UNISON warns thousands of NHS workers could fall below minimum wage without urgent pay talks as pressure mounts on the Government to act before April
Urgent calls for NHS pay talks are intensifying after UNISON warned that thousands of healthcare workers could soon be paid below the legal minimum wage. With Government-promised reforms still delayed and April’s statutory pay rise approaching, the union says immediate negotiations are needed to protect low-paid NHS staff and prevent a new pay crisis.
NHS staff at risk of falling below minimum wage
UNISON warns that thousands of NHS workers in the lowest wage bands will fall below the statutory minimum when it rises by 50p an hour to £12.71 from April 2026, risking legal breaches and financial hardship.
UNISON warns that delays and failure to address low earnings could lead the Government to breach legal obligations, urging policymakers to act now to uphold their responsibilities.
UNISON has written to NHS trusts across England to highlight how the pay system is at risk of breaching minimum wage rules. This is because the Government has yet to deliver on its 2024 promise to hold formal talks with unions to fix the pay structure.
Banish poverty pay in the NHS or risk industrial action
In September 2025, health unions made a plea to ministers to hold talks on headline pay and a restructuring, and to discuss proper funding. However, this has yet to happen, and negotiations for a pay package ready for April need to start now.
Unions criticise the NHS Pay Review body process as slow and ineffective, delaying formal talks for 2026/27 and increasing the risk of a pay crisis and industrial action.
UNISON’s letter to NHS trusts warns that the Government’s failure to make overdue talks happen 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.
UNISON highlights that the Government’s failure to adopt the real living wage undermines the NHS’s goal to be the ‘best employer,’ risking the dignity and support NHS staff deserve.
UNISON head of health Helga Pile said: “NHS pay needs sorting now to avoid letting down hundreds of thousands of staff yet again.
“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 significant 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.”
