The union said it will not participate in the 2026/27 NHS pay review body process, set to run over the next few months arguing the system was outdated, continually runs late and fails to deliver fair increases for Agenda for Change staff.

Unison said this year's 3.6% rise arrived in pay packets four months late and has already been overtaken by the CPI inflation rate, which currently sits at 3.8%.

The union says the best way to ensure an efficient wage rise is delivered on time when it's due in April next year is to cover this in negotiations over much-needed reforms to the Agenda for Change pay structure.

Seven in ten (70%) of Unison members who responded to a consultation said they'd back walkouts if the union were to ballot for strike action over the 2025/26 NHS pay award.

Unison general secretary Christina McAnea said: ‘Ministers are rightly focused on how the NHS needs to change to meet patients' needs and recover from years of neglect.

‘That change must include how NHS staff are treated when it comes to pay.

‘A Government that says it cares about efficiency and improving industrial relations in the health service shouldn't be sticking with a pay review system that belongs to a bygone era.

‘Nor should ministers promise staff they'll put money on the table for talks with unions to fix problems, only to drag their heels.

‘Staff are key to getting the NHS back on its feet. Putting time and money into getting wages right now will pay dividends in the future. Ministers must show they value all parts of the workforce by opening proper talks with unions now.'

A Department for Health and Social Care spokesperson said: ‘We have consistently demonstrated our commitment to supporting NHS staff, including through above inflation pay awards for the public sector. 

‘But we know there is more to do. We recognise Unison's concerns regarding NHS pay and will continue to work with all trade unions to ensure our NHS staff are fairly rewarded for their vital work.

‘We accepted the recommendation to provide the NHS Staff Council with a mandate to address issues around the Agenda for Change pay structure and have said we would work together to agree pay structure reforms to implement from 1 April 2026 and this remains the case. This, alongside our changes to job evaluation will help ensure all staff are fairly rewarded for the work they do.'

The DHSC said it remitted the pay review bodies in July significantly earlier than last year with a view to getting pay awards to staff as close to 1 April 2026 as possible.