Scotland Offers NHS Staff 8% Pay Rise Over Two Years

EDINBURGH – Nurses, midwives, and healthcare staff in Scotland have been offered a new two-year pay deal totalling an 8% increase, as part of a package aimed at keeping NHS Scotland salaries ahead of inflation and the highest in the UK.

The offer, announced Tuesday by Health Secretary Neil Gray, comprises a 4.25% rise in 2025–26 followed by a 3.75% increase in 2026–27. If accepted, it would cost the Scottish Government approximately £701 million and be underpinned by an inflation guarantee, ensuring annual rises are always at least 1% above CPI.

A high-stakes offer

The proposal comes amid wider tensions over NHS pay across the UK, with Westminster currently recommending only a 2.8% uplift. Scottish ministers’ offer significantly exceeds that figure and could place additional pressure on the UK government and devolved administrations in Wales and Northern Ireland.

“This is a strong offer,” said Gray, praising NHS workers for their “continued commitment.” He added: “It is guaranteed to remain above CPI inflation, which gives added reassurance to staff and will ensure Scotland’s NHS workers have the best pay in the UK.”

The inflation guarantee feature is a notable shift from previous settlements and aims to shield NHS pay from economic volatility — particularly as the Bank of England warns inflation could rise again in late 2025.

Union response: cautious but open

The response from unions has been mixed, with many describing the offer as credible but holding off full endorsement pending member consultation:

• Unison, the largest NHS union, will launch a digital consultative ballot, calling the offer the government’s “final position.”

• GMB Scotland, which represents ambulance and clinical support staff, will also ballot its members in the coming weeks.

• RCN Scotland said its board is reviewing the offer in detail, after having submitted a pay claim in January that called for action on both cost-of-living pressures and the historical erosion of pay.

• The Chartered Society of Physiotherapists described the offer as “the best that can be achieved” under current circumstances.

Key details of the offer

Political pressure across borders

The offer arrives just weeks before UK-wide local elections and is likely to fuel comparisons between Scotland’s devolved NHS and the systems in England, Wales, and Northern Ireland.

In a BBC interview, UK Health Secretary Wes Streeting defended the current pay review process south of the border. While acknowledging the 2.8% recommendation, he insisted “no final decision has been made” and asked NHS staff to “bear with us.”

But Unison’s UK leadership dismissed the idea that 2.8% was all that could be afforded as “ludicrous,” pointing to the Scottish deal as evidence of a political, not financial, choice.

The path to acceptance

The Scottish government’s pay proposal must now pass through union ballots and internal committees — a process that could take several weeks. If ratified, the deal would likely stabilize industrial relations in the NHS after a turbulent two years of strikes and staffing shortages.

But it also presents a budgetary challenge. With no new funds allocated from the UK Treasury, Holyrood ministers will need to find hundreds of millions within the existing Scottish budget — sparking concerns over potential cuts elsewhere.

Neil Gray declined to confirm which areas might face reductions, but insisted the pay rise was a “priority investment” in both staff morale and patient care.