Stand #WithNHSStaff for fair pay

The CSP stand #WithNHSStaff and the health unions for a significant pay rise.

On this page:

Moving forward on NHS pay graphic with trade union logos

NHS pay update

The governments in England and Wales have now announced a pay award of 3 per cent for staff employed by the NHS on Agenda for Change contracts following the recommendation of the Pay Review Body.

Responding, the CSP has warned that the pay rise for NHS Agenda for Change staff in England and Wales is not enough to prevent a workforce crisis in healthcare, risking patient care.

How NHS pay is decided

NHS pay is usually set through the Pay Review Body (PRB) process. The PRB reviews evidence from health unions, the government and NHS employers before making recommendations to government ministers who decide whether to accept them.

The governments in England and Wales have now accepted the recommendation of the PRB and are awarding 3 per cent to all Agenda for Change staff employed by the NHS across all bands and staff groups.

We are still waiting to hear the response of the Northern Ireland government. For Scotland, please see below.

The CSP, along with other health unions, is disappointed with this outcome. It is not the significant pay award that we believe is needed and deserved as outlined in the evidence we submitted.

However, the hard work of CSP members and reps during our campaign for fair pay kept the pressure on the government, and helped to shift Westminster away from their initial position of a 1 per cent pay rise. You can see how CSP members have stood #WithNHSStaff in their workplaces below.

Read the CSP’s evidence to the PRB:

We also contributed to joint union evidence together with all 14 health unions:

Next steps

Through the PRB process, the government can implement a pay award without further agreement or consultation with health unions or employers. However the CSP, and all health unions, will still be consulting with members on the award.

The CSP Pay Reference Group – a group of elected members from the CSP Employment Committee who oversee pay issues – have agreed we should survey all members who are employed by the NHS to seek views on the outcome, including whether members are prepared to take industrial action if they do not wish to accept it.

On Tuesday 10 August, CSP members in England and Wales were emailed an invite to complete our indicative pay survey.  The survey will be kept open till midday Wednesday 8 September.

The survey was sent to members employed by the NHS. Members employed by a Social Enterprise Company, a Community Interest Company or a primary care network are also eligible to vote, if employed on a full Agenda for Change (AfC) pay, terms and conditions contract with a contractual right to all the future pay awards and/or terms and conditions changes that are agreed and applied nationally.

If you think you should be able to vote but haven’t received the link:

If the survey link is not working for you:

  • try refreshing the page, and opening on a different device and browser (e.g Chrome, Safari)
  • if problems persis, contact the CSP enquiries team

What you can do

Respond to our survey

A link to a consultative survey was emailed to members on Tuesday 10 August, with reminders to follow until the survey closes midday 8 September. It is important that we hear from all members so we understand your views on this outcome.

Update your details now

It remains very important that we have accurate details for you so we can contact you during the consultation, and also if we move to ballot for industrial action at any stage. If this happens, it will be a legal requirement for us to have accurate details for our members on file.

You can update your details easily online. If you are not already logged in, you will be prompted to enter your username and password. Be sure to hit 'Save membership details' after you've made any changes.

Montage of CSP members holding #CSP4FairPay placards
CSP members demonstrating on social media to mark the NHS' birthday

CSP members campaigning for fair pay

Throughout the campaign, CSP members have been making their voices heard.

We will now be asking all members their views through the consultation process.

Frequently asked questions

This page will be used to respond to FAQs raised by members since the government announced their pay award.

What is a Pay Review Body (PRB) process?

The PRB process has been the usual method of determining pay for staff employed by the NHS for many years. The PRB is an independent panel that is appointed to consider evidence from a range of parties and then make a recommendation on pay to the government. Evidence is submitted to the PRB by bodies such as the Department of Health and Social Care (DHSC), NHS Employers, NHS England and Improvement, as well as Health Unions. The CSP submits evidence jointly with other health unions as well as our own evidence. This year, the PRB was asked to make recommendations across England, Wales and Northern Ireland.

The three year deal from 2018-21 was an exception when a deal was reached outside the PRB process.


What is the government role in the process?

The Westminster government submitted its evidence to the PRB earlier this year via the DHSC and recommended a 1 per cent pay rise. The PRB considered this along with the other evidence but then made a final recommendation that 3 per cent should be awarded across England, Wales and Northern Ireland. It is then up to the government in each country to decide on the award it will give based on the recommendation. Governments in both England (Westminster) and Wales have confirmed that they intend to award the 3 per cent. As it is an award and not a negotiation, it can be implemented without further consultation.

We are still waiting to hear about the decision in Northern Ireland.


What is likely to happen in Northern Ireland?

We are hoping the government will make an announcement soon. The health unions, including the CSP, have expressed their dismay regarding the 3 per cent recommendation of the PRB.


What is the CSP view of the 3 per cent award?

