Health Minister reaffirms commitment to 3.3% NHS pay rise in 2026

Health Minister Mike Nesbitt

Northern Ireland’s Health Minister Mike Nesbitt has reaffirmed his commitment to delivering a 3.3% consolidated pay uplift for NHS staff from 1 April 2026, following the latest recommendation from the NHS Pay Review Body (NHSPRB).

The proposed pay rise would apply to all Agenda for Change (AfC) pay points across Health and Social Care (HSC), impacting thousands of frontline staff including nurses, paramedics, healthcare assistants and administrative workers.

The announcement comes amid continued budgetary pressures facing the health service.

NHSPRB recommendation and tri-nation approach

Commenting on the latest report, Mr Nesbitt said:

“In its latest report, the NHS Pay Review Body (NHSPRB) has made a core recommendation for a 3.3% consolidated uplift effective from 1 April 2026 for all Agenda for Change pay points.

“Recommendations from the Doctors and Dentists Pay Review Body that will cover Medical and Dental staff (including those working in primary care) are not expected until early April 2026.

“We have continued to work with England and Wales on a tri-nation basis towards both a headline pay uplift and structural Agenda for Change reform. England and Wales have today confirmed that they will proceed with the NHSPRB recommendation of 3.3%.”

The Minister confirmed his intention to proceed in line with England and Wales, subject to budget clarity.

Commitment to pay and Real Living Wage

Mr Nesbitt emphasised that pay remains his department’s first priority for the coming financial year.

“I can confirm that I remain fully committed to ensuring that pay will be the first priority for the Department and it is my desire to proceed with a headline pay award of 3.3% for AfC staff in 2026/27 and to progress towards HSC becoming a Real Living Wage (RLW) employer.

“I also intend to honour my commitment to funding for independent sector adult social care staff who provide direct care through commissioned services, in order to deliver the RLW for these staff.”

The proposed Real Living Wage commitment would affect independent sector adult social care staff delivering commissioned services — a workforce that provides direct care to vulnerable people across Northern Ireland’s communities.

For health staff and social care workers, the outcome of the pay process has direct implications for household finances, recruitment and retention, and service stability.

Budget uncertainty and financial pressures

Despite his stated commitment, the Minister acknowledged that final confirmation depends on the Department’s budget settlement.

“Whilst it remains my firm ambition that pay increases will be received by all staff as early as possible in the incoming financial year, I am fully aware that I can only deliver against those commitments when clear about my budgetary position. However, even in the absence of agreement, I have asked my officials to progress the necessary preparatory work at pace.

“I must also be clear that the draft budget proposals currently being consulted on will mean another extremely challenging year, with very considerable savings required across HSC to meet the deficit.

“The imperative is to ensure that we can agree a three-year budget which would provide much needed certainty and greater freedom to plan ahead and progress with the necessary changes as to how health and social care will be delivered in the future.”

The draft budget proposals, currently under consultation, indicate significant savings will be required across Health and Social Care to address the deficit.

Agenda for Change structural reform

As part of the wider NHS pay package, structural reform of the Agenda for Change framework is also under discussion on a tri-nation basis.

According to the Department, alongside accepting the NHSPRB recommendation, work will continue with the NHS Staff Council to deliver improvements to the Agenda for Change pay structure.

Discussions with unions are ongoing regarding a potential multi-year funded mandate for structural reform across Northern Ireland, England and Wales.

The proposed reforms would prioritise better pay for those on the lowest grades and improve pay progression for new graduates. Subject to agreement, any structural changes would come into force from, and be backdated to, April 2026.