The Role of National Health Service Unions.

Unions, particularly those focused on the NHS, provide a vital platform for collective bargaining power and support for individual workers navigating the complex world of healthcare employment. With the ongoing challenges of staffing shortages and balancing individual and collective needs, unions continue to fight for better pay and working conditions for NHS workers, positively impacting their lives and the quality of care they provide.

Short Summary

  • Trade unions are essential for NHS workers, providing collective bargaining power to negotiate better pay and working conditions.
  • Unions have successfully negotiated a pay rise for NHS workers, addressing staffing shortages and balancing individual needs with collective action.
  • Unions have enabled positive impacts on the working lives of NHS staff by advocating extra payments and addressing workplace issues through representation.

The Importance of Trade Unions for NHS Workers

In today’s health sector, trade unions play a crucial role, particularly for NHS workers. Unions provide the collective bargaining power necessary for workers to negotiate better pay and working conditions with NHS employers, ultimately improving their working lives. By uniting the voices of thousands of union members, health unions can effectively advocate for improvements in areas such as wages, working hours, and workplace safety.

Moreover, unions ensure that NHS employees are fairly represented during negotiations with employers, allowing them to have a say in crucial decisions that directly impact their lives. Working together, unions and NHS trusts can navigate the complexities of healthcare employment, from AFC contracts to staff burnout, to create a more equitable and supportive environment for all.

Collective Bargaining Power

Collective bargaining power is the capacity of trade unions to engage in dialogue with employers on behalf of NHS workers to secure improved wages, working conditions, and benefits. This process allows NHS staff, including those employed by NHS trusts, to negotiate more favourable terms and conditions, ultimately improving their working lives.

Without the collective strength of union members, individual workers would struggle to achieve the same level of influence and bargaining power.

Advocacy and Support

Trade unions are instrumental in advocating for NHS workers, providing support, advice, and representation during times of transition and formal processes. From understanding their rights and obligations to resolving workplace disputes, unions offer invaluable guidance and expertise to individual workers.

By working together to address workplace issues and promote equitable compensation and benefits, unions ensure that NHS workers are treated fairly, and their rights are respected.

Key Health Unions in the NHS Workforce

Within the diverse NHS workforce, several key health unions play a significant role in representing and advocating for their members. These include the Royal College of Nursing (RCN), the British Medical Association (BMA), and various allied health professional unions. Each union serves a unique purpose, offering support and guidance to their respective members while fighting for better pay and working conditions in their specific fields.


The RCN, for example, is the largest nursing union in the UK and provides a range of services.

Royal College of Nursing (RCN)

The Royal College of Nursing (RCN) is the leading professional union for nurses and midwives in the UK. The RCN:

  • Establishes standards for nursing practice to ensure safe and effective patient care
  • Advocates for the professional interests of nursing staff
  • Negotiates on behalf of nursing staff through the NHS Staff Council for improved remuneration and working conditions.

British Medical Association (BMA)

The British Medical Association (BMA) serves as a trade union and professional body for doctors in the UK, representing and negotiating on behalf of its members and medical students. Recognised for collective bargaining purposes, the BMA advocates for comprehensive workforce strategies, including guidance on issues such as equality and diversity in the NHS workforce.

Allied Health Professional Unions

Allied health professional unions play a crucial role in representing and advocating for various healthcare professionals, such as physiotherapists, occupational therapists, and radiographers. These unions work tirelessly to ensure fair working conditions, negotiate contracts, and address issues related to pay, benefits, and working hours. Examples of allied health professional unions include the British Dietetics Association (BDA) and the Chartered Society of Physiotherapy (CSP).

In response to the 2022/23 pay award, the BDA and CSP voted to take industrial action, with the CSP commencing rolling strike action in January 2023. Both unions put a stop to strikes planned for March 2023 as they entered into pay negotiations. This exemplifies the determination of allied health professional unions to secure the best possible outcomes for their members, even in the face of challenging circumstances.

The NHS Staff Council and Its Role in Pay Negotiations

The NHS Staff Council plays a vital role in pay negotiations, working with unions to agree on pay awards for AFC contract workers. Comprised of representatives from both employers and trade unions, the Staff Council is responsible for the Agenda for Change (AFC) pay system, ensuring fair and equitable compensation for NHS staff.

By working together, the Staff Council and unions can achieve better pay and conditions for all NHS workers.

Agenda for Change (AFC) Contracts

The Agenda for Change (AFC) contracts provide the terms and conditions of service for staff in the NHS, standardising pay rates and ensuring fair compensation based on skills and job responsibilities. These contracts also serve as a framework for negotiations between unions and employers concerning pay awards and settlements, allowing the collective bargaining power of unions to secure better pay and benefits for all NHS staff.

The AFC contracts provide a platform for unions to negotiate better pay and benefits for NHS staff.

Recent Pay Rise Negotiations

In recent pay rise negotiations, unions have successfully secured pay awards for NHS workers, including additional non-consolidated payments in addition to their salary for the 2022–23 pay deal. The Department of Health and Social Care (DHSC) announced in July 2023 that NHS consultants, SAS doctors, salaried dentists, and salaried GPs would receive an increase in their pay of at least 6% for 2023/24. The increase is retroactive from 1 April 2023. Junior doctors received a pay increase of 6% and an additional £1,250. This marked a significant change in remuneration.

