NHS strikes: What is the new NHS pay offer?

The government has reached a pay settlement with a million health workers after a majority of unions representing NHS staff backed the deal.

Under the deal, which was first proposed in March, staff will get a 5% pay rise plus a one-off sum of at least £1,655.

But the Royal College of Nursing and two other unions have threatened more strikes.

Which NHS staff have been striking and what pay rises do they want?


  • Members of the Royal College of Nursing (RCN) union in England rejected the government’s current pay offer and held a 24-hour strike which ended at midnight on 1 May
  • The strike was originally scheduled to be 48 hours long, but the High Court ruled that would be unlawful because the existing RCN strike mandate expired after 24 hours
  • In March the government offered a 5% pay rise for 2023-24 and a one-off payment of at least £1,655 to top up last year’s salary, depending on staff grades
  • The offer covers all NHS staff except doctors
  • While 11 NHS unions accepted the pay deal on 2 May, the RCN rejected it again and warned it will continue to pursue strike action. To do so, it would need to ballot its members again to get another strike mandate
  • Unite also failed to back the deal – it currently has a strike mandate for local strikes in some ambulance services and a few hospitals
  • In Scotland, members of RCN and the Royal College of Midwives voted to accept a pay offer of 6.5% for this year from the Scottish government
  • That is on top of a 7.5% pay rise imposed for 2022-23 – meaning staff will see pay increase by 13-14% over two years
  • Health unions in Wales and Northern Ireland are still in negotiations with their governments

Ambulance staff

  • About 2,000 Unite members who are paramedics, call handlers and other staff working for ambulance trusts are walking out on 1 and 2 May in several parts of England
  • Ambulance workers in England have been offered the same deal as nurses and midwives – 5% from April and a one-off payment of at least £1,655
  • GMB and Unison members have accepted the pay offer, but members of Unite have voted to reject it
  • Strikes which had been scheduled in March by Unison, Unite and the GMB were called off while pay talks took place

Junior doctors

  • Junior doctors in England staged strikes between 13 and 15 March and a four-day walkout which ended at 07:00 BST on 15 April
  • The British Medical Association (BMA) said junior doctor roles have seen pay cut by 26% since 2008 once inflation is taken into account. It wants a 35% pay rise
  • The government has said a 35% pay increase is “unreasonable in the current economic context”

What have strikes meant for patients?


For the first time, the 24-hour walkout from 20:00 BST on 30 April to 20:00 on 1 May involved NHS nurses across all departments.

However every hospital was guaranteed a minimum level of cover for intensive care and trauma as the RCN has to abide by trade union rules to ensure life-preserving care can be provided during a walkout.