FOURTEEN health unions today jointly announced they will not take part in the “failed” and “defunct” NHS Pay Review Body (PRB) process, demanding talks with ministers instead.

The independent advisory body has settled pay issues for the majority of the health service’s staff since 2007.

In a letter to Health Secretary Wes Streeting, unions representing staff on “agenda for change” contracts called on the government to deliver on its promise of direct talks for next year's pay instead.

Union frustrations over lengthy delays, below-inflation awards and suspected political interference come as questions linger over Sir Keir Starmer’s leadership ahead of the party’s conference starting next week.

GMB had been the last major health union to engage with the PRB last year, which makes annual pay recommendations for NHS staff excluding doctors, dentists and some senior managers.

Chairwoman of the NHS unions and Unison’s head of health Helga Pile said: “The government promised talks over a year ago and they still haven’t got round the table with unions with any proper plan to sort things out.

“The only way to get a system that’s fit for purpose and meets the needs of staff in a modern health service is to fix the structure at the same time as making sure staff can cope with the cost of living.

“The Health Secretary wants a more efficient system and that begins with getting pay right.”

Secretary to the NHS unions and assistant director for employment relations at the Chartered Society of Physiotherapy Jim Fahie said: “The government’s failure to honour the structural reform commitment for the 2025-26 pay year, alongside a lower pay award than other PRB groups, has led to high levels of dissatisfaction among our members.

“Our collective efforts are focused on securing a fair annual uplift in pay for our members and for separate funding to be provided for Agenda for Change structural reform.”

GMB national officer Sharon Wilde said: “GMB was the only major union to engage with the process last year, giving the body one last chance to listen to our members’ concerns.

“It failed miserably. The PRB is clearly past it’s sell by date and should be out to pasture.”

Royal College of Nursing executive director Jo Galbraith-Marten said: “Ministers promised talks on reform over a year ago. Since then, nursing staff delivered another damning verdict on pay. There is no excuse for wasting more time, we need formal negotiations now.”

Despite massively increased responsibilities, she said that nursing pay has been “stuck in a time warp as if the last 20 years of progress didn’t happen.”

“The only way to recruit and retain the nursing staff we need is to deliver Agenda for Change structural reform.

“The best way to deliver reform and a fair pay award is to negotiate directly with trade unions.”

There is “palpable anger” among Royal College of Midwives members over the 2025-26 pay award, said general secretary Gill Walton.

“The government can no longer hide behind the NHS Pay Review body, it’s defunct.”

Keep Our NHS Public co-chair Dr John Puntis told the Morning Star that low pay is a key issue behind for the 110,000 vacancies in the NHS, with fears of as many as 100,000 job losses coming from a £6.6bn deficit across trusts and Integrated Care Boards.

“Wes Streeting has been dragging his feet over talks regarding changes to how pay is negotiated,” he said.

“With the Labour Party conference coming up and the autumn Budget soon afterwards, now is the time to remind him and Labour of its manifesto commitment to value NHS staff and improve conditions. 

“Fair pay for staff is crucial in providing high-quality care for patients and essential if promises to improve NHS performance are to be delivered.”

New deal for working people architect Andy McDonald MP said: “Unions have expressed dissatisfaction with the pay review bodies and their Treasury straitjacket for many years. No one believes or claims they are independent. They have been a tool for government to hold down pay and this government must commit to a long-term multi-year pay restoration deal. The government should take forward Fair Pay Agreements and direct employer and worker negotiations in all the areas covered by the pay review bodies."

The Department of Health and Social Care highlighted its “above-inflation pay awards for the public sector,” but added it recognises the pay concerns and “will continue to work with all trade unions to ensure our NHS staff are fairly rewarded for their vital work.

“We accepted the recommendation to provide the NHS Staff Council with a mandate to address issues around the Agenda for Change pay structure and have said we would work together to agree pay structure reforms to implement from April 1 2026 and this remains the case.”