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NHS pay settlements in Wales and Scotland likely

9 March 2023

Nurses on strike in January at University College Hospital, London - the message is the same across all of Britain. Photo Workers.

NHS workers in Wales and Scotland are close to settling their respective pay claims. Both devolved administrations have negotiated directly with trade unions.

While the settlements are below the level of inflation, workers in both regions have secured more than the original offers. In turn this has put pressure on the Department of Health and Social Care to agree to direct talks with all unions about NHS pay in England.

Industrial action across the whole of Britain by the various professions and groups of workers have made these gains possible.


The Scottish government made an offer of at least 6.5 per cent. RCN and Unison are both recommending acceptance in ballots closing on 13 and 20 March respectively.

GMB is balloting without recommendation. Others such as dietitians have already accepted. But all those unions recognise that their industrial action secured a better deal than was first offered.

In Wales the devolved government entered into direct negotiation with unions and made an improved offer. The outcome is less clear than in Scotland. The RCN sought further talks, but overall trade unions are in favour of settlement. Unison and others have accepted the offer.


Although NHS Wales and NHS Scotland are funded and administered separately from each other and from NHS England, their pay structures are closely linked through the 2004 Agenda for Change national agreement. That has made it possible for the trade unions and professional bodies to take coherent national approach to the separate employers.

These settlements are not the end of the story. These pay rises are still less than inflation, so there’s more to do in future. And there will no doubt be attacks on terms and conditions, whatever fine words are said now.