The unions says that without action, tens of thousands of employees on the lowest wage bands will once again drop beneath the statutory minimum level when it rises by 50p an hour to £12.71 from April 2026.
That is also the date all NHS staff are due their annual pay rise, but Unison says delays and a failure to tackle low earnings properly mean the government risks having to resort to a temporary top-up to avoid falling foul of the law.
The union has written to trusts across England to highlight how the pay system is at ‘constant risk' of breaching minimum wage rules. Unison says this is because the government has yet to deliver on its July 2024 promise to hold formal talks with unions on fixing the pay structure. Negotiations need to start now for a package to be ready for April, the union says.
Unison's letter to trusts warns that the government's failure to make good on overdue talks is increasing the risk of ‘serious industrial escalation'. The union also advises that funding allocations for pay will need to be higher than the amount that the government and NHS England have told trusts to plan for.
The statutory minimum wage rate rise was confirmed last week, but the Low Pay Commission forecast a similar figure as long ago as May. Unison says ministers failed to plan properly to ensure NHS wages will be compliant with the increase.
Unison head of health, Helga Pile, said: ‘Nurses, healthcare assistants, paramedics and porters need to see ministers stick to their promises. Those in the lower pay bands feel completely devalued by this annual minimum wage merry-go-round.
‘The government needs NHS workers on its side to deliver on health reforms, but too many of them are worried sick about making ends meet. The NHS knows full well the damage financial stresses cause to people's health and wellbeing. Yet too many staff working in the service are struggling.
‘Paying at least the real living wage so everyone can have a basic standard of living would reap big benefits and help staff give their best for patients. Time is running out to deliver a pay rise on time for April despite all the government's promises to sort this. The pay review body is slow, ineffective and must be replaced with direct negotiations with unions.'
