What’s happened 

A group of trade unions representing NHS staff have launched a joint open letter urging ministers to reconsider the proposed 3.3% pay award for Agenda for Change staff in England. 

Martin Furlong, Deputy General Secretary at the Royal College of Podiatry, said members continue to feel the impact of sustained workforce pressures. “Our members are working under sustained pressure, and many continue to feel the effects of pay erosion,” he said, adding that meaningful engagement with unions will be essential to rebuild trust. 

The campaign is supported by several health unions; it calls on staff to add their names to the letter in a coordinated show of concern over pay, workforce pressures and morale across the NHS. 

The letter, addressed to Wes Streeting, the Secretary of State for Health and Social Care, argues that the proposed increase does not reflect the reality facing healthcare professionals. 

“3.3% is not enough,” the letter states. “NHS staff feel angry and let down. Day in, day out it's a struggle to deal with understaffing, overwork and the constant feeling that – hard as staff try – patients are not getting the standard of care they should.” 

Union leaders warn that years of pay restraint have contributed to recruitment and retention challenges, with many staff facing rising living costs and considering leaving healthcare professions for better-paid roles elsewhere. 

The letter also raises concerns about the Pay Review Body process, arguing that it has failed to deliver meaningful improvements in pay and does not allow sufficient input from unions or staff themselves. 

“We hoped things could start to change, and that government would negotiate with unions and employers to agree a plan for improving pay,” the letter continues. “Instead, once again, a Pay Review Body recommendation has resulted in a real-terms pay cut.” 

Alongside the headline pay award, the government has indicated that discussions will take place to improve the Agenda for Change pay structure, with any agreed changes backdated to April. However, unions say delays to these talks, first promised more than 18 months ago, have undermined confidence. 

The open letter calls for urgent progress and greater transparency around how negotiations could lead to improved outcomes for NHS staff. 

“We all want the NHS to succeed,” it concludes. “But that requires a workforce properly supported to give its best.” 

Members are being encouraged to sign the open letter as part of the campaign.