New analysis by the union of NHS data for England over three years shows no marked improvement, and a decline in some cases, in pay satisfaction levels for workers on Agenda for Change (AfC) contracts.

Medical and dental staff are the only group where pay satisfaction levels have risen to any extent, with an 18% increase in the past three years.

Unison says these findings underline the need for pay restructuring talks between the government and AfC unions – expected to begin in the coming weeks – to yield results.

The Government imposed the 2026/27 headline wage rise of 3.3% for AfC staff today on 1 April. Some workers could receive additional rises if a deal is reached with the government.

The Unison analysis of pay satisfaction was based on data from annual NHS staff surveys for England covering the three years to 2025.

Results show the proportion of support staff such as porters, catering staff, IT workers and administrators who were content with their earnings dropped by 2% from 2023 to 2025. Levels of satisfaction did not increase at all among nurses and midwives during the same time period.

The data reveals a rise in pay satisfaction of just 1% among nursing and healthcare assistants, and other clinical professions. It is 2% among ambulance workers including paramedics.

Healthcare assistants and ambulance staff had the lowest satisfaction levels of all groups in the 2025 data with only 21% and 25% satisfied with their pay.

Leaving these dissatisfaction levels unchecked risks more staff leaving for better paid jobs elsewhere, which represents a real risk to patient care at a time when the NHS has barely begun to recover, the union says.

Unison head of health, Helga Pile, said: ‘The Government's failure to invest in the NHS workforce has left many angry and disillusioned. Paramedics, nurses, porters and other staff feel neglected and ignored especially in the current staffing crisis.

‘Soaring living costs have eaten into the pay of all health workers and inflation will quickly wipe out the pay award that kicks in today.

‘The Government must ensure there's proper funding when talks with Agenda for Change unions finally begin in the coming weeks.'

A Department of Health and Social Care spokesperson said: ‘This Government hugely appreciates the incredible work of talented staff across our NHS, which is why we are working with the NHS Staff Council to reform the Agenda for Change pay structure and to prioritise increasing pay for graduates and the lowest paid members of staff.

‘Alongside these imminent talks, we have accepted the pay recommendation from the independent NHS Pay Review Body to deliver an above forecast inflation pay increase for the third consecutive year to 1.4m NHS staff, including nurses, paramedics, midwives and hospital porters. 

‘This pay boost will be in pay packets from this month for the first time in six years, demonstrating our commitment to getting money into the pockets of NHS staff in a timely fashion.'