The CSP is extremely disappointed that the government has not taken the opportunity to show how much they value NHS staff and give a significant award that would be so deserved, would continue to address the years of austerity that was only just started by the three-year deal, and would support the critical recruitment and retention needs throughout services. While the movement from the initial 1 per cent is welcome, this is far short of what staff deserve.


Why did Scotland get a different award?

Health is devolved and therefore pay awards are decided by each country’s government and as such are a political decision. In Scotland this year, the government did not want to follow a PRB process but instead entered into direct negotiations with health unions, including the CSP. The CSP has always supported and promoted the principle of the same pay awards across all countries, but over recent years there have been differences due to the devolved nature of pay.

Scotland has previously made higher pay awards and so has pay scales that are already different to the rest of the UK. In Northern Ireland, there was a significant period when pay scales were behind England and Wales during the three years without an executive. Similarly, there are other differences between countries such as the tax rate in Scotland being higher than elsewhere.


What is happening to pay in other areas of the public sector?

The government in England has previously announced a pay freeze this year across most other areas of the public sector. Recent announcements confirmed that teachers and the police will see no pay rise this year. This is not the same across all UK countries.


What is the current rate of inflation?

The annual rate of inflation currently stands at 2.5 per cent according to the Consumer Price Index (CPI), and is predicted to rise further during the year.


How will the pay award be funded?

At present, it is not clear how the award will be funded and whether there will be additional money or whether the increased cost will need to be met from current money in the NHS.


Will the 3 per cent rise be applied to high cost area supplements (i.e. London weighting)?

The current understanding is that the minimum and maximum  high cost area supplements (HCAS) will be uprated by 3% in line with the award.   


When will the award be implemented?

We expect announcements soon regarding when the money will be put into pay packets. It is usual for the award to be paid in one month, with the back pay element to 1 April 2021 being paid at a later date due to the complexities of working out the figures.


I am in a social enterprise/community interest company – will I be entitled to the award?

Following the 3 year deal in the NHS we worked to influence the government to support public funding of similar deals outside the NHS for organisations delivering NHS services.  This was successful within social enterprises and some other organisations.

Most staff employed by SECs/CICs are on dynamic Agenda for Change employment contracts. This means they have a contract which states that Agenda for Change rpay, terms and conditions will be followed, including all future pay awards/changes to the pay scales. If so, your employer should implement this award in full. If you are not sure what your contract says, then we would advise you to speak with your steward in the first instance.


I work for a private provider but we provide NHS services – am I entitled to the pay rise?

The PRB process and government award only apply directly to staff employed by the NHS on Agenda for Change contracts, or the small number in SECs as set out previously.   Private employers have a right to set their own pay, terms and conditions which should be set out in contracts of employment. You will need to check your own contract to see what it says about pay. If it does clearly state it will follow Agenda for Change pay rates, including any annual awards, then it is likely your employer will pay the 3 per cent, but it is always important to check the detail of the contract. However, most private employers will have their own processes for pay determination.


What support does the CSP give members for pay in the private sector?

We believe all our members deserve decent pay and conditions, and we will do what we can to support members employed outside the NHS when pursuing better pay.

We have been working hard in recent years to secure union recognition agreements outside the NHS where possible and where we have them to seek improvements in the conditions of employment of our members.  We have also been seeking to build a CSP workplace presence through new roles like workplace contacts to enable us to better represent members on a range of employment matters.

However, most private-sector employers do not have structures that allow health unions to negotiate or influence pay directly.  Even where we have successfully gained recognition rights for the CSP with an employer, it is very rare for that to include the right to negotiate or influence pay. 

Still, it is important to note that the NHS remains the biggest healthcare employer and strongly influences the rate for the job, terms and conditions across the healthcare sector for physiotherapists and physio support workers – including setting the rate in many instances. 


Will the pay rise result in me moving to a higher pension contribution tier?

The pension contribution tiers are set separately to pay awards so any increase in pay, through an award or an increment, can move staff into a higher contribution tier.  Although this does lead to receipt of a higher pension, due to the higher pay, we are aware it can be very disappointing to find an increase in pay is partly taken by an increase in pension contributions.  The vast majority of staff will not see a change in their pension tier due to the 3% award.  Further information on the tiered contribution rates can be found here, and the tiered rates themselves can be found here.


NHS pay in Scotland

In 2021-22, the Scottish government did not put evidence into the PRB process. Pay was instead discussed directly between the government and NHS trade unions.

In May 2021, CSP members voted by a significant majority to accept the NHS pay offer in Scotland.

The offer from the Scottish government will see most NHS staff receiving a 4 per cent pay rise, backdated to December 2020. The Scottish government decided that since the majority of unions voted to accept the offer, it would be implemented at the earliest opportunity.

Find out more

The joint trade unions' #WithNHSStaff webpage will keep NHS staff updated about union activity over the summer.

The following pages contain information about the implementation of the 2018-2021 agreement:

Last reviewed: