Nurses threaten industrial action ballot after pay offer rejected

The Royal College of Nursing (RCN) has warned its members will be balloted on industrial action if the Government fails to reach an agreement on investment in the profession over the summer.

It comes after members of the union rejected a 3.6% pay increase for 2025/26 in England.

Professor Nicola Ranger, general secretary and chief executive of the RCN, said nurses feel “deeply undervalued”.

The Department of Health and Social Care (DHSC) said the Government “hugely” values the work of nurses, but stressed the profession has had “two above-inflation pay rises”.

The RCN represents hundreds of thousands of nurses across the NHS in England.

According to the union, 91% of members voted to reject the pay award on a 56% turnout, with more than 170,000 staff taking part.

It warned the profession faces widespread vacancies, stunted career progression and years of pay erosion, and it urged ministers to use the summer to agree an investment plan or face a formal escalation to a dispute and a ballot on industrial action.

Prof Ranger said: “My profession feels deeply undervalued and that is why record numbers are telling the Government to wake up, sense the urgency here and do what’s right by them and by patients.

“Record numbers have delivered this verdict on a broken system that holds back nursing pay and careers and hampers the NHS.

“As a safety-critical profession, keeping hold of experienced nursing staff is fundamentally a safety issue and key to the Government’s own vision for the NHS.

“Long-overdue reforms to nursing career progression and the NHS pay structure aren’t just about fairness and equity but are critical for patient safety.”

Nurses in Wales and Northern Ireland were consulted on the same pay award and voted to reject it, according to the RCN.

Prof Ranger added: “We deliver the vast majority of care in every service and deserve to be valued for all our skill, knowledge and experience.

“To avoid formal escalation, the Government must be true to its word and negotiate on reforms of the outdated pay structure which traps nursing staff at the same band their entire career.”

A DHSC spokesperson said: “After receiving two above-inflation pay rises from this Government, new full-time nurses will earn £30,000 in basic pay for the first time this year, so it’s disappointing that RCN members are dissatisfied with this year’s pay rise.

“We hugely value the work of nurses, and through our 10-Year Health Plan, we are rebuilding the NHS for the benefit of patients and staff, and ensuring nursing remains an attractive career choice.

“This Government is clear we can’t move any further on headline pay but will work with the RCN to improve their major concerns, including pay structure reform, concerns on career progression and wider working conditions.”

Nurses staged unprecedented industrial action over pay in 2022 and 2023.

In June 2023, the threat of more strikes ended because a ballot on further walkouts failed to meet the legal threshold of 50%.

In response to the RCN’s announcement, the shadow health secretary said “short-sighted decisions have lasting consequences”.

Stuart Andrew added that the Tory party “warned Labour that giving an inflation-busting pay rise to junior doctors would inevitably raise questions among other hardworking NHS staff, like nurses, about their own value to this government”.

An RCN executive director claimed nursing salaries need to be “raised at the bottom” with clearer career progression opportunities to head off a “crisis”.

Patricia Marquis told BBC Radio 4’s World At One programme: “Nursing pay has fallen further and further behind after years and years of below-inflation pay rises.

“We could argue about the level of inflation over the last few years, but their salaries are really worth less than they were previously.

“But the issue is bigger than that. The issue we can see is not going to be solved in one year with a simple percentage pay rise.

“We need to see nursing salaries raised at the bottom and the career progression recognised for nurses across all of their experience ranges – so it’s not about the percentage pay rise, it’s about the crisis in nursing and the solutions that the Government needs to come to the table to discuss to ensure that nursing is a profession that people want to join and that there are enough nurses to provide the care that the patients and the public need.”

Responding to a question on the prospect of industrial action, Ms Marquis said “if we have to go there, we will have to go there”.

A poll published earlier this week found Britons are split on the idea of nurses striking over pay.

The YouGov survey found 19% of 4,300 British adults “strongly support” nurses going on strike, while 28% “somewhat” back them.

Meanwhile 23% said they “strongly oppose” strike action while one in five (20%) “somewhat oppose” it.

The RCN warning over a potential ballot for industrial action follows a five-day walkout by resident doctors in England, with medics returning to work at 7am on Wednesday.

Health Secretary Wes Streeting has since written to the British Medical Association saying he is willing to meet the union’s resident doctors committee to resume talks.

However, he warned resident doctors have squandered the “considerable goodwill” they had with Government after the strike.

On Thursday, a Cabinet minister urged health staff to work with the Government on “delivering the NHS they want to see and we want to see”.

Speaking to reporters in Swindon, Business Secretary Jonathan Reynolds said: “We know the workforce of the NHS had a difficult decade-and-a-half. We know how they feel.

“But we ask them to work with us on delivering the NHS they want to see and we want to see. We’ve got to be partners with each other.”