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The TUC has today (Friday) warned that if ministers impose below inflation pay settlements of 3% on NHS workers, they will deliver “a hammer blow” to the local economy – resulting in a hit of £335 million to the North West spending power.

In 2021, NHS workers got a 3% pay settlement. Ministers have asked the NHS pay review body to recommend a similar award this year. Unions warn this will fall well below the cost of living, with inflation running at 9%.

The TUC has modelled household spending power in the event of a projected 3 per cent pay rise for NHS workers, and compared it with household spending power if NHS workers were offered a pay rise that keeps the pace with the cost of living.

As well as a £315 million hit to the North West’s spending power, England faces a whopping £2.1 billion loss of economic activity as a result of wages failing to keep pace with inflation, according to the union body.

The TUC warns that any decision to hold down NHS workers’ wages will suck demand out of the economy and stunt economic growth.

The union body points to the new research and says healthy pay rises for public sector workers are not only important for the workers, but the wider economy too.

Real wage cuts  

The TUC analysis also reveals NHS key workers will face a huge real terms pay cut this year should ministers impose a 3% pay settlement. 

The new analysis reveals that nurses’ pay will be down as much as £1,600 in real terms this year if ministers impose just a 3% pay settlement. 

The picture is bleak for many other NHS staff too – the analysis shows that with a 3% pay settlement:

  • Porters’ real pay will be down by £1,000 this year 

  • Maternity care assistants’ real pay will be down by £1,200 this year 

  • Paramedics’ real pay will be down by up £2,000 this year 

The analysis has also found that a 3% pay settlement for NHS staff this year would be “swallowed up” by rising energy costs – with energy prices rising 40 times faster than NHS workers’ wages.

Brutal decade of lost pay

The cost of living emergency comes after a “brutal” decade of standstill wages, which the TUC says has left workers badly exposed to skyrocketing bills. 

Key workers in the NHS are still earning thousands of pounds a year less – in real terms – than in 2010, according to new analysis by the union body: 

  • Nurses’ real pay is down £5,200 

  • Porters’ real pay is down by £2,500 

  • Maternity care assistants’ real pay is down by £4,300 

  • Paramedics’ real pay is down by £6,700 

The TUC says that stagnant wages have played a major role in the “crippling staff shortages” that vital NHS services are facing.  

The union body is calling for decent pay rises for all public service workers to at least match the cost of living and begin to restore earnings lost over the last decade.   

TUC North West Regional Secretary Jay McKenna said:  

“Our brilliant key workers in the NHS helped get Britain through the pandemic. But many are now at breaking point – struggling to afford the basics and put food on the table. 

“After a brutal decade of wage cuts and freezes overseen by successive Tory governments, NHS staff have been pushed to the brink by skyrocketing bills. 

“Miserly pay offers will only be swallowed up by runaway prices.  

“Any offer that falls below the cost of living will be a hammer blow to staff morale – especially as staff shortages continue to cripple vital services – and many NHS workers may choose to vote with their feet.  

“Below-inflation pay offers would not only be bad for workers and our NHS, but for our economy too.  

“It’s time the government started to undo the damage of the past decade. That means giving all our key workers the decent pay rise they are owed.”


Editors note


  • Pay data comparing wages in 2010 and in 2022 is adjusted for inflation using CPI – comparing 2010 wages in real terms today (if they had kept up with the cost of living) with 2022 wages. 

  • Pay data in 2022 compares NHS workers’ pay if increased by the same as last year pay award (3%) to a pay rise in line with inflation (CPI)  

  • The pay figures are for individual occupations at the top of NHS agenda for change pay band. 

  • At least half of Agenda for Change staff are at the top of the pay band 

  • Pay in the NHS for lower grades falls well below the real Living Wage, and – in April this year – for the lowest grades, fell below the national minimum wage in Northern Ireland and England, where employers had to apply supplementary payment to lift NHS pay rates over the legal minimums 

  • The TUC used NHS digital data on the number of NHS staff (full time equivalent) and mean annual basic pay. 

  • To show the impact an increase in spending power has on demand and on regional economies, a multiplier of 1.3 was applied to the loss of NHS staff earnings based on the midpoint of the multiplier range identified by the International Monetary Fund’s (IMF) research in the last recession. 


Real terms pay loss  


Real term pay loss  

2021 - 2022 




Medical secretaries 



Nursery Nurse 



Maternity Care Assistants 

Speech and Language Therapy Assistants 




Community nurses 


Radiographer Specialist  




Hospital midwife 


Economic hit  

Loss of spending power as a percentage of Gross Disposable Household Income  

East of England 

-£             199,749,164  



-£             396,710,034  


North East and Yorkshire 

-£             335,389,761  


North West 

-£             315,854,001  



-£             378,696,168  


South East 

-£             289,697,379  


South West 

-£             198,621,315  



-£           2,114,717,821  


- About the TUC: The Trades Union Congress (TUC) exists to make the working world a better place for everyone. We bring together the 5.5 million working people who make up our 48 member unions. We support unions to grow and thrive, and we stand up for everyone who works for a living. 


TUC press office   
020 7467 1248

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