Nurses, midwives, and NHS staff across Scotland have been offered a significant Scotland NHS pay rise, totalling 8% over two years, in a move that positions them as the best-paid healthcare professionals in the UK. The Scottish Government’s offer, announced by Health Secretary Neil Gray, includes a 4.25% increase in 2025-26 followed by a 3.75% rise in the following year, at an estimated cost of £701 million.
What sets this pay proposal apart is the inclusion of an “inflation guarantee,” ensuring the offer will always exceed the Consumer Price Index (CPI) by at least 1%. This contrasts sharply with the UK Government’s current recommended 2.8% rise, prompting fresh scrutiny of NHS pay disparities across the UK nations.
Unions to Ballot Members on Inflation-Linked Deal
Unison, GMB Scotland, and the Royal College of Nursing (RCN) Scotland are among the unions now consulting members on the proposed deal. Unison will hold a digital ballot, while the RCN board is reviewing the offer’s details. GMB Scotland and the Scottish Ambulance Service also intend to ballot NHS staff shortly.
Matt Mclaughlin, Unison’s co-lead for health in Scotland, confirmed that the government has marked the offer as final. “The union’s health committee will now take soundings from NHS staff and then meet to discuss next steps,” he said.
RCN Scotland’s director, Colin Poolman, highlighted that their January pay claim aimed to reflect rising living costs and begin reversing years of pay erosion. Claire Ronald of the Chartered Society of Physiotherapists described the deal as “the best that can be achieved” and will also consult members.
Scotland Leads the UK on NHS Pay Talks
Scotland is the first UK nation to present a formal pay offer to NHS staff for the next two years, with unions directly involved in the negotiation process. Approximately 170,000 NHS staff in Scotland will be affected—many of whom already earn more than their counterparts elsewhere. For example, newly qualified Band 5 nurses in Scotland currently start at just under £32,000 compared to £30,000 in England and Wales.
While doctors’ pay is negotiated separately, the bulk of NHS workforce salaries make up nearly 60% of Scotland’s total health budget. The pay deal is part of a broader strategy to address long-standing challenges in recruitment and retention within the health service.
UK Pay Talks Ongoing, But Funding Concerns Loom
UK Health Secretary Wes Streeting confirmed that the 2.8% increase for England is still under review, acknowledging recent shifts in the economic landscape. However, if Scotland’s more generous offer is finalised, it will need to be funded from within existing budgets, as no extra money will come from Westminster.
This raises concerns about potential cuts in NHS services or delayed recruitment to balance the books. Last year, the Scottish Government was forced to implement £500 million in emergency cuts, partly due to public sector pay agreements.
Health Secretary Neil Gray defended the Scottish offer, calling it a “strong deal” resulting from “constructive discussions” with unions. “It ensures Scotland’s NHS staff have the best pay in the UK, and guarantees earnings remain ahead of inflation,” he said.
