal talks on the condition strikes were paused.

"However we are pleased the BMA has now accepted our offer to enter talks based on the same terms as with the Agenda for Change unions - which concluded positively this week.

"We want to find a fair settlement which recognises the crucial role of junior doctors and the wider economic pressures facing the UK, as we have done with other unions."


  1. Agenda for Change pay offer
  2. Junior doctors

1. Agenda for Change pay offer

What is the offer that's been negotiated?

The fair offer that has been discussed with Agenda for Change unions includes steps on pay as well as measures to improve working conditions. The offer covers:

  • A one-off award of 2% for 2022/2023 on top of at least 1,400 already received for this year. The one-off 2% award is worth between 405 and 2,189 depending on their pay band.
  • A one-off NHS Backlog Bonus worth between 1,250 and 1,600 depending on how much experience staff have and their pay band. The average nurse in pay band 5 with at least four years of experience, for example, would receive 1,350.
  • A 5% pay rise for 2023/2024, worth at least 1,065. In addition, the lowest paid staff will see their pay matched to the top of band 2, resulting in a pay uplift of 10.4%, or 2,113.
  • Non-pay reforms to make the NHS a better place to work. This includes a drive to tackle violence against staff, measures building on existing safe staffing arrangements, amendments to terms and conditions to support NHS staff to develop their careers through apprenticeships, and a consultation to make the suspension of the pension 'retire and return' rules introduced during the pandemic permanent.

What would this offer actually look like for staff?

  • For example, a newly qualified nurse would see their salary go up by more than 2,750 over two years from 2021/22 to 2023/24. On top of this they would also receive over 1,890 in one-off payments this year.
  • A band 6 paramedic with less than two years' experience would see their salary go up by more than 3,000 over two years from 2021/22 to 2023/24. They would also receive over 2,020 in one-off payments this year.

How will this offer be paid for?

  • We are absolutely committed to ensuring the NHS has the funding it needs to deliver for patients. There will be no impact on frontline services or quality of care that patients receive as a result of this offer.
  • DHSC has already made funding available for 3.5% for pay in 2023/24 in its existing budgets, and HMT and DHSC will work together to resolve any new funding needs in the usual way.

Will this offer fuel inflation?

  • The government firmly believes this is a fair deal which gives all Agenda for Change staff a fair and proportionate pay rise, at a time when people across the country are facing cost of living pressures and there are multiple demands on the public finances.
  • It protects the Prime Minister's promise to halve inflation as a one off payment in 22/23 does not create a future inflationary pressure, and the award for next year is broadly in line with pay growth in the wider economy, and so won't drive significant growth in private sector pay.

What will happen now?

  • Each Agenda for Change union will now inform their members of this new offer, and the RCN, UNISON, GMB, CSP and British Dietetic Association will recommend that their members vote to accept. Unite is putting the offer to their members but is taking a neutral stance.
  • The details of the balloting process will be for individual unions to agree.
  • Strike action will continue to be paused while they are consulted.

What does this mean for the rest of the pay review process?

  • We have asked the NHSPRB to report by the end of April, and would anticipate the progress made and the outcome of the union ballot to be taken into account.
  • If the offer is accepted by the unions, the government will move to implement it, and would welcome observations from the NHSPRB on the pay deal in England.

2. Junior doctors

What is the BMA asking for and how much would this cost?

  • The BMA is asking for full restoration of junior doctors' pay to levels equivalent to 2008/2009 based on RPI inflation to April 2022.
  • Meeting this demand would require an average pay award of around 35% in 22/23 (including the existing Junior Doctor pay award for this year).
  • To restore real terms pay to 2008/09 levels on this basis would cost around 2 billion on top of the existing 22/23 award. This is around 1.3% of the total NHS budget (152.6bn for 22/23)
  • Each 1% pay award for all junior doctors will broadly cost around 60 million.

How much do junior doctors get paid?

  • A junior doctor starting training in Foundation Year 1 can expect full-time basic pay of 29,384 in 22/23. On average, Foundation Year 1 Doctors have additional earnings worth around 31% of basic pay, covering payments for additional activity and unsocial hours payments, resulting in total earnings of around 38,000.
  • A junior doctor progressing into Foundation Year 2 can expect full-time basic pay of 34,012 in 22/23. On average, Foundation Year 2 Doctors have additional earnings worth around 35% of basic pay, covering payments for additional activity and unsocial hours payments, resulting in total earnings of around 46,000.
  • A junior doctor progressing into specialty training can expect a starting basic pay of 40,257 in 22/23. On average, doctors in specialty training have additional earnings worth around 36% of basic pay covering payments for additional activity and unsocial hours payments, resulting in total earnings of around 55,000.
  • The maximum basic pay as a junior doctor depends on the specialty they train in, but once they are qualified, they have opportunity for career advancement into roles in the consultant, Specialty and Associate Specialist, or general practice workforces, potentially earning significantly more.
  • Junior doctors who are also members of the NHS Pension Scheme receive a pension contribution worth 20% of their salary.

Details on the current multi-year pay deal

  • Junior doctors are in a pre-existing multi-year pay and contract reform deal, which ends in March 2023.
  • The junior doctor pay and contract reform deal will see all pay points increase by a cumulative 8.2% between 2019/20 - 2022/23.
  • This deal came alongside an estimated 90 million of additional investment over the four years which:
  • provided the most experienced junior doctors with a higher pay band, recognising that they are often taking decisions and delivering care at near-consultant level. This meant they received a cumulative increase of 24% over the four years. All junior doctors that reach the highest pay point as part of their specialty training will benefit from this.
  • increased allowances for those working the most frequently at weekends.
  • increased rates of pay for night shifts. Shifts between midnight and 4am are paid an additional 37% of the hourly basic rate.
  • created a permanent allowance of 1,000 a year - on top of their usual pay - for junior doctors who work less than full time to recognise the additional costs they face.

Is the BMA's claim that the majority of junior doctors are looking to leave the NHS accurate?

  • The NHS Staff Survey 2022 indicated that over 79.4% of junior doctors are not considering leaving their organisation (50.9%) or if they left would be most likely to move to a different NHS trust or organisation (28.5%).
  • We are committed to making the NHS the best place to work and the NHS will publish a long-term workforce plan in Spring to recruit and retain more staff.
Company: Department of Health and Social Care Media Centre

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