On 12 February 2026, Welsh Government announced it had accepted the NHS Pay Review Body (PRB) recommendation from 1 April 2026. You can read the statement here. For years, the PRB has failed to report on time, leaving NHS staff waiting months to receive their annual pay award.
The recommended pay award is a 3.3% uplift, to be paid from 1 April for all Agenda for Change employees.
Welsh Government says this uplift is above current inflation forecasts, using the Consumer Prices Index (CPI) rate of 3%. However, CPI does not include costs such as housing, rail fares and mobile phone contracts, which are real pressures for most of us. When these essentials are included, inflation is 3.8%, measured by the Retail Prices Index (RPI).
NHS staff have received below-inflation or just-at-inflation pay awards for years. In real terms, pay has fallen behind the cost of living. Staff are being expected to deliver more while being given less. While it is positive that this year’s increase will be paid on time, the award itself is likely to be swallowed up by rising household costs.
Welsh Government had already announced its intention to pay the Real Living Wage (RLW) Foundation rate from 1 April. This will apply to Bands 1, 2 and the entry point of Band 3. As a result, the increase for the lowest-paid NHS staff will range from 3.8% to 5.9%, which Welsh Government says is significantly above inflation.
However, this creates pay compression at the bottom of the scale, with staff in different bands ending up on the same rate of pay. That cannot continue indefinitely. UNISON has written to the Cabinet Secretary for Health and Social Care on behalf of members in those bands, demanding urgent talks to resolve this issue.
The UK Government promised 18 months ago to begin talks on reforming the Agenda for Change pay structure. UNISON has been pressing for those talks to begin. They must now happen and governments must be serious about providing proper funding for any changes. We need meaningful negotiations, backed by real investment, to deliver a fair pay structure for NHS staff.
