The government's submission says that it can afford only a 2.5% pay rise for healthcare staff in 2026/27.

The DHSC said that should a pay award be recommended above 2.5%, it would need to consider ‘whether and how this could be made affordable' from existing budgets.

‘Accepting such an award would inevitably have an impact on healthcare delivery,' it said.

In response, BMA council chair Dr Tom Dolphin, said: ‘It is frankly indefensible that yet another Government is once again suggesting real-terms pay cut for doctors – an increase of less than 50p per hour for many newly-qualified doctors. After more than a decade of pay erosion, spiralling workloads, and an NHS in a state of near chaos, this is a deliberate choice to devalue those who hold the health service together, a profound disregard for our doctors and the state of the profession.

‘This is not responsible governance; it is a calculated decision to let a vital profession bear the cost of political failure. Each sub-inflation offer pushes more doctors to leave the NHS or the country altogether, and it is patients who ultimately pay the price for this foolishness.'

RCN general secretary and chief executive, Professor Nicola Ranger, said: ‘With too many leaving nursing and too few joining, we need urgent and fundamental pay reform, not derisory pay deals that fail to cover living costs.'

Prof Ranger added: ‘The pay review body process has become a sham. Unions are refusing to engage with it, and the government cannot hide behind it. We need direct talks at pace to transform nursing pay and health and care services.'

Sharon Wilde, GMB national officer, said the offer is ‘not good enough'.

Wilde said: ‘Ministers must recognise the Pay Review Body is broken. They need to come to the table themselves and deliver the decent pay that NHS workers deserve.'

Unison head of health Helga Pile said the offer was an ‘insult' and would go down badly across the NHS.

Pile added: ‘It's likely this amount won't even be enough to ensure the NHS can comply with minimum wage laws when the rate goes up in April.

‘This is surely the final nail in the coffin for the pay review body process. Ministers must now get unions in for talks and put a decent level of funding on the table. The government must show it's serious about getting the NHS back on its feet and improving patient care.'

The Review Body on Doctors' and Dentists' Remuneration and the NHS Pay Review Body are taking evidence ahead of recommendations to the government on 2026/27 pay uplifts.