The previous industrial action mandate ended at midnight on May 1. Thus the college is asking for a new one.
In reaction to the Government’s implementation of the NHS pay award for the fiscal years 2022-2023 and 2023-2024, ballots are being held among RCN members employed under Agenda for Change contracts in England.
Why are NHS employees on strike?
The Government issued a salary offer for NHS employees for 2022–2023 and some of the NHS employees’ trade unions rejected the offer. Unions pointed out that the wage increase was a pay decrease in real terms and claimed that it was insufficient given the rising cost of living.
According to union members, health professionals seek to increase patient safety, which is put at risk by insufficient staffing levels and staff burnout. They are also worried that employees would be hesitant to work for the NHS or stay in their current positions without higher remuneration, compounding the current staffing issues.
The decision to go on strike was voted among union members. For a mandate to strike, unions must satisfy the legal requirements.
What early benefits did NHS employees receive?
Regarding remuneration, terms, and conditions, NHS employees are divided into various classes. Most NHS employees are paid using the Agenda for Change (AfC) pay scale, except for doctors, dentists, and senior managers. The AfC scale consists of nine payment bands from 1 to 9. Many clinical workers with recent degrees, such as nurses, begin in band 5.
Based on an examination of data from employers, unions, and the Department of Health and Social Care, independent pay review organisations representing the worker groupings offer recommendations to the Government on pay for NHS personnel. Whether or not to accept the recommendations is ultimately up to the Government.
The following pay awards, retroactive to April 2022, were declared by the Government in July 2022 based on the recommendations of the pay review bodies:
- Salaries for physicians and dentists increased by 4.5 percent.
- Employees on the AfC scale received a permanent rise of £1,400 in their full-time equivalent salary (not a one-time payment), with a backdate of April 1, 2022.
- Staff in band 7 and at the top of band 6 of the AfC received an additional improvement to guarantee a pay increase of at least 4%.
- The rise of £1,400 was on top of National Living Wage adjustments for employees in bands 1 and 2.
Negotiations and strike action
Midwives and nurses
In England, the Royal College of Nursing (RCN) members went on strike in December 2022 as well as in January and February 2023. When the RCN and the Government began “a process of intensive talks” on February 22, 2023, and were later joined by the other health unions, a second 48-hour strike set for March 2023 was postponed.
Following the RCN’s rejection of the Government’s new pay offer, another strike occurred from April 30 to May 1, 2023.
It was intended for the strike to last for 48 hours. However, a High Court judge ruled on April 27 that the RCN’s six-month strike mandate would expire on May 2 and that the strike had to end on May 1.
Following the July 2022 salary award, a ballot of Royal College of Midwives members in England failed to produce a strike mandate.
Advanced health specialists
In response to the 2022–23 salary award, certain unions representing allied health workers under AfC contracts decided to strike. Some unions, like the Society of Radiographers, chose not to have a formal ballot for a strike.
The Chartered Society of Physiotherapy (CSP) and British Dietetics Association (BDA) members in England voted for industrial action, and the CSP started rolling strikes in January 2023. The two unions entered into salary negotiations while postponing their March 2023 strikes.
Other Health Unions
Ambulance drivers, nurses, and technical personnel are just a few of the employees represented by other health unions, Unison, Unite, and GMB Union.
In December 2022, as well as January and February 2023, members of the unions participated in strikes that affected NHS trusts throughout England. When the unions and the Government started salary negotiations, some strikes scheduled for March 2023 were postponed.
On May 1 and 2, 2023, Unite members carried out their scheduled local strikes at hospitals and ambulance trusts in England.
Physicians and dentists
The Hospital Doctors Union (HCSA) represents young physicians and approved strike action in England in January 2023. British Medical Association (BMA) junior physicians in England also decided to strike in a national vote held in February.
On March 13–15, 2023, union members participated in a 72-hour nationwide walkout, followed by a 96-hour walkout on April 11–15, 2023.
The British Dental Association’s hospital trainee members joined the junior doctor strikes in England by voting in favour of industrial action at several trusts.
Why aren’t strikes affecting all trusts?
According to the Trade Union Act of 2016, a strike ballot in “important public services” requires a minimum turnout of 50% and a majority vote of at least 40% of all eligible members to be legal.
Following trade union laws, unions may conduct individual workplace balloting of members or collective balloting of employees with similar terms and conditions. Accordingly, depending on the ballot, the thresholds may apply to trusts or the country as a whole.
Which new wage offer did you receive?
Following industrial action, the Government updated its pay offer to AfC scale employees in England for 2022–2023 and 2023–2024 in March 2023. The revised pay offer included the following:
- A one-time, non-pensionable payment for 2022–2023 on top of the wage award for 2022–2023 that consists of two components:
- A payment equal to 2% of salaries for all employees and a tier-based “backlog bonus” payment (with an average value of 4%) for all employees. AfC pay bands are grouped into tiers; for instance, tier 1 includes pay bands 1-4.
- Pay increases of 5% for most personnel in 2023–2024 and 10.4% for entry-level employees in bands 1 and 2.
Which unions approved the revised offer in the vote?
The unions representing employees under AfC contracts requested a vote from their members on whether or not to accept the improved salary offer. The following union members decided to accept the offer:
- Chartered Society of Physiotherapy and the Royal College of Midwives
- United Kingdom Dietetic Association
- Trade Union for the British Orthoptic Society
- Unison GMB Union
- The outcomes of a paid consultation have not been made public by the Federation of Clinical Scientists.
The following union members decided to reject the offer:
- Royal College of Nursing
- Radiographers United
- Royal College of Podiatrists
What happens next?
The AfC pay system is overseen by the NHS Staff Council, which comprises representatives from trade unions and NHS employers.
AfC trade union delegates overwhelmingly decided to accept the improved pay offer on May 2 during a meeting of the NHS Staff Council. The voting is purportedly based on an electoral college method, with each union’s vote weighted to match the size of its membership, though specifics on the procedure and how weightings are decided upon are not made public.
According to a statement from Health Secretary Steve Barclay, NHS employees will start receiving their additional salary in June 2023.
Statements regarding their next measures have been released by three of the four unions who voted against the offer:
- The Royal College of Nursing declared that a national election would take place in May.
- Unite has declared its intention to intensify strike activity.
- The Society of Radiographers has written to the Health Secretary demanding immediate negotiations, but they will vote to strike if a “positive response” is not given.
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