Unions warn award amounts to real-terms cut as inflation remains above headline figure

NHS staff across Wales will receive a 3.3% consolidated pay increase from April 1, 2026, after the Welsh Government accepted recommendations from the 39th NHS Pay Review Body.

The uplift applies to all staff employed under Agenda for Change terms and conditions, including nurses, healthcare assistants, porters, cleaners and other frontline health workers.

Health and Social Care Secretary Jeremy Miles said the award followed independent economic advice and was above current inflation forecasts issued by the Bank of England and the Office for Budget Responsibility.

He said inflation was expected to fall progressively towards the two percent target by early 2027 and described the settlement as fair and responsible within the current financial climate.

Lowest-paid staff

The Welsh Government confirmed that its commitment to pay the Real Living Wage from April 2026 means the lowest-paid NHS staff will see increases ranging from 3.8% to 5.9%.

However, it was also noted that Bands 1 and 2 and the entry point of Band 3 will remain on the same pay rate from April because the previously announced living wage uplift already exceeds the Pay Review Body recommendation.

Ministers said discussions will continue alongside England and Northern Ireland on structural reforms to the Agenda for Change framework, with any agreed changes backdated to April 2026.

Union anger

The announcement prompted sharp criticism from health unions, who argue that with inflation currently at 4.2%, many staff will still see a reduction in real-terms pay.

The Royal College of Nursing described the award as “very disappointing” and said it falls short of commitments to restore nursing pay to 2008 levels.

RCN Wales Executive Director Helen Whyley said: “At a time when the cost of living remains high another real term pay cut is being imposed again on a workforce already stretched to its limits.”

She also criticised the continued use of the Pay Review Body process after unions had raised expectations of direct negotiations.

Meanwhile, UNISON Cymru said health workers are likely to be angry at what it called “another below inflation pay award”.

UNISON Cymru health committee chair Dawn Ward said some NHS staff were struggling with rising household bills and felt undervalued.

The union has called for Wales to move towards a Scottish-style model of direct pay negotiations between government, employers and unions.

Political pressure

The pay announcement is likely to intensify debate about NHS funding, recruitment and retention across Wales.

While ministers argue the settlement reflects economic forecasts and financial constraints, unions maintain that headline percentages do not reflect the pressures facing frontline staff.

With morale described as fragile and vacancies continuing across Welsh health boards, the dispute is expected to remain politically sensitive in the months ahead.

Calls for “honest leadership” over future of Bronglais, Withybush and South Pembrokeshire

A WEST WALES councillor has accused health chiefs and the Welsh Government of repeatedly failing local communities over the future of hospital services.

Cllr Aaron Carey has issued a public statement calling for what he describes as “honest leadership and 21st-century care” for residents across Ceredigion, Pembrokeshire and Carmarthenshire.

In his statement, Cllr Carey said hospitals including Bronglais Hospital in Aberystwyth and Withybush Hospital in Haverfordwest are “lifelines” that must be strengthened rather than allowed to decline.

He claimed Hywel Dda University Health Board had repeatedly reassured the public that services would be protected, only for those assurances to be weakened or reversed.

“Time and again, residents have been told that no decisions have been made, that services are safe, or that changes are temporary,” he said. “Too often, those words have proven hollow.”

Cllr Carey also referenced long-running uncertainty over proposals for a new “super hospital” in the region, arguing that delays and ambiguity surrounding the project had contributed to what he described as “drift and decline” at Withybush.

He said Bronglais Hospital faces continued pressure, with concerns about staffing levels and the sustainability of key services in rural mid and west Wales.

The councillor further highlighted issues including long ambulance response times, pressures on GP surgeries, reduced community provision and difficulties accessing timely treatment.

Rural communities, he said, should not receive “second-class care”.

South Pembrokeshire Hospital closure

Cllr Carey pointed to the temporary closure of services at South Pembrokeshire Hospital over the Christmas period, which were later reinstated following public pressure and a petition he said he personally presented to the health board.

He claimed that those services were subsequently closed again “without warning or meaningful consultation”.

“This sequence of events speaks volumes about how decisions are being made and how little respect is shown for local voices,” he said.

Call for Welsh Government action

Cllr Carey said Hywel Dda Health Board operates under the oversight of the Welsh Government, which he argued must provide greater intervention and investment.

“We need honesty instead of spin, genuine engagement instead of box-ticking consultations, and a clear commitment to strengthening hospitals like Bronglais and Withybush for the long term,” he said.

In previous statements, Hywel Dda University Health Board has said it faces significant financial pressures and workforce challenges, alongside increasing demand for services across a largely rural region. The board has previously maintained that any changes to services are made with patient safety, sustainability and clinical evidence at the forefront, and that public consultation forms part of its decision-making process.

The Welsh Government has also stated that it continues to invest in NHS Wales, including capital funding for new facilities and improvements in community-based care, while working with health boards to ensure services remain safe and sustainable.

HEALTH staff across Wales and the rest of the UK are set to receive a 3.3 per cent pay rise from April after the Government accepted the latest recommendations from the independent review body – but unions say the increase still falls short after years of falling real-terms wages.

The decision follows months of pressure from unions representing nurses, paramedics, porters and other frontline staff, many of whom have taken industrial action in recent years amid rising workloads and the cost-of-living crisis.

The Health Secretary has confirmed that ministers will implement the headline award recommended by the NHS Pay Review Body for workers in England, Wales and Northern Ireland, meaning most staff covered by the Agenda for Change contract will see their salaries rise at the start of the new financial year.

Union leaders say the timing is welcome – but the figure itself does not go far enough.

Responding to the announcement, GMB Trade Union said the increase marks the first time in several years that NHS staff will receive their pay award on schedule, avoiding the delays that have previously left workers waiting months for back pay.

Rachel Harrison, national secretary for the union, said: “GMB welcomes the efforts made to ensure NHS workers will receive their pay increase when it is due, in April.

“The first time this will have happened in years.

“But this award is just not enough to make up for more than a decade of pay cuts under the Tories. NHS workers deserve more and GMB will fight for that at the long overdue Agenda for Change structural talks we have now been promised.

“GMB reps will now meet to discuss the pay award and determine next steps.”

Years of pressure

Health unions argue that although pay has risen in cash terms, inflation and years of below-inflation settlements have left many National Health Service workers worse off than they were a decade ago.

Since 2010, a combination of pay freezes, capped rises and soaring living costs has eroded real-terms earnings, with some estimates suggesting experienced staff are thousands of pounds a year worse off compared to pre-austerity levels.

Recruitment and retention remain major concerns across Welsh hospitals and ambulance services, with health boards continuing to rely on agency staff to plug gaps.

Union representatives say pay remains one of the biggest factors pushing experienced workers to leave the profession.

Impact in Wales

For NHS staff in west Wales, including Pembrokeshire and Carmarthenshire, the award will be felt from April payslips, covering a wide range of roles from healthcare assistants and cleaners to nurses, paramedics and administrative teams.

While some will welcome the certainty of an on-time rise, local staff have previously told The Herald that rising energy bills, fuel costs and housing pressures mean even modest increases are quickly swallowed up.

GMB said it will now consult workplace representatives on whether further action is needed and will push for wider reforms during upcoming structural talks on pay bands and career progression.

The union added that “timely” must not be confused with “sufficient”.

For many on the frontline, the question is no longer just when pay rises arrive – but whether they are enough to keep the health service staffed at all.