These negotiations demonstrate the ongoing commitment of unions, such as the RCN and the BMA, to fight for better pay for their members, even in the face of challenging economic times and ongoing staffing shortages. The successful outcomes of these negotiations are a testament to the power of collective bargaining and the importance of unions in advocating for better pay and conditions for all NHS workers.

Challenges Facing NHS Unions in 2023

In 2023, NHS unions are faced with several challenges, including:

  • Addressing staffing shortages
  • Balancing the needs of individual workers with collective goals
  • Advocating for better recruitment and retention strategies
  • Improving pay and working conditions

As staffing shortages continue to impact patient care and strain resources, unions must work tirelessly to address these challenges.

At the same time, unions must navigate the delicate balance between addressing individual worker concerns and focusing on collective bargaining efforts.

Staffing Shortages

The ongoing staffing crisis in the NHS presents a significant challenge for unions, as it directly impacts the quality of patient care and puts immense pressure on existing staff. Unions must advocate for more effective recruitment and retention initiatives, such as increasing wages, improving working conditions, and providing additional support for staff.

By addressing these staffing shortages, unions can help alleviate some of the strain on the NHS workforce and ensure that patients receive the highest quality of care.

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Balancing Individual and Collective Needs

Striking a balance between addressing individual worker concerns and focusing on collective bargaining efforts is a significant challenge for NHS unions. Unions must work to ensure that the healthcare system can provide the personal goals and support required by each individual while also taking into account the overall needs and priorities of the collective population.

By advocating for and assisting individual workers and negotiating collective bargaining agreements that guarantee equitable salaries and working conditions, unions can help to achieve equilibrium between individual and collective needs in the NHS.

Success Stories: How Unions Have Positively Impacted NHS Workers

Unions have had a profound impact on the lives of NHS workers by:

  • Securing extra pay and lump sum awards
  • Addressing workplace issues such as bullying and harassment
  • Advocating for their members and positively impacting their working lives
  • Ensuring fair compensation and giving workers a voice in decision-making processes

Unions have been instrumental in ensuring that NHS workers are treated fairly and have a say in what they do.

Securing Extra Pay and Lump Sum Awards

Through their collective bargaining power, unions have successfully negotiated pay rises and lump sum awards for NHS workers in recent years, enabling their members to receive better pay and benefits. For example, the Royal College of Nursing (RCN) and the British Medical Association (BMA) recently engaged in negotiations on behalf of NHS workers, resulting in a 3.1% pay rise for all NHS staff.

These successes demonstrate the vital role of unions in fighting for better pay and conditions for their members.

Addressing Workplace Issues

Unions have played a crucial role in addressing workplace issues, providing support and advocacy for individual workers facing challenges such as bullying and harassment. By offering representation in negotiations with employers, legal advice, and emotional support, unions have been able to help workers navigate difficult situations and find solutions to their problems.

Through their efforts in addressing workplace issues, unions have positively impacted the working lives of NHS workers and contributed to a healthier and more supportive work environment.


In conclusion, trade unions play an indispensable role in advocating for NHS workers, providing collective bargaining power and support for individual workers facing workplace challenges. As the healthcare landscape continues to evolve, unions remain steadfast in their commitment to ensuring better pay and working conditions for all NHS staff. Through their tireless efforts in addressing staffing shortages, balancing individual and collective needs, and securing extra pay and lump sum awards, unions have positively impacted the lives of countless NHS workers, ultimately contributing to a better and more equitable healthcare system.

Frequently Asked Questions

Does the NHS have unions?

Yes, the NHS has unions. Unison, Unite and GMB Union represent members working across the health sector on AFC contracts, including ambulance workers, nurses and technical staff.

GMB is a trade union with over 500,000 members across public services and private companies, advocating for better pay, rights and workplace protection.

Which is the best union for NHS staff?

Unite is the best union for NHS staff, offering a democratic and campaigning approach to protecting rights and supporting members in health. It has a strong presence in the health sector, with over 100,000 members across all occupations and professional groups.

What is the role of trade unions in advocating for NHS workers?

Trade unions provide collective bargaining power and support for NHS workers, advocating for their workplace matters to ensure they benefit from improved conditions.

They are a key part of the NHS workforce, helping to ensure that staff are treated fairly and have access to the resources they need to do their jobs.

They also provide a platform for workers to learn.

Which health unions represent members employed on AFC contracts?

Unison, Unite, and the GMB Union are the health unions that represent members employed on AFC contracts. They work closely with NHS employers to negotiate terms and conditions.

What challenges are NHS unions likely to face in 2023?

NHS unions are likely to face challenges related to pay and conditions, staffing retention, bureaucracy, digital technology, information sharing, and industrial action in 2023.

These challenges will require unions to be proactive in their approach to negotiations and to ensure that their members’ rights are protected. They will need to be prepared to take action if necessary, and to be able to respond quickly to changes in the environment.

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