This is a fast-moving topic and information should be read as correct at the time of publication.  

Which NHS workers are striking in Autumn 2023?

Strikes among members of some unions representing NHS workers have continued into Autumn 2023.

Junior doctor and consultant members of doctors’ unions in England took joint strike action in September and October 2023.

Members of the British Dental Association who work in hospitals in England also took strike action at some trusts, coinciding with the doctors’ strike.

Members of the Royal Society of Radiographers in England also took 24-hour strike action during this time.

Members of Unite took part in local strikes in September. Unite represents workers from across the health sector, including nurses, cleaners and porters.

Are further strikes planned?

Specialist, Associate Specialist and Specialty (SAS) doctor members of the British Medical Association (BMA) in England have voted in an indicative ballot on whether to take strike action. SAS doctors mostly work in hospitals alongside junior doctors and consultants. The ballot closed on 16 October 2023.

On 4 October 2023, the BMA consultants committee chair said he would not call further strikes for four weeks to give the Government the opportunity to end the pay dispute with consultants.

What are the latest pay deals?

NHS staff are split into different groups when it comes to pay, terms and conditions. Most NHS staff, except doctors, dentists and senior managers, are paid on a scale called Agenda for Change (AfC) made up of pay bands.

Independent pay review bodies make annual recommendations to Government on pay based on evidence from employers, unions and the Department of Health and Social Care. The Government makes the final decision on whether to accept the recommendations.

Doctors and dentists

On 13 July 2023, the DHSC announced SAS doctors, NHS consultants, salaried dentists and salaried GPs would receive a consolidated pay uplift of at least 6% for 2023/24, backdated to 1 April 2023. Junior doctors would receive a consolidated pay uplift of 6% plus £1,250.

The DHSC made the recommendations in line with the latest report from the Review Body on Doctors’ and Dentists’ Remuneration.

Reacting to the announcement, the British Medical Association (BMA) said the Government had “missed a huge opportunity to put a credible proposal on the table to end strikes.”

The Royal College of Nursing (RCN) said it was “outraged” at the 6% pay uplift awarded to doctors and dentists, in the context of the 5% pay uplift implemented for NHS workers on Agenda for Change terms and conditions.

Agenda for Change employees

On 2 May 2023, a majority of representatives from AfC trade unions voted to accept a pay offer from Government in a meeting of the NHS Staff Council. The NHS Staff Council has responsibility for the AfC pay system and includes representatives from NHS employers and trade unions.

The deal includes a one-off payment for 2022/23 and a pay uplift for 2023/24. This is broken down as:

  • A one-off, non-pensionable payment for 2022/23, on top of the original 2022/23 pay award (see below), including two elements:
  • a payment equal to 2% of salary for all staff
  • a tiered “backlog bonus” payment for all staff, depending on the tier (average value of 4%). Tiers are groups of AfC pay bands, for example tier 1 includes pay bands 1–4.
  • A pay uplift of 5% in 2023/24 for most staff and 10.4% for those at band 1 and 2 entry points.
  • A series of “non-pay measures to support the workforce”, including challenging recruitment and retention issues in nursing and reviewing the process for setting pay.
  • Health Secretary Steve Barclay issued a statement saying he would implement the pay deal and NHS staff would receive their extra pay from June 2023. Information about eligibility for the pay deal, including how the non-consolidated (“lump sum”) payment applies to bank staff, can be found from an FAQ page by NHS Employers.

    Why have some Agenda for Change unions stopped striking?

     Some unions, including GMB Union and Unison, stopped strike action after their members voted in favour of accepting the Government’s March 2023 pay offer.

    Four unions voted against the offer. Unitethe Society of Radiographers and the Royal College of Nursing (RCN) said they would continue strike action.

    The RCN’s mandate to strike lapsed in May 2023. Between May and June 2023 it carried out a national ballot, but the 50% turnout threshold required by law was not met (see information on thresholds below). General Secretary & Chief Executive of the RCN, Pat Cullen, said the fight for fair pay is not over.


    Why did NHS workers start striking?

    In July 2022, based on the review bodies’ recommendations, the Government announced it was making the following changes to NHS pay, backdated to April 2022:

    • Doctors and dentists received a 4.5% increase in their salaries.
    • Employees on the AfC scale received a £1,400 permanent increase to their full-time equivalent salary (not a one-off payment), backdated to 1 April 2022.
    • Staff at the top of band 6 of AfC, and those in band 7, received a further enhancement to ensure their pay increased by at least 4%.
    • For staff in bands 1 and 2, the increase of £1,400 was in addition to National Living Wage adjustments.

    Trade unions representing some NHS workers noted the increase in pay amounted to a pay cut in real terms and argued it was too low in the context of the rising cost of living.

    Union members also said health workers want to improve patient safety, which is being compromised by inadequate staffing levels and staff burnout. They were also concerned that people would be reluctant to join the NHS or stay in their jobs without better pay, exacerbating existing staffing problems.

    These concerns led trade unions to ask their members to vote on whether to take strike action.

    What does the law say about voting to strike?

    Under the Trade Union Act 2016, for a strike ballot in “important public services” to be valid there must be a 50% minimum turnout and at least 40% of all eligible members must vote in favour.

    Under Trade Union laws, unions can ballot members at individual workplaces or organise aggregated ballots of staff who have common terms and conditions. This means the thresholds can apply to trusts or nationally, depending on the ballot.

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